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Occupational hazards awareness and preventive practices among students of a dental institution in South India.

Introduction

Dentists constitute a group of professionals who are likely to get exposed to biological, chemical, and physical health hazards. A dentist can get infected either directly or indirectly from different sources during clinical work. It is due to long working hours, changing shifts, physically demanding tasks, and exposures to infectious diseases; harmful chemicals are sources of hazards that put these professionals at risk for illness and injury. Occupational hazard refers to a risk or danger as a consequence of the nature or working conditions of a specific work. [1] The history of occupational hazard awareness can be traced back to the eighteenth century when Bernadino Ramazzini, who is referred to as the father of occupational medicine, recognized the role of occupation in dynamics of health and diseases. [2,3] Dentistry is known to be a profession with a variety of environmental factors that prove to affect the health of dentists or even aggregate their preexisting ailments. [4,5] However, modernization of dental profession reduces the risk of occupational hazards; in spite, many risks remain in dental practices, which continue to challenge this status. [6] Carrying out their professional work, dentists are exposed to numerous occupational hazards. This cause the appearance of diseases and disorders, which further develop and intensify with time. [7]

In addition, through this kind of health-care practice, many infectious agents may be transmitted [8] as the dentists and patients are in direct or indirect contact with traumatized tissues, saliva, blood, and other body fluids on a daily basis [9] Where such risks cannot be figured out of the dental clinic, appropriate occupational health and safety measures need to be adopted and adhered to, by dental professionals. Assessment of the occupational hazard awareness among dental students would help in motivating and planning preventive strategies at the training and teaching level. Hence, the current study was aimed to assess the level of awareness and preventive measures practice by the students studying at a dental institution in South India.

Materials and Methods

This study was conducted at Manipal College of Dental Sciences (MCODS), Manipal, India. The data were obtained using a self-administrated questionnaire that included questions on baseline characteristics, awareness of occupational hazards, and safety measures practiced by the study participants. Informed consent was obtained from all the participants and ethical approval was obtained from the institutional ethical committee for conducting the study. The study participants were asked to answer each questionnaire item as "yes" or "no" closed-ended questionnaire. All the students attending the second year class (preclinical) and all internship students (postclinical) attending the clinics of the hospital were included in the study. Subsequently, 164 dental students agreed to participate in the study voluntarily and completed the questionnaires. However, four questionnaires were rejected as they were either incomplete or had multiple responses for questions. The final sample size was 160 students including 82 students from second-year bachelor of dental surgery and 78 students from internship. Statistical Package for Social Sciences (SPSS), version 15.0 was used for statistical analysis. The data have been presented as frequency tables, and chi square test was used to assess the association between the year of study and their respective responses.

Results

All participants were well aware of the term occupational hazards and its definition with its risk factors at workplace. Out of the 160 participants, 72.5% were females and 27.5% were males. The mean age of the study participants was 21.40 [+ or -] 1.72 years. About 29.4% study participants experienced an injury from a sharp instrument over the past 6 months and 57.5% had regular exposure to dental amalgam. There was no significant difference between the genders for preventive measures undertaken against occupational hazards at workplace. Figure 1 shows that the most prevalent preventive practice reported by the participants was use of face mask (99.4%) and changing gloves between the patients (96.2%). However, only 6.9% of the participants had attended workshops or conferences on occupational hazards. It is significant to notice that 3.8% participants reported latex allergy in the current study and 84.4% of the participants were vaccinated against Hepatitis B. By using chi square test, significant p value is found for Hepatitis B vaccination (0.002), washing hands before and after wearing gloves (0.001), sharp injury over the past 6 months (0.009), regular contact with amalgam (0.001), knowledge on where to report exposure incident (0.001), knowledge about the use of disinfectant (0.001), and awareness about silicosis (0.004) among the internship and second-year BDS Students. This clearly shows that clinical experience and practice with more years of clinical exposure improved the knowledge, awareness, and preventive practices among dental professionals.

Discussion

The present trends of dentistry in India demands more lecture hours, competition, and proper time management among the students. At workplace, dentist assumes a strained posture both while standing and sitting close to the patients who remain in a sitting or a lying position; this overstress negatively affects the musculoskeletal system. [10] In the present study, only 35.5% of the participants reported any kind of musculoskeletal problem; this finding is significantly lower than past surveys among Danish, Israel, and US military and Australian dentist where 50%-60% of the dentists reported musculoskeletal pain. [11] Turjanamaa et al. [12] observed that 8.8% of the dentists were found to be allergic to latex which is more than 3.8% reported in the present study. Sharp instrument injuries represent the most efficient method for transmitting blood-borne infections between patients and health-care professionals. [11] In the present study (29.4%), participants reported sharp instruments injury, which is significantly lower. In contrast, 72% of the dental students of Australia [14] had experienced sharp instrument injury during their clinical training. Wearing of face masks and changing of the gloves were the preventive measures routinely employed by the study population in accordance to previous studies. [15,16] Only 6.9% of the participants reported of attending workshops on occupational health, similar finding was reported by Tadakamadla et al. [17] It was motivating to note that 84.4% of the participants had taken Hepatitis B vaccination. However, in a previous report among Indian Navy dentists, all the subjects were vaccinated against Hepatitis B, [1] whereas this was only 38% in dentists of East Jerusalem. [6] Majority of the participants were well aware about the biological hazards (HIV and HBV) associated with dentistry, which might be a reason for many participants in our study undergoing vaccination.

Conclusion

Majority of the participants were aware of the biological, chemical, and physical hazards associated with the practice of dentistry. Occupational hazard awareness among dental students will help in motivating and planning preventive strategies at the training and teaching level. If the knowledge of preventive practices is imparted during the curriculum, it will result in the use of effective practice of dentistry in future.

DOI: 10.5455/ijmsph.2016.13042016473

Acknowledgment

We sincerely acknowledge Dr. Nirmala Rao (Dean, MCODS, Manipal) for giving us permission to conduct this study. We would like to express our deepest appreciation to all the participants in our study who have willingly shared their precious time and information.

References

[1.] Chopra SS, Pandey SS. Occupational hazards among dental surgeons. MJAFI 2007; 63:23-5.

[2.] Asuzu MC. Occupational Health: A Summary, Introduction, and Outline of Principle. Ibadan: Afrika-Links Books, 1994. pp. 1-11.

[3.] Fasunloro A, Owotade FJ. Occupational hazards among clinical dental staff. J Contemp Dent Pract 2004; 5:134-52.

[4.] Puriene A, Aleksejuniene J, Petrauskiene J, Balciuniene I, Janulyte V. Self-reported occupational health issues among Lithuanian dentists. Ind Health 2008; 46:369-74.

[5.] Puriene A, Aleksejuniene J, Petrauskiene J, Balciuniene I, Janulyte V. Occupational hazards of dental profession to psychological wellbeing. Stomatologija. Baltic Dent Maxillofac J 2007; 9:72-8.

[6.] Al-Khatib IA, Ishtayeh M, Barghouty H, Akkawi B. Dentists' perceptions of occupational hazards and preventive measures in East Jerusalem. East Mediterr Health J 2006; 12:153-60.

[7.] Tosic G. Occupational hazards in dentistry-part one: allergic reactions to dental restorative materials and latex sensitivity. Facta universitatis. Series: Working and Living Environmental Protection 2004; 2:317-24.

[8.] Castiglia P, Liguori G, Montagna MT, Napoli C, Pasquarella C, Bergomi M, et al. Italian multicenter study on infection hazards during dental practice: control of environmental microbial contamination in public dental surgeries. BMC Publ Health 2008; 8:187.

[9.] Hovius M. Disinfection and sterilisation: the duties and responsibilities of dentists and dental hygienists. Int Dent J 1992; 42:241-4.

[10.] Szymanska J. Occcupational hazards of dentistry. Ann Agric Environ Med 1999; 6:13-9.

[11.] Leggat PA, Kedjarune U, Smith DR. Occupational health problems in modern dentistry: a review. Ind Health 2007; 45:611-21.

[12.] Turjanmaa K, Alenius H, Makinen-Kiljunen S, Reunala T, Palosuo T. Natural rubber latex allergy. Allergy 1996; 51:593-602.

[13.] McDonald RI, Walsh LJ, Savage NW. Analysis of work-place i njuries in a dental school environment. Aust Dent J 1997; 42:109-13.

[14.] Marshall ED, Duncombe LM, Robinson RQ, Kilbreath SL. Musculoskeletal symptoms in New South Wales dentists. Aust Dent J 1997; 42:240-6.

[15.] Leggat PA, Chowanadisai S, Kukiattrakoon B, Yapong B, Kedjarune U. Occupational hygiene practices of dentists in Southern Thailand. Int Dent J 2001; 51:11-6.

[16.] Verrusio AC, Neidle EA, Nash KD, Silverman S Jr, Horowitz AM, Wagner KS. The dentists and infectious diseases: national survey of attitudes and behavior. J Am Dent Assoc 1989; 118:553-62.

[17.] Tadakamadla J, Kumar S, Swapna LA, Reddy S. Occupational hazards and preventive practices among students and faculty at a private dental institution in India. Stomatologija, Baltic Dental and Maxillofac J 2012; 14(1):28-32.

Ravi Kant Singh (1), Abhay Taranath Kamath (2), Manish Kumar Bhagania (2), Tanvi Bansal (1)

(1) Department of Public Health, Manipal University, Karnataka. India.

(2) Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Karnataka. India.

Correspondence to: Ravi Kant Singh, E-mail: ravisinghk@gmail.com

Received April 13, 2016. Accepted May 02, 2016
Table 1: Association between number of study years and awareness (n
= 160)

Variables   Second year   Internship   p Value

Hepatitis B vaccination
  Yes           62            73        0.002
  No            20            5

Washing hands before and after wearing gloves
  Yes           57            77        0.001
  No            25            1

Sharps injury over the past 6 months
  Yes           32            15        0.009
  No            50            63

Regular contact with amalgam
  Yes           64            28        0.001
  No            17            50

Knowledge on whom to report exposure incident
  Yes           12            70        0.001
  No            64            14

Knowledge on use of disinfectants
  Yes           28            61        0.001
  No            54            17

Knowledge of silicosis
  Yes           52            66        0.004
  No            30            12

Figure 1: Preventive measures undertaken by the study participants.

have you taken hepatitis    84.4
  B vaccination
attended any workshop on    6.9
  occupational hazards
proper waste disposal       90.6
ensure instrument           92.5
  sterilisation
use of protective eyewear   70
use of face masks           99.4
change gloves before and    96.2
  after gloving
wash hands before and       83.8
  after gloving
wear gloves routinely       98.1
wash hands with soap        98.8
sharp injury over the       29.4
  last 6 months

Note: Table made from bar graph.
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Article Details
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Title Annotation:Research Article
Author:Singh, Ravi Kant; Kamath, Abhay Taranath; Bhagania, Manish Kumar; Bansal, Tanvi
Publication:International Journal of Medical Science and Public Health
Article Type:Report
Geographic Code:9INDI
Date:Nov 1, 2016
Words:1856
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