Abstract
In April 2016, a Virginia dentist who had recently received a diagnosis of idiopathic pulmonary fibrosis (IPF) and was undergoing treatment at a specialty clinic at a Virginia tertiary care center contacted CDC to report concerns that IPF had been diagnosed in multiple Virginia dentists who had sought treatment at the same specialty clinic. IPF is a chronic, progressive lung disease of unknown cause and associated with a poor prognosis (1). Although IPF has been associated with certain occupations (2), no published data exist regarding IPF in dentists. The medical records for all 894 patients treated for IPF at the Virginia tertiary care center during September 1996-June 2017 were reviewed for evidence that the patient had worked as a dentist, dental hygienist, or dental technician; among these patients, eight (0.9%) were identified as dentists and one (0.1%) as a dental technician, and each had sought treatment during 2000-2015. Seven of these nine patients had died. A questionnaire was administered to one of the living patients, who reported polishing dental appliances and preparing amalgams and impressions without respiratory protection. Substances used during these tasks contained silica, polyvinyl siloxane, alginate, and other compounds with known or potential respiratory toxicity. Although no clear etiologies for this cluster exist, occupational exposures possibly contributed. This cluster of IPF cases reinforces the need to understand further the unique occupational exposures of dental personnel and the association between these exposures and the risk for developing IPF so that appropriate strategies can be developed for the prevention of potentially harmful exposures.
Highlights
Having worked in the “office of dentists” and 19 categorized as having the occupation “dentist,” with proportionate mortality ratios of 1.52 (95% confidence interval [CI] = 1.05–2.11) and 1.67, respectively (Respiratory Health Division, CDC, unpublished data, 2017). These findings suggest that a higher rate of Idiopathic pulmonary fibrosis (IPF) might occur among dental personnel than among the general population
Dental personnel who perform tasks that result in occupational exposures to known respiratory hazards should wear adequate respiratory protection if other controls are not practical or effective
If respiratory protection is used, a written respiratory protection program should be implemented as required by the Occupational Safety and Health Administration Respiratory Protection Standard, including training, fit testing, and maintenance and use requirements
Summary
During 2016, approximately 650,000 dental personnel were estimated to be employed in the United States, including 122,330 dentists. This cluster of IPF cases reinforces the need to understand further the occupational exposures of dental personnel and the association between these exposures and the risk for developing IPF so that strategies can be developed for prevention of potentially harmful exposures. These findings suggest that a higher rate of IPF might occur among dental personnel than among the general population.
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