1
|
Tang F, Wen X, Zhang X, Qi S, Tang X, Huang J, Zhu C, Shang G, Xu Y, Cai J, Wang R. Ultrafine particles exposure is associated with specific operative procedures in a multi-chair dental clinic. Heliyon 2022; 8:e11127. [PMID: 36276750 PMCID: PMC9574865 DOI: 10.1016/j.heliyon.2022.e11127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/12/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Air quality in dental clinics is critical, especially in light of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, given that dental professionals and patients are at risk of regular exposure to aerosols and bioaerosols in dental clinics. High levels of ultrafine particles (UFP) may be produced by dental procedures. This study aimed to quantify ultrafine particles (UFP) concentrations in a real multi-chair dental clinic and compare the levels of UFP produced by different dental procedures. The efficiency of a high-volume evacuator (HVE) in reducing the UFP concentrations during dental procedures was also assessed. UFP concentrations were measured both inside and outside of a dental clinic in Shanghai, China during a 12-day period from July to September 2020. Dental activities were recorded during working hours. The mean (±standard deviation) concentrations of indoor and outdoor UFP during the sampling period were 8,209 (±4,407) counts/cm3 and 15,984 (±7,977) counts/cm3, respectively. The indoor UFP concentration was much higher during working hours (10,057 ± 5,725 counts/cm3) than during non-working hours (7,163 ± 2,972 counts/cm3). The UFP concentrations increased significantly during laser periodontal treatment, root canal filling, tooth drilling, and grinding, and were slightly elevated during ultrasonic scaling or tooth extraction by piezo-surgery. The highest UFP concentration (241,136 counts/cm3) was observed during laser periodontal treatment, followed by root canal filling (75,034 counts/cm3), which showed the second highest level. The use of an HVE resulted in lower number concentration of UFP when drilling and grinding teeth with high-speed handpieces, but did not significantly reduce UFP measured during laser periodontal therapy. we found that many dental procedures can generate high concentration of UFP in dental clinics, which may have a great health impact on the dental workers. The use of an HVE may help reduce the exposure to UFP during the use of high-speed handpieces.
Collapse
Affiliation(s)
- Fengqin Tang
- Department of Stomatology, Clinical Medical College of Shanghai Tenth Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xueyun Wen
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Xu Zhang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Shengcai Qi
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, PR China,Department of Prosthodontics, Shanghai Stomatology Hospital, Fudan University, Shanghai, PR China
| | - Xiaoshan Tang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Jieying Huang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Chenjie Zhu
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Guangwei Shang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Yuanzhi Xu
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China,Corresponding author.
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, PR China,Corresponding author.
| | - Raorao Wang
- Department of Stomatology, Clinical Medical College of Shanghai Tenth Hospital of Nanjing Medical University, Nanjing, PR China,Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China,Corresponding author.
| |
Collapse
|
2
|
Karveli A, Tzoutzas IG, Raptis PI, Tzanakakis EGC, Farmakis ETR, Helmis CG. Air Quality in a Dental Clinic during Er:YAG Laser Usage for Cavity Preparation on Human Teeth-An Ex-Vivo Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010920. [PMID: 34682658 PMCID: PMC8535664 DOI: 10.3390/ijerph182010920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022]
Abstract
Chemical air pollution in dental clinics consists of the emission of gases and particulate matter (PM), both generated by dental equipment and tooth tissues. One basic application of Erbium Laser devices is cavity preparation on human teeth due to its strong affinity to water and hydroxyapatite. The objective of this study was the evaluation of indoor air quality during the application of an Er:YAG laser, as a dentin removal instrument, in a Dental Clinic. Particulate Matter (PM) was measured using the standard method of EN legislation. In order to measure total Volatile Organic compounds (VOCs), a portable monitor was used. In the first experiment, PM10 and PM2.5 concentrations were increased by approximately 10 and 15 times, respectively. From the second experiment it can be concluded that neither of the measured particle concentrations exceeded the recommended indoor limit values while windows were open, although laser influence was still detectable. Within the limitations applied herein, it was found that Er:YAG laser activity for hard dental tissue removal was associated with high PM and TVOCs concentration values in the working environment, under insufficient or no ventilation. Physical ventilation in the aforementioned setting proved to be an important key factor in improving air quality, as both PM and TVOCs concentrations decreased significantly.
Collapse
Affiliation(s)
| | - Ioannis G. Tzoutzas
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.T.); (E.-G.C.T.)
| | | | - Emmanouil-George C. Tzanakakis
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.T.); (E.-G.C.T.)
| | - Eleftherios Terry R. Farmakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Constantinos G. Helmis
- Division of Applied Physics, Department of Physics, University of Athens, 11527 Athens, Greece;
| |
Collapse
|
3
|
Indoor Air Quality in Healthcare and Care Facilities: Chemical Pollutants and Microbiological Contaminants. ATMOSPHERE 2021. [DOI: 10.3390/atmos12101337] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The indoor air quality of healthcare and care facilities is poorly studied. The aim of this study was to qualitatively and quantitatively describe the chemical pollution and the microbiological contaminations of the indoor environment of these facilities. Methods: A wide range of chemical compounds (39 volatile and 13 semi-volatile organic compounds, carbon dioxide, fine particulate matter) and microorganisms (fungi and bacteria) were studied. Sampling campaigns were conducted in two French cities in summer 2018 and winter 2019 in six private healthcare facilities (general practitioner’s offices, dental offices, pharmacies) and four care facilities (nursing homes). Results: The highest median concentrations of chemical compounds (μg/m3) were measured for alcohols (ethanol: 378.9 and isopropanol: 23.6), ketones (acetone: 18.8), aldehydes (formaldehyde: 11.4 and acetaldehyde: 6.5) and terpenes (limonene: 4.3). The median concentration of PM2.5 was 9.0 µg/m3. The main bacteria of these indoor environments were Staphylococcus, Micrococcus and Bacillus genera, with median bacterial concentrations in the indoor air of 14 cfu/m3. The two major fungal genera were Cladosporium and Penicillium, with median fungal concentrations of 7 cfu/m3. Conclusions: Indoor air in healthcare and care facilities contains a complex mixture of many pollutants found in higher concentrations compared to the indoor air in French hospitals in a previous study.
Collapse
|
4
|
Indoor Air Quality Evaluation Using Mechanical Ventilation and Portable Air Purifiers in an Academic Dentistry Clinic during the COVID-19 Pandemic in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168886. [PMID: 34444634 PMCID: PMC8395055 DOI: 10.3390/ijerph18168886] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19), which is mainly transmitted through droplets without overlooking other sources of transmission, rendered attention on the air quality in indoor areas and more specifically in healthcare settings. The improvement of indoor air quality (IAQ) is ensured by frequent changes of the air that must be carried out in healthcare areas and with assistance from special devices that undertake the filtration of the air and its purification through special filters and lamps. In this research, the performance of air purifiers is assessed in terms of the limitation of PM2.5, PM10, VOCs and CO2 in a postgraduate clinic of the Dentistry School of the National and Kapodistrian University of Athens in parallel with mechanical ventilation. Our findings indicate that the use of mechanical ventilation plays a key role on the results, retaining good IAQ levels within the clinic and that air purifiers show a positive impact on IAQ by mainly reducing the levels of PM2.5 and secondly of TVOC.
Collapse
|
5
|
Huang Q, Marzouk T, Cirligeanu R, Malmstrom H, Eliav E, Ren YF. Ventilation Assessment by Carbon Dioxide Levels in Dental Treatment Rooms. J Dent Res 2021; 100:810-816. [PMID: 33973494 PMCID: PMC8120146 DOI: 10.1177/00220345211014441] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
It is important for dental care professionals to reliably assess carbon dioxide (CO2) levels and ventilation rates in their offices in the era of frequent infectious disease pandemics. This study was to evaluate CO2 levels in dental operatories and determine the accuracy of using CO2 levels to assess ventilation rate in dental clinics. Mechanical ventilation rate in air change per hour (ACHVENT) was measured with an air velocity sensor and airflow balancing hood. CO2 levels were measured in these rooms to analyze factors that contributed to CO2 accumulation. Ventilation rates were estimated using natural steady-state CO2 levels during dental treatments and experimental CO2 concentration decays by dry ice or mixing baking soda and vinegar. We compared the differences and assessed the correlations between ACHVENT and ventilation rates estimated by the steady-state CO2 model with low (0.3 L/min, ACHSS30) or high (0.46 L/min, ACHSS46) CO2 generation rates, by CO2 decay constants using dry ice (ACHDI) or baking soda (ACHBV), and by time needed to remove 63% of excess CO2 generated by dry ice (ACHDI63%) or baking soda (ACHBV63%). We found that ACHVENT varied from 3.9 to 35.0 in dental operatories. CO2 accumulation occurred in rooms with low ventilation (ACHVENT ≤6) and overcrowding but not in those with higher ventilation. ACHSS30 and ACHSS46 correlated well with ACHVENT (r = 0.83, P = 0.003), but ACHSS30 was more accurate for rooms with low ACHVENT. Ventilation rates could be reliably estimated using CO2 released from dry ice or baking soda. ACHVENT was highly correlated with ACHDI (r = 0.99), ACHBV (r = 0.98), ACHDI63% (r = 0.98), and ACHBV63% (r = 0.98). There were no statistically significant differences between ACHVENT and ACHDI63% or ACHBV63%. We conclude that ventilation rates could be conveniently and accurately assessed by observing the changes in CO2 levels after a simple mixing of household baking soda and vinegar in dental settings.
Collapse
Affiliation(s)
- Q Huang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - T Marzouk
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - R Cirligeanu
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - H Malmstrom
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - E Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Y-F Ren
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
6
|
Mirhoseini SH, Koolivand A, Bayani M, Sarlak H, Moradzadeh R, Ghamari F, Sheykhan A. Quantitative and qualitative assessment of microbial aerosols in different indoor environments of a dental school clinic. AEROBIOLOGIA 2021; 37:217-224. [PMID: 33462523 PMCID: PMC7805567 DOI: 10.1007/s10453-020-09679-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
In the indoor environment of dental clinics, dental staff and patients are exposed to various types of infectious agents transported by aerosols and particles, generated during dental procedures, promoting an increased risk of cross-infection. The aim of this study was to determine the levels and diversity of microbial aerosol in relation to particle load in five different departments of a dental school clinic. The air samples were collected by an active single-stage Andersen sampler during the treatment procedure. The mean concentrations of airborne bacteria were in the range of 52-1030 and 8-844 CFU/m3 at the distances of 0.5 and 2 m, respectively. Bacterial aerosols in pediatric, endodontics, and restorative wards and fungal aerosols in all the sampling wards were significantly higher at the distances of 0.5 m. The dominant bacteria and fungi were identified as Micrococcus, Bacillus, Streptococcus, Staphylococcus, Penicillium, Cladosporium, Aspergillus, Rhizopus, and Alternaria. The positive associations were also obtained between bacteria and fungi levels and particulate matter (PM) concentrations.
Collapse
Affiliation(s)
- Seyed Hamed Mirhoseini
- Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Golestan Ave, Ghods St, Arak, Iran
| | - Ali Koolivand
- Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Golestan Ave, Ghods St, Arak, Iran
| | - Mojtaba Bayani
- Department of Periodontics Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Hamid Sarlak
- Department of Periodontics Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Farhad Ghamari
- Department of Occupational Health, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Adel Sheykhan
- Student Research Committee, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
7
|
Hong YJ, Huang YC, Lee IL, Chiang CM, Lin C, Jeng HA. Assessment of volatile organic compounds and particulate matter in a dental clinic and health risks to clinic personnel. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2015; 50:1205-1214. [PMID: 26301846 DOI: 10.1080/10934529.2015.1055129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was conducted to assess (1) levels of volatile organic compounds (VOCs) and particulate matter (PM) in a dental clinic in southern Taiwan and (2) dental care personnel's health risks associated with due to chronic exposure to VOCs. An automatic, continuous sampling system and a multi-gas monitor were employed to quantify the air pollutants, along with environmental comfort factors, including temperature, CO2, and relative humidity at six sampling sites in the clinic over eight days. Specific VOC compounds were identified and their concentrations were quantified. Both non-carcinogenic and carcinogenic VOC compounds were assessed based on the US Environmental Protection Agency's Principles of Health Risk Assessment in terms of whether those indoor air pollutants increased health risks for the full-time dental care professionals at the clinic. Increased levels of VOCs were recorded during business hours and exceeded limits recommended by the Taiwan Environmental Protection Agency. A total of 68 VOC compounds were identified in the study area. Methylene methacrylate (2.8 ppm) and acetone (0.176 ppm) were the only two non-carcinogenic compounds that posed increased risks for human health, yielding hazard indexes of 16.4 and 4.1, respectively. None of the carcinogenic compounds increased cancer risk. All detected PM10 levels ranged from 20 to 150 μg/m(3), which met the Taiwan EPA and international limits. The average PM10 level during business hours was significantly higher than that during non-business hours (P = 0.04). Improved ventilation capacity in the air conditioning system was recommended to reduce VOCs and PM levels.
Collapse
Affiliation(s)
- Yu-Jue Hong
- a School of Nursing, Meiho University , Pingtung , Taiwan
| | | | | | | | | | | |
Collapse
|