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Old 09-24-2009, 04:46 PM
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Default Vets: Some compassion for their silent suffering ...

I found this shocking report while surfing. This is very sad and many of us are unaware of their silent suffering and loneliness while totally absorbed with the welfare of our furry beloveds. It ignited an awareness in my heart that our vets are humans and that behind that white coat, they have feelings, and they too, bleed like the rest of us ... especially when our pet or a stray dies ....

An emerging occupational threat?
Study seeks reasons for high suicide rate among veterinarians

May 1, 2008
By: Krista Schultz

UNITED KINGDOM — Veterinarians' suicide rate is proportionally four times that of the general population and twice that of other health professionals, studies show.

Job stress, lethal drug access and euthanasia acceptance are among the potential driving forces behind DVMs' heightened risk, according to "Veterinary Surgeons and Suicide: Influences, Opportunities and Research Directions," published in the UK's Veterinary Record.

Table 1: Interplay of factors (see attachment below)

Health-care professionals, including doctors, pharmacists and dentists, are all high suicide risks based on their proportional mortality ratio (PMR), with veterinarians topping the list as the most susceptible, say article authors David Bartram, BVetMed, DipM, MCIM, CDipAF, MRCVS, and David Baldwin, MB, BS, DM, FRCPsych, at the University of Southampton School of Medicine in Hampshire, UK.

"The number of veterinarians who die by suicide is four times higher than would be expected based on suicide rates for the general population," Bartram says.

The reasons for this elevated susceptibility are unknown, but Bartram is performing a mental-health study of the UK veterinary profession to determine what they might be.

His study will assess work-related stress, other key stressors and potential intervention strategies in the profession, compare veterinarian data with that of the general population and explore the relationship between mental well-being and demographics, including age, gender and type of practice, among other factors.

"Such research would be important not only for the well-being of individual members of the profession, but also in view of the potentially deleterious impact of practitioners' mental ill health on the welfare of animals under their care and the additional insight that research in this professional group might provide into influences on suicide in other occupations," according to Baldwin and Bartram's Veterinary Record article.

Although study results are not expected until the fall, Bartram and Baldwin point a hypothetical finger at several possible influences — including attitudes, opportunities and personal characteristics seen in the profession — that they believe are driving the trend.

Access to pharmaceuticals

Deliberate drug ingestion is the most common method of veterinarian suicide, most likely because lethal medication is so openly available in the profession.
DVMs "have ready access to medicines, as they are typically stored in practice premises, and knowledge of medicines for self-poisoning, which together offer a possible contributory factor for their high suicide rate," say Baldwin and Bartram in the article.

Table 2: By the numbers (see attachment below)

Intentional medicinal overdose accounts for an average of 82 percent of veterinarian suicides, compared with only 33 percent in the general population, which typically does not have the everyday availability of drugs. "Access to lethal means has a strong influence on the suicide rate," the article says.

Death in daily life

Euthanasia is a frequent duty of veterinarians, and the action must often be explained, encouraged and justified to clients. This constant interaction, performance and support of euthanasia in the animal population may affect profession attitudes on death in general. A small-scale European study determined that 93 percent of veterinary health-care workers interviewed approved of human euthanasia, the authors say.

"Veterinary surgeons may experience uncomfortable tension between their desire to preserve life and their inability to treat a case effectively, which may be ameliorated by adapting their attitudes to preserving life to perceive euthanasia as a positive outcome. This altered attitude to death may then facilitate self-justification and lower inhibitions toward suicide as a rational solution to their own problems."

Job dissatisfaction

Depression is a factor impacting suicide, and those choosing to join the veterinary profession may have predisposed personalities that ultimately lead to depression, say Bartram and Baldwin.

"It is possible that the choice of a veterinary career is subconsciously influenced by factors such as a preference for working with animals rather than people, with consequential influences on the risk of depressive illness through relative social isolation," the article says.

Regret also is apparent through the profession; Baldwin and Bartram cite a study revealing that, while 53 percent of practicing veterinarians would still enter the profession knowing what they know now, 20 percent would not and 27 percent were not sure. This disenchantment of almost half of those surveyed most likely has a negative impact on the profession's overall mental health, according to the article.

"There is a need for veterinarians to recognize mental-health problems in themselves and to seek help before the problems become chronic and potentially destabilizing," Baldwin and Bartram say.

Surviving with stress

More than 80 percent of UK veterinary surgeons surveyed consider the profession to be stressful — specifically citing long working hours, client expectations, unexpected clinical outcomes, after-hours on-call duties, peer, manager and client relationships, lack of resources, emotional exhaustion, inadequate professional support, personal finances, the possibility of client complaints or litigation and making professional mistakes as key stressors.

"Most new veterinary graduates move abruptly from the university environment to the relative professional and social isolation of general private practice. Many work with little supervision, do not always have access to assistance from other veterinary colleagues and make professional mistakes, which have a considerable emotional impact on themselves and may be a significant factor in the development of suicidal thoughts," says the article.

Perceived and actual stress is alarming, with Baldwin and Bartram noting an association between work stress and suicide rates, and a study reporting one-third of students at a U.S. veterinary school showing symptoms of depression.

Until Bartram's study is complete, the true reasons behind the DVM suicide risk and rate remain murky and inferential at best. "It might merely be that veterinarians have greater and less restricted access to medicines, or the 'culture of death' in the profession, which is familiarity with and acceptance of euthanasia, or some inherent difference in the psychological characteristics of individuals entering the profession. It might be all or none of these. No one knows," Bartram says.
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"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies
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Old 09-24-2009, 08:34 PM
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Default Re: Vets: Some compassion for their silent suffering ...

Do the same study on Asians and you may not find similar results due to the different cultures.
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Old 09-25-2009, 09:14 AM
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Default Re: Vets: Some compassion for their silent suffering ...

Some differences may occur across cultures making some differences to the numbers but the stress encountered remain common, especially the killing of healthy animals part which really tears the human heart. As one vet told me, many vets choose to enter veterinary science because they deeply love and care for animals, and their intensive training is geared towards healing and saving animal life, not end it out of convenience, especially one that is not afflicted with something terminal.

In order to grasp the picture more effectively, compare that to killing a human whose injuries are not life-threatening (not to mention a healthy human which is tantamount to murder) but for convenience eg. your aged parents, or your not so beautiful child ... or your neighbour's playful kid that tresspassed into your yard.

But on the other hand, the nature of human beings are as wide as the spectrum of the rainbow. There exists some humans who simply enjoy killing and destroying lives and sleep very well at night too. Example, people who hate and cannot stand the sight of dogs loitering around cannot understand all the fuss dog-lovers make to save them. People who hate and simply cannot stand the sight of cats around anywhere neutered or not and think they should just be removed from the face of this earth (oh yes, there are humans like that - read the Bukit Merah report!) will not understand the passion of cat rescuers like myself who firmly believe that healthy cats have the right to life. And there are humans who firmly believe that no animal has the right to walk on this earth at all ... and there are even humans who stand firm that only they alone have the right to live and other people are totally insignificant.

Yes, in Japan there is concern that an alarming number kids are under so much pressure that they commit suicide at a tender age compared to some other countries.

And yes, some cultures are trained from young to suppress their feelings better but at the end of the day, they are manifested in some other forms often at later different stage in life, all taking its toll, and few are able to perceive the subtle connection.

However, the bottom line is that the stress encountered remains common regardless of culture and sex and stress is a very silent killer.

And, having the courage and compassion of heart to recognise what many of our very own vets have to go through, may we fellow animal lovers be able to offer them some understanding and some emotional and psychological support in the very least.
"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies

Last edited by FurKids; 09-25-2009 at 09:43 AM.
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Old 09-25-2009, 10:05 AM
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Default Re: Vets: Some compassion for their silent suffering ...

This sheds more light on the UK study.

Although in Malaysia, veterinarians who specialize in equines are lower in number, regardless of culture and sex, we can identify many glaring common issues below:

Shock Central: Veterinarian Suicides
by Candy Lawrence

A British study concluded that veterinarians experience the highest incidence of suicide compared to all other occupations, outranking dentists and doctors in risk factors. Research conducted by Dr. Richard Mellanby and published in the Veterinary Record in October of 2005 indicates that the suicide rate for the veterinary profession is four times higher than that of the general population and twice as high as that of doctors or dentists. Veterinarians who specialize in equines are particularly susceptible.

A number of stress issues were cited as cause for the high incidence in veterinarian suicides, among them: compassion fatigue, irregular hours, overwhelming workloads, the expectations and demands of clients, working in an environment of psychological or physical isolation and a lack of tools or resources to deal with stress.

Veterinarians are minimally trained, if at all, in psychological issues to cope with the emotional states of their human clients. During vet school, little is addressed in terms of juggling financial aspects of running a practice or anything outside of the technical core complexities of clinical veterinary medicine. Career-threatening litigation is another factor that enters into the stress equation.

In the last several decades the collective consciousness has elevated animals to a status on par with humans. Animals have been absorbed as intimate members of the extended family unit and with that membership comes equality in their level of importance. The responsibility of the veterinarian to maintain the health of these family members creates enormous pressure.

Additionally, stress factors for the veterinarian include the stringent pace and long hours which take a toll on personal and family relationships. A paradox becomes clear. The majority of veterinarians pursue their field of interest as a by-product of their deeply compassionate and empathetic natures. Their objective is to heal, to alleviate or reduce the pain and suffering of others, an altruistic and lofty goal. Yet maintaining a healthy level of emotional detachment with their patients and clients is contrary to the core essence of the occupation.

Another paradox is that veterinarians tend to be perfectionists, constantly intent on improving themselves and dedicated to putting forth a 180% effort. As a whole, they are deeply committed to the welfare of their patients and clients. And when they fail to heal, when they fail to prolong the quality of life, this is often perceived as an internalized, magnified and personal defeat. High levels of self-criticism are often associated with high levels of depression. The mental, spiritual and emotional balance necessary in the field of veterinary medicine is often one of the most difficult if not elusive traits to maintain.

Additionally, the work of the veterinarian accustoms them to routinely ending the lives of animals who are suffering. This permanent solution to a situation that is beyond hope easily bleeds through as a natural alternative to their own stress levels when the magnitudes of those stresses become overwhelming.

According to Richard Halliwell of the Royal College of Veterinary Surgeons, veterinarians tend to be not only conscientious but introspective. Their vulnerability to depression is magnified because of the high standards that they impose on themselves. It is estimated that 80% of suicides are a result of profound depression.

Dr. Raj Persaud, author of The Motivated Mind, maintains that veterinarians, particularly equine veterinarians, are often reluctant to address mental health issues due to an ingrained fear that admission of depression by highly skilled professionals such as themselves, is akin to weakness. Dr. Persaud believes that since veterinarians consistently exhibit perfectionist personality types they are all the more susceptible to depression and mental health issues. Mental illness does not always follow stress, Dr. Persaud explained. It is the inability to successfully implement strategic tactics to cope with that stress that results in an anguished, unbearable depression.

According to Dr. Persuad, veterinarians are traditionally problem-solvers and they find it difficult to accept that not all problems in life are solvable. He cites two ways that stress is usually resolved: by problem solving or by emotionally-focused coping. The former involves life style or environment changes. The latter involves changing the internal perception, changing the attitude. For some veterinarians, a third option, suicide, becomes a viable alternative when the other two choices seem unobtainable, unimaginable or out of reach.

Finally, it’s theorized that access to potentially lethal drugs along with familiarity of euthanasia procedures contribute to the high incidence of suicide among veterinarians. According to the British Veterinary Association, lethal injection is the preferred choice among veterinarians who have chosen to end their own lives.

In a tempting irony, veterinarians have legal access to chemicals that can both save and destroy lives. Staring them in the face on a daily basis is the horse tranquilizer, ketamine, an anaesthetic drug that has been shown to successfully treat depression almost instantly. Standard medications to combat depression take weeks or even months before they become effective and there are no guarantees that the therapy of choice will even work successfully. The suggestion that veterinarians who are experiencing mental or emotional life difficulties might resort to occasional dosages of the drug to weather their internal storms is not unfounded.

In a study by the National Institute of Mental Health involving treatment-resistant patients diagnosed with acute depression, ketamine, given in low doses had remarkable effects in rapidly alleviating symptoms.

The drawback is that in higher doses, side effects include intense euphoria coupled with hallucinations and dissociation. Ketamine has long been associated as a drug of choice among recreational users, particularly those that frequent raves, all night dance parties, and it is often abused. There is wide spread speculation among mental health professionals studying the statistics on veterinary suicide that self medicating utilizing any number of drugs individually or in cocktail form, increases the risk of suicide.

Like any profession, the veterinary profession is hardly exempt from sorrows, difficulties or addictions. The desperateness of dark depression often overrides the dangers. The ease of accessibility is often too seductive to ignore, especially when the indulgence offers an immediate solution, alleviating the torture, the mental, emotional and spiritual anguish of devastatingly painful depression.

For veterinarians, the order of drug abuse preference is primarily alcohol with ketamine coming in a close second followed by benzodiazepines, opiates, street drugs (cannabis, heroin, cocaine and ecstasy) and nitrous oxide. Coincidentally, studies have shown that ketamine can have a positive effect in reducing the desire for alcohol.

When used in moderation, the average person can often function surprisingly efficiently when under the influence of coping-type drugs and can effectively disguise the fact that they have self-medicated. An example of this acute level of performance has been proven to be highly efficient in the battlefield. The Department of Defense has explored the use of internasal ketamine spray theorizing that an injured soldier on ketamine can more efficiently guide a tank to safety than an injured soldier sedated with morphine.

Although ketamine depresses consciousness at a high level, it does not disrupt breathing or circulation like most anaesthetics. This means that an anaesthesiologist is not necessary for surgery. For this reason it was used extensively in army field hospitals in Vietnam.

At higher doses Ketamine can produce an out-of-body effect similar to a near-death-experience. Because of its euphoric properties and effectiveness in alleviating anguish and depression, it lends a strong possibility that could predispose suicidal after-effects. The ketamine metamorphosis of an actual near-death-experience is a double-edged sword as it reduces anxiety and fear of death, increases altruism and creates a lack of concern with material goals. This effect in itself could cause the suicidal act to be perceived as desirable, a spiritual experience.

The Federal Centers for Disease Control and Prevention released statistics in a new five-year analysis of the nation’s death rate among the general population. Of the more than 32,000 people who committed suicide in 2004, 14,607 were 40 to 64 years old; 5,198 were over 65 and 2,434 were under 21-years-old. Males are 75% more likely to commit suicide than females.

On the cutting edge of offering a solution to the problem of veterinarian burn-out is Dr. Elizabeth Strand, the founding Director of Veterinary Social Work, (VSW) a collaborative effort between UT’s College of Veterinary Medicine and College of Social Work. The VSW is designed to address the emotional issues of veterinarians and their clients. Dr. Strand explained that veterinarians experience death at five times the rate of human doctors. Suffering of their patients cause further emotional draining of the animal health care professional and can lead to illness, depression and suicide. She stresses that vets need to be kind to themselves.

When the oxygen masks drop down from the overhead compartments as the airplane is spiraling down, out of control and in a panicked, rudderless spin, the flight attendants calmly instruct passengers to adjust the mask on their own face before trying to assist other passengers. It’s an image that everyone who cares for animals, particularly veterinarians, needs to indelibly imprint in their memory banks.
"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies
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Old 09-25-2009, 11:26 AM
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Default Re: Vets: Some compassion for their silent suffering ...

This is the Australian report.

Rural vet suicide rate a concern

Wednesday, 30/04/2008

Vets have the highest expected suicide rate in Australia, with rural vets the most vulnerable.

A new study in the mental health of vets found they are four times more likely to commit suicide compared to the general adult population, due to isolation and long hours.

Dr Helen Fairnie, from Curtin University's School of Public Health, says 13 vets have taken their lives in Western Australia and Victoria in the last 13 years, indicating a serious national issue.

"Because we are such a small profession, when you work it out per hundred thousand, for comparison with the national average, it is very high," she said.

"And we are now trying to find ways of alleviating some of the concerns of the veterinarians.

"But the first thing we need to do is to get statistics for the whole of Australia, and there are problems in South Australia, New South Wales and Queensland."

Kangaroo Island vet, Greg Johnson, says that he has known several South Australian vets to take their own lives, and it's just the long hours that depress them.

"Certainly there are times when you get frustrated and there are times you think it would be nice to be able to shut the door and walk away," he said.

"There is stress in dealing with the animals and with the owners that are obviously concerned about the welfare of their pets.

"And there's also the quite a bit of stress from running the business and particularly the stress associated with people who don't want to pay for the cost of veterinary treatment in some circumstances."
"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies
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Old 09-25-2009, 11:41 AM
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Default Re: Vets: Some compassion for their silent suffering ...

We people who love and care for the animals need our vets ... and we need to be aware of, understand, support and care for them too .... where would we (or more accurately, our animals) be without our precious vets? ... Vets love the animals too ..... that is why they chose to be vets .......

From The Times October 6, 2005

Suicide: it shouldn't happen to a veterinary
By Valerie Elliott, Countryside Editor

SENIOR vets are so concerned at the suicide rate among their colleagues that they are urgently seeking to extend a new support scheme across the profession.

A survey has found the rate among vets to be nearly four times the national rate and double that of doctors and dentists. Women vets are particularly prone to depression and suicide. The study is reported in the latest edition of The Veterinary Record, the journal of the British Veterinary Association (BVA).

Senior vets want to ensure that all newly qualified vets have mentors to keep a check on their wellbeing. A national helpline is also being set up to encourage vets to seek assistance if they are feeling depressed or have problems relating to drink or drugs or even eating disorders.

Richard Halliwell, a former president of the Royal College of Veterinary Surgeons and one of the report’s authors, said that veterinary degree courses were very demanding “and do not prepare students enough with coping and communications skills — and then when they get into practice the level of support is quite variable. A survey we did showed that only 43 per cent could rely on advice from older colleagues.”

Professor Halliwell spoke too of the stresses of the career. “Not only do vets have to care for the animals but they have to care for owners who often treat their pet like a child.”

He suggested that vets were so used to putting animals to sleep to relieve suffering that this might alter their view of the sanctity of human life.

It appears that lethal injection is the most common method of suicide for a vet.

The survey found that two thirds of calls to a helpline were from women. The average age of callers was about 30, and 30 per cent of all vets who commit suicide were under 40.

Professor Halliwell said: “We must do everything to ensure that people under stress are given every help and support. Vets have a massive workload and the average working week is 60 hours and may be more for those who travel into remote areas on farm visits.”

Austin Kirwan, a vet from Ormskirk, Lancashire, is co-ordinator of a helpline for BVA members, which receives about 200 calls a year. He confirmed that most of the calls were from women but was concerned that men might be hiding their emotions and not seeking help.

Mr Kirwan said that women vets tended to choose to work with small animals and this too was very stressful.

“In farming there is not the same emotional attachment to livestock as people have to their pets. Pet owners are very demanding and so emotionally attached to their animals they treat them as human beings.”
"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies
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Old 09-25-2009, 03:49 PM
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Default Re: Vets: Some compassion for their silent suffering ...

From Editorials of Occupational Medicine

It shouldn't happen to a vet

Veterinary medicine is hazardous and there is evidence that small animal work in particular has a significant injury and disease morbidity. The paper by D'Souza and colleagues investigating the management of health and safety in small animal practices is therefore important and as a veterinary surgeon and practice standards inspector for the Royal College of Veterinary Surgeons (RCVS) Practice Standards Scheme (PSS) I found the research to be significant [1]. While the paper shows the positive effect of standards schemes on health and safety in veterinary practices, the situation has moved on considerably since the survey was conducted in 2002.

In 2005, the British Small Animal Veterinary Association and British Veterinary Hospitals Association standards schemes were combined and expanded into the RCVS PSS [2]—a voluntary scheme in which practices are inspected every 4 years. Practices may choose to join this scheme at three different levels—‘core standard’, ‘general practice standard’ or ‘hospital standard’. Health and safety requirements are included in the core standard, so apply to all practices in the scheme. Over 50% of practice premises are registered with the scheme (Royal College of Veterinary Surgeons, personal communication) and it now includes equine and farm animal practices, widening the availability of health and safety information to encompass these areas of work. As mentioned in the article, the PSS has been a major driver and source of advice for improvements in health and safety in the profession, and even those practices that decide not to join the scheme can access the relevant information.

It is well recognized that there are some areas of health and safety where veterinarians are good at identifying risk. For example practices clearly understand the risks of radiography, and PSS inspectors check that practices are complying with their Radiation Protection Adviser's advice. Veterinary practices are also very conscious of risks of pollution in anaesthesia, and the PSS asks for evidence of either measurement of personal exposure to anaesthetic gases or an annual test certificate for an active scavenging system. However, as noted by the research authors, extraction ventilation is sometimes overlooked and can be a particular problem in recovery wards where animals are still exhaling anaesthetic gases.

PSS inspectors find that most practices make a good assessment of the risks of veterinary medicines. In a recent report, Irwin [3] a Health & Safety Executive inspector visiting practices on a voluntary basis in West Yorkshire commented that although the information on Control of Substances Hazardous to Health (COSHH) was not always in the form required by the legislation, vets and veterinary nurses showed good knowledge on this subject. The availability of safety data sheets on disc and online has made it much more straightforward for practices to access the relevant information. Where cytotoxic drugs are used in practice, a comprehensive and detailed assessment of risks to staff in intravenous administration is asked for in the standards. However, if oral formulations are administered at home, the discussion of the potential hazards with owners is not specifically required. D'Souza's paper showed that although all practices gave some advice on precautions to owners, these did not cover disposal of animal waste and possible health risks in >50% of cases.

Another area mentioned in the survey by D'Souza and others is a lack of awareness of workplace allergens. Latex gloves are mentioned briefly in the COSHH section of PSS, but they are widely used and many practices do not provide alternatives. Cases of latex allergy in veterinary practices have been documented [4]. Animal allergens are completely overlooked in the guidance to practices; these are more of a problem in pig practice (C. Clarke, personal communication) but clearly there is a need to consider occupational health in drawing up the practice standards. The observation that while 24% of practices used some form of pre-employment health screening, only 14% sought advice from a doctor or nurse qualified in occupational medicine is also significant.

Manual handling is another significant problem area in veterinary practice; it is now quite well addressed by both risk assessments and training but moving heavy, wriggling, potentially aggressive patients is still a challenge! Lifting boxes of drug deliveries and moving cadavers and oxygen cylinders also needs to be considered and the risks minimized. Needlestick injuries in practice (22% of reported accidents in one veterinary hospital) [5] are a real risk not only to vets and veterinary nurses but also to clients who might get in the way of the needle while restraining their fractious pets. An American survey [6] of these injuries in female veterinarians showed effects ranging from mild and localized to systemic illness, with one report of spontaneous abortion following accidental self-injection of a prostaglandin. In this country, new waste regulations have encouraged practices to separate syringes from needles for disposal, but in many cases, no risk assessment of this procedure has been carried out.

Bites, scratches (accounting for 48% of accidents reported in one veterinary hospital [5]) and, in large animal practice, kicks are an everyday hazard for practice staff. In an Australian survey [7], it was found that vets had a 9-fold greater relative risk of serious injury compared to their medical general practitioner colleagues. In small animal practice, cat bites can be a particular danger as most normal cats carry a variety of pathogenic bacteria in their mouths—including Pasteurella multocida, Streptococci and Fusobacterium organisms—which can be deeply implanted when the cat bites. Early antibiotic therapy is usually required (particularly where a joint is involved) and failure to do this can lead to partial or complete loss of a finger. Effects can be serious or even life threatening in people with prostheses and in individuals with a compromised immune system [8,9]. A significant proportion of cats also carry Bartonella species, now considered to be the cause of cat scratch disease. Tetanus, while not to be ignored, is of lesser significance.

Lone working is another area where risks need to be assessed and the requirement for 24 h cover and home visits to unknown clients can put staff members at risk.

The use of display screen equipment, while not mentioned in 2002, is now an area listed as requiring risk assessment in the current version of the standards, as is the employment of young persons, so if the survey was to be repeated now we would expect to find a noticeable improvement on the 2002 results. In my experience, practices are generally very good at assessing and implementing the proper use of work equipment.

Many practices use health and safety consultants to assist in fulfilling all these requirements, as observed by the HSE inspector [3] these need to be customized by the practice itself, rather than imposed generically by a commercial company. Only 31% of practices in the survey had a member of staff who had received training in health and safety, but this may have improved as veterinary nurses now receive training on risk assessments as part of their course, but it is still an area needing further development by the profession. Staff consultation is similarly neglected—while all practices inspected have to demonstrate that their staff have access to health and safety information and risk assessments—consultation with staff on their health and safety concerns is not routine. Staff concerns should always be addressed when introducing new equipment or work procedures.

A major health concern in veterinary practice not considered in the article is work-related stress. Sources of stress to vets in practice include long working hours, on-call commitment, problems with work-life balance, client expectations and unexpected outcomes. In a New Zealand survey [10], vets in small animal or mixed practice experienced more stress than those working in other areas and women more than men. With the changing gender balance of the profession, this is an increasingly important consideration. A German study [11] also showed that practising vets are more frequently affected by psychosocial stress and have a greater risk of alcohol or drug consumption than those working in non-clinical areas. The proportion of deaths by suicide in the veterinary profession is four times higher than the general population and twice as high as other high-risk groups such as farmers, pharmacists, doctors and dentists [12]. Possible explanations for this include ready access to drugs, social and professional isolation, subconscious acceptance of euthanasia as a treatment option, rising client expectations and financial pressures. In response to this, the profession have set-up the Veterinary Surgeons Health Support programme to give specific help and action on alcohol, drug abuse and addiction. There is also a ‘Vet Helpline’ a 24-h confidential helpline run by volunteers from within the profession to assist members in distress [13].

In conclusion, this very interesting paper shows that veterinary practices are very conscious of health and safety issues and that they get most of their advice from their professional organizations and PSS. Those of us involved in setting and implementing practice standards must be mindful of the health issues affecting our profession and must be prepared to take advice from our colleagues working in human occupational health.

The RCVS PSS scheme is currently consulting on a revision in the standards which would be a very good opportunity to promote co-operation between our two professions.

Pamela A. Mosedale

RCVS Practice Standards Inspector and BSAV,A representative on RCVS Practice standards group

e-mail: pam.mosedale@btinternet.com


1. D'Souza E, Barraclough R, Fishwick R, Curran A. Management of occupational health risks in small-animal veterinary practices. Occup Med (Lond) 2009; doi:10.1093/occmed/kqn125.

2. Practice Standards Group. RCVS Practice Standards Manual (2007) http://www.rcvs.org.uk/Shared_ASP_Fi...ual_310309.pdf (date last accessed 14 April 2009).

3. Irwin M. Summary Report of Recent HSE Inspections in Yorkshire (2004) http://www.rcvs.org.uk/shared_asp_fi...HSE_report.pdf (date last accessed 14 April 2009).

4. van Veen L. Sterility & hygiene pays the price, latex allergy. Tijdschr Diergeneeskd (2000) 125:476–481.[Medline]

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13. www.vetlife.org.uk.
"We organized in the past to make Trap-Neuter-Return possible. Today, we organize to make Trap-Neuter-Return the norm and to end the unnecessary killing of cats in animal shelters across the country and provide humane care." - Alley Cat Allies
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