General dental practitioners and hearing impairment
Introduction
Environmental noise is responsible for hearing impairment (HI). Daily exposure for 8 hours to noise levels ≥85 A-weighted decibels (dB(A) is associated with permanent hearing loss.1, 2 The A-weighting system (dB(A)) approximates the frequency response of our hearing system, weighting lower frequencies as less important than mid- and higher frequencies). Within healthcare settings, high environmental noise in hospitals may be responsible for abnormal hearing among healthcare workers,3, 4 while the orthopaedic staff experienced the highest prevalence of hearing-associated problems, due to high-powered tools in orthopaedic theatres.5, 6, 7, 8, 9, 10
In the 1960s, environmental noise produced in dental healthcare settings was considered responsible for HI in the dental staff.11, 12, 13 However in almost all previous studies dentists did not experience higher HI risk than the general population.14, 15, 16, 17, 18 This success was probably due to the technological improvement of dental equipment which considerably reduced the degree of environmental noise.19, 20, 21, 22 Nowadays, the noise levels generated by suction tubes, turbines, ultrasonic scalers and micromotor hand-pieces are generally below the HI threshold of 85 dB(A), irrespectively of brands, type of material cut, type of bur, etc.23, 24, 25 Thus, excluding peculiar situations, such as occasional peaks during burring21 or children's crying episodes,22 the environmental noise during daily practice could be considered reasonably safe.
Nevertheless, the problem of HI among dental healthcare workers became relevant once again in recent years. Indeed, hearing loss at speech frequencies was reported among dental hygienists26 and dentists.27, 28 In addition, three questionnaire-based surveys reported that 11.3% dentists from Thailand had hearing problems or were not sure about their hearing capacity,29 19.6% from Belgium had auditory disorders27 and 5% from United Arab Emirates had hearing problems.30 We hypothesized that the revival of this problem was due to the prevalent specialty practiced by general dental practitioners (GDPs) and to the use of aged or worn instruments. Indeed, environmental noise produced by worn or extremely aged instruments is high: levels > 85 dB(A) can be produced during everyday practice and turbines become louder after one year of use-sterilization cycles if they are not properly maintained.21, 22, 31, 32, 33, 34 In addition, differences by 10–20% in environmental noise levels are reported between units according to the prevalent specialty.20 Thus, the aim of this study was to investigate prevalence and factors associated with perceived HI among GDPs.
Section snippets
Methods
We decided to select only GDPs exposed to occupational environmental noise for at least 10 years, a period generally considered sufficient to generate HI.1, 2 GDPs were compared to general practitioners (GPs). We chose GPs because in Italy they are MDs with the Diploma of Special Training in General Medicine and have no exposure to other medical specialties (e.g. orthopaedics), and are a homogenous group according to type and duration of medical studies and practice. This choice to select
Results
A high response rate was achieved: 93.5% (100/107) for GDPs and 87.8% (115/131) for GPs. The two groups did not appreciably differ with respect to age and gender classes (Appendix 1) and to the various factors and characteristics potentially associated with HI (Table 1). Tinnitus was reported by 10% and 4%, hypoacusis by 16% and 10%, fullness by 7% and 3% of GDPs and GPs, respectively. Presumptive HI prevalence was double among GDPs.
The variables included in the initial regression model to
Discussion
The most important drawback of this study is that HI was not diagnosed using a formal audiometric test, therefore, the profile that emerged from the present analysis is associable with perceived symptoms of HI, which we have defined as “presumptive”. The significant predictors that we found could be roughly considered HI risk factors solely under the assumption of a substantial agreement between perceived HI, assessed through informal screening tests such as questionnaires, and true HI,
Acknowledgements
We wish to thank Dr Roberto Petti, MD, otolaryngologist for his theoretical and practical support and Dr Lidia Socci, for her support in editing the manuscript.
References (54)
- et al.
Reducing noise pollution in the hospital setting by establishing a department of sound: a survey of recent research on the effects of noise and music in health care
Preventive Medicine
(2000) - et al.
Noise exposure from dental drills
Journal of the American Dental Association
(1963) - et al.
High-speed drill noise and hearing: audiometric survey of 70 dentists
Journal of the American Dental Association
(1978) The air turbine and hearing loss: are dentists at risk?
Journal of the American Dental Association
(2002)- et al.
Occupational health problems of dentists in southern Thailand
International Dental Journal
(2000) - et al.
Occupational health problems of dentists in the United Arab Emirates
International Dental Journal
(2012) - et al.
Performance of high-speed dental hand pieces subjected to simulated clinical use and sterilization
Journal of the American Dental Association
(1999) Why guidelines for early childhood caries prevention could be ineffective amongst children at high risk
Journal of Dentistry
(2010)- et al.
Molecular genetic epidemiology of age-related hearing impairment
Auris Nasus Larynx
(2011) - et al.
The prevalence and correlates of self-reported hearing impairment in the Ibadan study of ageing
Transactions of the Royal Society of Tropical Medicine and Hygiene
(2010)
Occupational hazards in orthodontics: a review of risks and associated pathology
American Journal of Orthodontics and Dentofacial Orthopedics
The noise hazard in a large health care facility
Journal of Occupational Medicine
Noise-induced hearing loss in orthopaedic staff
Journal of Bone and Joint Surgery, British Volume
Noise levels of orthopedic instruments and their potential health risks
Orthopedics
Occupational noise levels in orthopaedic surgery
Irish Journal of Medical Science
Noise exposure in the orthopaedic operating theatre: a significant health hazard
ANZ Journal of Surgery
Noise exposure in orthopedic practice: potential health risk
Journal of Laryngology and Otology
Exposure to noise in orthopaedic theatres – do we need protection?
International Journal of Clinical Practice
The hearing threshold levels of dental practitioners exposed to air turbine drill noise
British Dental Journal
The effects of dental drill noise on the hearing of dentists
Journal of the Tennessee Dental Association
Hearing loss and the high speed dental handpiece
American Journal of Public Health
High frequency hearing of dental personnel
Community Dentistry and Oral Epidemiology
The long-term effects of noise on dentists
Zahn-, Mund-, und Kieferheilkdunde mit Zentralblatt
Hearing-damage risk and communication interference in dental practice
Journal of Dental Research
Environmental comfort in 2 Roman dental clinic complexes
Annali di Igiene
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