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OCCUPATIONAL HAZARDS AMONG JORDANIAN DENTISTS.

Byline: WADDAH EL-NAJI, AHMAD M. ALWARAWREH, SALEM A AL-SARAIREH, AYMAN D. AL-SHAWABKEH, MOHAMMAD A. ALQUDAH and AMJAD M. ALWARAWREH

KeyWords: Occupational hazards, musculo-skeletal disorders, dermatitis

INTRODUCTION

Dentistry was described as stressful and hard profession in the last century.1 Exposures to chemicals and dental equipment leads to high risk occupational hazards.2 Some authors described dentistry as the least hazardous of all occupations.3 Infection hazards from needles, sharp objects, blood and aerosols can transmit a life threatening disease like Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV)4,5 or bacterial infection like tuberculosis and syphilis.6 There may be allergic reactions7, non-ionized radiation and ionized radiation hazards,8,9 chemical hazards including mercury,8 physical hazards like musculoskeletal problems which have direct relation to dental treatment postures,10,11 visual and hearing impairment and injury from chemicals and dental equipment.12-21 Dermatitis can be caused due to increased use of gloves and rubber dams.22-24 There may be psychological hazards due to stress which can effect even their families.25-27

New materials and chemicals have been introduced in dentistry. Laser was also introduced in dental treatments. All of these developments increased the hazards in the dental professional. Many studies show factors like gender, age, years of experience and working hours in relation to occupational hazards.11-27 Studies have been done on Dental Occupational Hazards in Norway, Australia and Belgium.28-31 In Jordan there was few studies investigating musculoskeletal problems among Jordanian dentists.

The aim of this study was to find out common dental occupational hazards among dentists in Jordan.

MATERIALS AND METHODS

Present study was approved by Royal Medical Services Ethical Committee and was conducted in 2018. Participants included 5th year dental students from university of Jordan in Amman and licensed dentists from North, Middle and South of Jordan. Two hundred questionnaires were distributed among these. The response rate was 67%. A pilot study was done on 20 participants to ensure the clarity, relation and correct sequence of questions. The questionnaire were repeated on the same participants to ensure reliability. Reliability was calculated by using Cohort Kappa method which showed high reliability with the kappa coefficient of 0.9. The questionnaire included personal information like name, gender, age, place of living whether married or not. Years of working in the profession and nature of hazard like musculoskeletal disorders, dermatitis stress etc. were particularly recorded.

Data were coded and entered in Statistical package for social sciences software (SPSS version 17.0, Chicago, IL.USA) Frequency was used on Category variable. Mean and standard deviation were used for continues variable, and chi square test for assisting the association between variables (age, gender,years of experience,institution,profession level,working hours) P value equal or less than a$?0.05 was considered as statistical significant.

TABLE 1: MUSCULOSKELETAL DISORDERS

###Musculoskeletal###Total

###Yes###No

Gender###Male###21###58###79

P Value=0.01###Female###5###50###55

###26###108###134

Age Group###21-30###1###60###61

P Value=0.00###31-40###13###34###47

###41-50###6###7###13

###>=50###6###7###13

###26###108###134

Years Of Experience###0-9###4###72###76

###10-19###15###24###39

###20-29###5###8###13

###>30###2###4###6

###26###108###134

Institutions###Public###22###64###86

###Private###4###18###22

###5th Year Dental Students###0###26###26

###26###108###134

Profession level###5th Year Dental Students###0###27###27

P Value=0.01###General Practitioners###15###52###67

###Specialists###11###29###40

###26###108###134

Working Hours/Week###50###3###6###9

Total###26###108###134

TABLE 2: DERMATITIS

###Dermatitis###Total

###Yes###No

Gender###Male###6###73###79

P Value=0.14###Female###1###54###55

###7###127###134

Age Group###21-30###1###60###61

P Value=0.21###31-40###3###44###47

###41-50###1###12###13

###>=50###2###11###13

###7###127###134

Years Of Experience###0-9###3###73###76

P Value=0.01###10-19###2###37###39

###20-29###0###13###13

###>30###2###4###6

###7###127###134

Institutions###Public###7###79###86

P Value=0.13###Private###0###22###22

###5th Year Dental Students###0###26###26

###7###127###134

Profession level###5th Year Dental Students###0###27###27

###General Practitioners###4###63###67

###Specialists###3###37###40

###7###127###134

Working Hour/Week###50###0###9###9

Total###7###127###134

RESULTS

Response rate was 67%. Among the responder there were 59% males and 41% females.

Musculoskeletal disorders and dermatitis were particularly noticed. For details see table 1 and 2.

DISCUSSION

This survey was conducted among all stages of dentists starting from final year at university till exceeding 30 years of practicing. Musculoskeletal Disorders (MSDs) was one of the most investigated subject in dentistry. In this study, frequency of MSDs was 19.4% which was less than previously reported study in Jordan by Barghout et al which was 86%.11 MSDs show significant relation with gender, age, profession institution and years of experience (Table 1). Males were more susceptible than females which disagree with previous studies11,39,40 who have reported the opposite. Present study also showed that risk of MSDs increased with age and 10-19 years of experience which agree with the study done by Barghout et al11. In addition the GDP had more incidence of MSDs than specialists and much more than dental students.

Most of MSDs were found among dentists who worked in Public Institutes due to increased working hours and crowded dental clinics in Public Hospitals and Primary care centers in Jordan. Dermatitis was another common hazard noted among the dentists and staff.41 Latex was considered as one of the major factors which caused contact dermatitis.42-44 Other factors were increased use of rubber dam.22 The frequency of latex allergic reactions has rapidly increased.22,24,45 Different studies done in Sweden have reported 15% of hand eczema.46 In Thailand a study reported 22% of contact dermatitis47, and around one third of dentists reported hand dermatitis in Newzeland48, Australia49 and UK41.

In this study it showed increased risk of dermatitis in first years of practice but then it reduced followed by increase in longer years (P value=0.01) (Table 2). which is logical because most dermatitis is diagnosed in early years of practice. All dentists who were affected with dermatitis were found in public institutes (5.2%).

CONCLUSION

Present study show the frequency of musculo-skeletal disorder and dermatitis among the dentists in Jordon, and their relations to factors (institutions, working hours and professional level). Male dentists suffered more than females. Those who had served longer also suffered more.

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Publication:Pakistan Oral and Dental Journal
Date:Jun 30, 2019
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