Online Program

A narrative review of chiropractic infection control literature

Monday, November 4, 2013 : 9:20 a.m. - 9:30 a.m.

Jonathon Todd Egan, DC, MPH, Chief of Staff, Campus Health Center and Assistant Professor, New York Chiropractic College, Seneca Falls, NY
INTRODUCTION: Chiropractors have frequent skin contact with millions of patients annually. Chiropractic students have frequent skin contact with peers and chiropractic tables as they train. In an era of methicillin-resistant staphylococcal skin infections and pandemic influenza, chiropractors could represent a potential reservoir and at-risk population for transmissible (and preventable) infections. The purpose of this review is to provide an overview of chiropractic infection control literature relative to attitudes and behaviors in the areas of hand and table hygiene and general infection control (such as immunization). METHODS: PubMed and ICL were searched from the beginning of their respective indexing years through March 2012. References of located articles were searched. Case reports, textbooks, editorials, commentaries, and other non-primary articles were excluded. Articles were included if they were primary research literature applicable to chiropractic practice or chiropractic education and concerned hand or table hygiene, or infection control (such as immunization). RESULTS: Following information extraction, 28 citations were included: 22 primary research articles, 1 infection control protocol, 4 historical reviews, and 1 case report (an exception that documents the only published infection transmission in a chiropractic office). Information is organized into two categories: hand and table sanitation attitudes and behaviors among chiropractic students and chiropractors, and immunization attitudes and practices among chiropractic students and chiropractors. CONCLUSION: There is a relatively small body of literature regarding infection control attitudes and behaviors among chiropractors and chiropractic students. Behaviors appear to be influenced by beliefs about hygiene and infection transmission that may impact infection control practice.

Learning Areas:

Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe chiropractic student and practitioner attitudes and practices regarding hand hygiene, table hygiene, and immunization - all key infection control practices. Compare primary research articles located through PubMed and ICL regarding infection control in chiropractic from the beginning of indexing in each database through March 2011. Evaluate literature detailing chiropractic treatment table contamination. Explain the role of infection control in chiropractic education and practice.

Keyword(s): Chiropractic, Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have authored a textbook chapter on "Infectious Disease" for a chiropractic public health textbook, and am mid-dissertation for my PhD - topic is MRSA in chiropractic students.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
New York Chiropractic College Chiropractic Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.