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Workplace Hazards Among Australian Dental Students

2009; Wiley; Volume: 54; Issue: 2 Linguagem: Inglês

10.1111/j.1834-7819.2009.01116_8.x

1834-7819

Derek Smith, Peter A. Leggat, Laurence J. Walsh,

Dental Anxiety and Anesthesia Techniques

Musculoskeletal disorders (MSD), needlestick and sharps injuries (NSI) and occupational skin diseases represent three of the most common workplace health issues in the dental profession.1 MSD are particularly important for dental students as research suggests that chronic MSD tends to appear early in dental careers.2 Of the occupational skin diseases, hand dermatitis (HD) and latex allergy (LA) are generally the most common.3 Although dental students usually perform similar clinical tasks as dentists in private practice4 and therefore face similar risks, few studies have investigated occupational health issues among Australian dental students. To help rectify this shortfall of knowledge, we surveyed students from a large dental school in Queensland, Australia. MSD were assessed via a modified version of the Standardised Nordic Questionnaire5 which has been widely used for investigating these conditions among a range of occupations and student groups, including dental students in other countries.4 NSI were assessed using a questionnaire based on similar studies previously conducted in the dental profession.6–8 HD was assessed using a modified version of the Dutch HD questionnaire,9 which requires the presence of two or more symptoms in the previous 12-month period, that either persisted for more than three weeks or recurred. A convenience sample of 56 dental students in their second (36%), third (36%) and fifth (25%) year of study at the University of Queensland were surveyed. A further 3% of the group were postgraduates. This represented approximately one-third of the student body enrolled in the course at the time. The majority (57%) were male and their average age was 22.5 years (standard deviation: 4.7 years). Although around half (48%) consumed alcohol on a semi-regular basis, we were encouraged to find that only 1.8% were current smokers. This compares well to other countries where relatively higher smoking rates have been documented among dental students.10 The self-reported prevalence rate of MSD at various body sites is displayed in Table 1. Slightly more than half (55.4%) of all dental students reported experiencing some kind of MSD in the previous week, while 83.9% had experienced it in the previous year. One-quarter had sought medical treatment for their MSD in the previous year. Almost two-thirds (60.7%) reported suffering MSD of the neck in the previous 12-months, followed by MSD at the lower back (46.4%), shoulder (44.6%), upper back (37.5%) and wrist (37.5%). Female students were more likely to report wrist-related MSD than their male counterparts (P = 0.0053). Wrist pain was also associated with year of study in the dental course (P = 0.0288), being most common in the third year of study. The finding of high MSD prevalence rates among our students is consistent with similar research conducted among dental students in other countries.2,4,11 MSD are also reported by experienced dentists, with an earlier study conducted in New South Wales12 revealing that 82% had experienced one or more MSD symptoms in the previous month. A more recent investigation of Queensland dentists13 found that 87% had experienced at least one MSD over the past 12 months, mainly at the neck or lower back, similar to their student counterparts in our current study. Almost one-third (32.1%) of the dental students in our study had suffered an NSI at some point during their student life, with 19.6% experiencing an NSI in the previous year. NSI represent an effective method for the transfer of blood-borne diseases between patients and staff. Previous research has shown that these injuries are not uncommon in contemporary dental practice. In a Queensland study for example, more than one-quarter of all dentists had sustained an NSI in the previous year and a further three-quarters had damaged their gloves during a clinical procedure.7 Among students, an earlier investigation of injuries within a New South Wales dental school revealed that 72% of dentistry students had received one or more penetrating sharps injuries during their clinical training.6 Another study reported that dental students suffered between 3 and 6 non-infectious workplace injuries per 100 students, per year.8 SD, HD and LA prevalence rates among our dental students are displayed in Table 2. The most commonly reported skin diseases over the previous year were acne or pimples (57.1%), allergic rashes (17.9%), cold sores (8.9%) and fungal infections (3.6%). Of interest, students reporting allergic rashes were more likely to suffer HD (P = 0.0004). Slightly more than one-quarter (26.8%) were currently suffering some kind of allergic disease, and 9.0% had a childhood history of allergy. When evaluated according to the criteria of Smit et al.,9 29.1% of our students were assessed as having HD, a prevalence rate which is very similar to a previous study of Queensland dentists, where almost one-third suffered HD.3 This is also comparable to a 1995 study that reported a range of skin problems across 201 Brisbane dentists, of which HD symptoms such as itching (18%), dryness (27%), redness (10%) and scaling (9%) were linked to wearing latex gloves.14 HD, and to a lesser extent, latex allergy represent ongoing problems for dental health care workers, and it is interesting to note that 87.5% of our students had a history of latex exposure through glove wearing. Although it was not specifically investigated in the current study, a previous survey from Sydney found that 33% of dental personnel reported symptoms related to wearing gloves.15 From an epidemiological perspective, a previous study of Queensland dentists during 2004 revealed that around 2% had been medically diagnosed with latex allergy.3 Overall, this study suggests that dental students are suffering musculoskeletal disorders, needlestick and sharps injuries and occupational skin diseases at reasonably high rates. By virtue of their clinical training, students are often exposed to similar hazards as their professional counterparts. For these reasons it is imperative that dental schools continue to enforce standard precautions, as well as ensuring that students employ correct ergonomic techniques and proper sharps management when working with patients in the pre-clinical laboratory setting as well as when providing patient care in student clinics. The authors would like to thank all the dental students who completed our survey.