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"
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
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.