https://doi.org/10.33573/ujoh2018.03.034

Varyvonchyk D. V.1, 2, Kopach K. D.1, Demetska A. V.3, Andrusyshyna I. M.1, Movchan B. O.1, Bezverbnyi P. S.2, Edzhybiya A. M.1

DEVELOPMENT OF A COMBINATION OF HYGIENIC MEASURES FOR PREVENTION OF HARMFUL EFFECT OF NANO- AND LOW DISPERSED AEROSOLS ON WORKERS OF THE DENTAL SERVICE

1State Institution "Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine", Kyiv

2National Medical Academy of Post-Graduate Education named after P. L. Shupyk, Kyiv

3Private higher institution "Kyiv International University"

Full article (PDF), UKR

Introduction. Resulting in high-speed processing of tooth tissues, dental implants, orthopedic prostheses, orthodontic devices, etc., there is a process of developing dispersed aerosols that can have an adverse effect on the health of dental workers. Purpose of the study is to develop measures on prevention of formation and harmful effect of dispersed aerosols on dental workers. Materials and methods. The concentration of metals (Ag, Al, As, Ca, Cd, Cr, Fe, Mg, Mn, Ni, Pl, Si, Ti, Zn) in air aerosols of the working area of dentists and dental technicians was studied. The concentrations of metals in the control and respiratory protective equipment (RPE) used during one shift, in medical masks "Trident N203" and anti-aerosol filter respirators with exhalation valve "Resppharm M-300 P-1K FFP-1D" were investigated and there were estimated coefficients of toxic environmental hazards and protection coefficients of RPE. The time dynamics of nano- (d = 1–100 nm) and finely dispersed (101–200 nm) aerosols in the air of the working area was studied, 2 hours after the start of work and immediately after the use of the sanitary measures (through ventilation, wet cleaning of industrial premises).

Results. It has been established that dental workers at their workplace are exposed to harmful effect of metal aerosols – As, Cr, Zn, Ca, and nanoaerosols – Ni, As, Cr, Si, Ca, Al, Mg, Ti, Fe. The use of medical mask "Trident N3" do not provide safe concentrations of metal aerosols – Ni, As, Cr, Mn, Zn, Ca, Al under the mask space.

The use of anti-aerosol filter respirators with exhalation valve "Respparm M-300 P-1K FFP-1D" allows to ensure safe concentrations under the mask space for all the metals studied. Dispersive aerosols with nano-sized particles (d = 1–100 nm) (85,5 %) prevail in the air of the working zone of the production premises of the stomatological service, with a maximum particle concentration of 10–25 nm in diameter, whose concentration in the air significantly increases in 90–120 min after starting the work causing formation of aerosols. The use of sanitary measures (through ventilation, wet cleaning of industrial premises) allows to significantly reduce the initial concentration of dispersed nano- and fine-dispersed aerosols in the air of the working zone (by1,8–3,8 times).

Conclusion. To reduce the risk of exposure to dispersed nano- and fine-dispersed aerosols for dental workers, the use of antiaerosol filter respirators of at least I and II degrees of protection (P3 and P2 according to the European classification) is recommended, in combination with other measures of sanitary and hygienic control at workplaces (periodic through ventilation, wet cleaning of industrial premises, use of forced exhaust ventilation system) as well as all-round introduction of technologies for reducing dust formation (wet tissue processing system for tooth, filling materials, orthodontic and orthopedic structures, etc).

Key words: stomatological service, medical workers, working conditions, aerosols, metals, personal protective equipment, respiratory organs, prevention

Reference

  1. Burya L. V. and Маrchenko І. Ya. (2007), "Hygienic characteristics of factors of the work environment for dentists", Ukr. J. Occup. Health, 4,79–85.
  2. Vyznachennya 33 elementiv metodom atomnoemisiinoyi spektrometrii z induktyvno- zvyazanoyu plasmoyu u vodi (2007) [Determination of 33 elements by the method of atomic-absorption spectrometry with inductively coupled plasma in water], State Standard ISO 11885,1996, Кyiv, Derzhspozhyvstandart Ukrayiny.
  3. Gigiyena ta okhorona pratsi medychnykh pratsivnykiv (2009) [Occupational health and work protection of medical workers: a textbook], Моskalenko V.F. and Yavorovskyi O.P. (ed.), Меdytsyna, Kyiv.
  4. Demetska О. V., Andrusyshyna І. М., Коpach К. D. (2016), "Assessment of nanoparticle emission in the air of the working zone, using modern dental materials", Lvivskyi medychnyi forum, 8, 64–67.
  5. Коpach К. D., Varyvonchyk D. V. (2017), "Identification of chemical danger at workplaces of dentists", Collection of papers of workers of NMAPG E, 27, 409 – 417.
  6. Кundiiev Yu. I., Varyvonchyk D. V. and Коpach К. D. (2017), "Hygienic conditions of dentists in conditions of using modern medical technologies", Ukr. J. Occup. Health, 4, 3–11.
  7. Моvchan V. О., Salnikova N. А., Andrusyshyna І. М. (2012), Sposib vyznachennya nanoichastynok v povitri robochoyi zony [ Method of determination of nanoparticles in the air of the working zone], Patent for utility model No.UA72951 U.
  8. Order of the Derzhgirpromnaglyadu 28.12.2007 № 331"Rules for selection and usage of means of personal protection of the respiratory organs", URL: http:// zakon2.rada.gov.ua/laws/show/z0285-08/page (Accessed date: 15.06.2018).
  9. Gadbury-Amyot C. C., Williams K. B., Overman P. R. and Glaros A. (1994) "The effect of personal protective equipment on high-and low-dental fear patients", J. Dent. Hyg. , 68 (2), 75–81.
  10. Janssen L. and Bidwell J. (2007), "Performance of a full face piece, air-purifying respirator against lead aerosols in a workplace environment", Journal of Occupational and Environmental Hygien, 4 (2), 123–128. https://doi.org/10.1080/15459620601128845
  11. Laube B.L., Janssens H.M. and de Jongh F.H. (2011), "What the pulmonary specialist should know about the new inhalation therapies", Eur. Respir. J., 37 (6), 1308 – 1331. https://doi.org/10.1183/09031936.00166410
  12. Zhuang Z., Coffey C. С. and Jensen P. A. (2003), "Correlation between quantitative fit factors and workplace protection factors measured in actual workplace environments at a steel foundry", American Industrial Hygiene Association Journa, 64 (6), 730–738. https://doi.org/10.1080/15428110308984867

ORCID ID of co-authors and their contribution to the preparation and writing of the article:

Varivonchyk D.V. (ORCID 0000-0003-2107-6269) - formation of the concept and methodology of research, the choice of tools and methods of research; Participate in statistical processing, analysis, interpretation of data, formation of conclusions; writing an article;

Kopach KD (ORCID 0000-0002-6771-4556) - participate in the development of research methodology; collection of control and used means of personal protection of respiratory organs in workers of the dental service; participation in field and experimental research, in statistical processing, analysis, interpretation of data, formation of conclusions and recommendations;

Demetska O.V. (0000-0002-8174-7813) - development of methodology and quantitative research on the content of air in the working zone of nano- and fine dispersed aerosols;

Andrushishina I.M. (ORCID 0000-0001-5827-3384) - development of the methodology and conducting of the chemical-analytical study of metal content in the air of the working zone and in the means of individual protection of the respiratory system (by the method of atomic emission spectrometry with an inductively coupled plasma) ;

Movchan V.O. (ORCID 0000-0001-8756-3727) - development of research methods, sampling and preparation of air samples of the working zone for chemical analysis of the content of metal aerosols in the air of the working zone;

Pereless P. S. (ORCID 0000-0002-9851-8830) - Participation in the research, in the interpretation of data, in the formulation of recommendations;

Ezhbija O. M. (ORCID 0000-0002-0243-7615) - Participation in the research, in the processing of data, in the writing of the article.