Veterinarians play an important role in ensuring food security and safeguarding public health. If not played out effectively,  they  could  serve  as  sentinels  to  emerging diseases, disseminating zoonotic pathogens to their relatives or animals (Baker and Gray, 2009). The sero prevalence of zoonotic pathogens is reported to be higher in veterinarians than in the general population (Sanchez et al., 2017). That’s why zoonosis is a recognized occupational risk to which veterinarians are subjected (Sanchez et al., 2017). Though there is no statistics from Nigeria till date, women had been long predicted to represent the majority of Veterinarians (Anonymous, 2002). Systematic literature reviews showed that 30–40% of veterinarians in the USA and 60–65% in the United Kingdom and South Africa have been infected with zoonotic diseases (Gummow, 2003; Lipton et al., 2008). Fatal cases have been also reported (Hanna et al., 2006). In the past, Personal Protective Equipment (PPE) – specialized clothing or equipment worn by workers, has been used to prevent some of these occupational hazards. Some factors encouraging its use are the supervisor's attitude, organizations support for worker's safety and health, reinforcements for individual compliance level, proper training and refresher courses, personnel responsibility, peer pressure to use PPE, and appropriate and comfortable pieces of equipment (Lombardi et al., 2009). The use of PPE has been evaluated among animal farmers (Fatiregun and Saani, 2008; Odo et al., 2015), healthcare and textile workers (Lee et al., 2015; Tadesse et al., 2016). However, there is not much information on the use of PPEs by veterinarians in Nigeria. Therefore this study aims to assess the rate of PPE use among veterinarians in Nigeria. The objectives of this study include (1) assessing the attitude of veterinarians’ toward the use of PPE in some clinical activity and (2) determining the frequency and determinants of PPE usage among veterinarians in Nigeria.

The questionnaire was pre-tested at six veterinary institutions from the six administrative regions, which formed 10% of the total veterinarians sampled. It was thereafter administered across the studied regions in 2017. PPE use for the different clinical situations in this survey was categorized into: No PPE, Inadequate PPE, and adequate PPE use (Scheftel et al., 2010). For this purpose, boiler suits/Laboratory coats, boots, and gloves were considered adequate while the omission of one of these makes it inadequate.

Consent of ethics

The study was conducted following the Declaration of Helsinki, and approved by the University of Abuja Ethical Review Board.

A total of 516 Veterinarians with specialties in large animal (40.7%), small animal (36.8%), aviary (19.4%), wildlife (1.9%), and general practice (1.2%) participated in the study. Respondents were with varying qualifications. While none specialized in wildlife, the participation of female  veterinarians  was  more  in  small (15.5%) than in aviary (3.9%), large (1.9%), and general practitioners (0.4%) (Table 1). Only 44.2% of respondents always use PPE when treating animals. Occasional use of PPE was observed more among small animals (25.4%) when compared to large animals (22.7%), avian medicine (5.8%), and general practitioners (1.9%) (P < 0.05). Disease severity (53.8%), PPE availability (37.2%), and client requests (9.0%) were the determinants of the occasional use of PPE, and these varied across the specialties. The use of PPE by other Veterinary Doctors also varied among respondents (Table 2). Only 176 (34.1%) veterinarians have attended PPE seminars on training and re-training since they began to practice. Although organized by the government (23.3%) and non-governmental organizations (76.7%), attendee sponsors at such seminars were personal (38.6%), government (44.3%), and non-governmental organizations (17.0%) (Table 3). The proportion of PPE among the specialties varied with procedures encountered in practice (Table 4).

The concept of ‘One Health’ has made the action and activity of veterinarians an important tool to safeguard human health. To this end, this study states the attitude of animal practitioners to PPE use and proposes measures that can improve the use of personal protective equipment. It is the first study to summarize PPE use among the different specialties of the profession. The gender participation of more males than females may be explained by the decreasing population of female veterinary graduates in Nigeria, as females accounted for 49% in the year 2007 and 35% in 2017 (In a conversation with D. Fadipe, VCN (March 2017)). This is contrary to the increasing worldwide participation of females in the veterinary profession (Lofstedt, 2003). The sex ratio was lower in small animals than in other specialties. The less physical and outdoor activity in small animal practice could have accounted for this gender specialty preference. This study did not assess the impact of post-graduate qualification on PPE use. However, it suggests that higher qualification has no impact on PPE use. This is at variance with Dowd et al. (2013), who reported that veterinarians with post-graduate qualifications were more likely to use PPE.

As earlier reported by Dowd et al. (2013), the irregular and conditional use of PPE during practice could lead to a higher risk of zoonosis among veterinarians. However, it has been opined that the use of PPE is very low in small animal practice unless it is to reduce transmission of some organisms like Parvovirus, as dealing with zoonotic diseases is extremely rare in this specialty (In a conversation with D. Fadipe, VCN (March 2017)). Aside from zoonosis, a veterinarian’s PPE use status could be used for litigation when the opportunity presents itself. Our data indicated that PPE use, in the examination of apparently healthy animals, by  veterinarians  in  different practice types, was lacking or inadequate. This finding agrees with the study of Wright et al. (2008) who found lower PPE usage among United States veterinarians during the examination of healthy animals. Professional bias and PPE costs could be some of the barriers to its usage.

The aseptic nature associated with surgeries and the zoonotic concerns during post-mortem could be   some   factors   that   improved   PPE   usage compliance among veterinarians that reported adequate PPE use in the examination of sick animals, during surgeries, post-mortem, and assisted deliveries. However, lack of or inadequate PPE usage as reported by some respondents of different  practice   types   is   alarming  and  could result from the personal unexplained belief of PPE not preventing zoonosis. After all, some studies showed that none or inadequate PPE use was a significant risk factor for brucellosis in Indian veterinarians and Q-fever infection in Dutch veterinarians  (Van    den   Brom    et    al.,   2013; Mangalgi et al., 2016). Except for wildlife veterinarians, respondents of different practice types reported poor adherence to PPE use during sample collection. This could have occurred because of the age-long importance of wildlife, as it  constitutes a large and often unknown reservoir of emerging diseases (Chomel et al., 2007). This is contrary to Anderson and Weese (2015) that reported good PPE utilization during staff-animal contacts in veterinary clinics in Ontario, Canada. Contrary to the work of Shirangi et al. (2007) and Epp and Waldner (2012) that some veterinarians who did not use PPE in Western Canada and Australia were exposed to chemicals especially pesticides, Garrigou et al. (2020) found that wearing of PPEs does not always guarantee effective protection against pesticides. These notwithstanding, most of the study respondents reported adequate PPE use when handling chemicals such as pesticides.

Either by personal decision, enforcement by the employer, or industry regulators, Veterinarians must be kept abreast, updated, or reminded of PPE use continually. Methods that could be adopted to prevent exposures, and improve professional practice and patient outcomes are (1) Establishment of infection controls committees across all veterinary establishments that care for animals. (2) Development of practical workplace interventions like incorporating PPE into various continuing education programs, and introduction of live video camera monitors in their work environments, among others.

The article processing charge was covered by Bill and Melinda Gates Foundation under grant number OPP1075.

The authors have not declared any conflict of interests.