Periodontal health and oral mucosal lesions as related to occupational exposure to acid mists

Sulphurous air pollutants and exposure events of workers in thermal-mineral springs: a case study of Contursi Terme (Salerno, Italy)

Thermo-mineral springs are widely spread over the volcanic areas of Salerno, a city in southern Italy. Although the water of thermal structures provides beneficial effects on human health, the air is characterized by the presence of potentially toxic compounds, such as hydrogen sulphide (H₂S) and sulphur dioxide (SO₂). Exposure to sulphurous compounds may have detrimental effects on human health, with asthma being the most common. In this study, air concentrations of H₂S and SO₂ in the thermal springs of Contursi Terme (Salerno, Italy) were monitored for 4 months (using both active and passive sampling), along with the chemical and microclimatic characterization of thermal water, to assess workers' exposure to these pollutants. An in-depth characterization of indoor air at the springs is paramount to establish emission control limits for occupational exposure and to take protective measures. The air concentration of SO₂ varied from 0.11 ± 0.02 to 0.91 ± 0.02 mg/m³, following a seasonal pattern (higher values in winter and lower in spring). Conversely, indoor H₂S concentrations did not vary significantly with time, but outdoor levels (from 0.40 ± 0.03 to 1.90 ± 0.03 mg/m³) were always higher than indoor ones (from 0.11 ± 0.03 to 0.56 ± 0.03 mg/m³). Not negligible air concentrations of these pollutants were detected in this thermal spring workplace, so further investigations are needed to ensure workers' safety.

Examining relationship between occupational acid exposure and oral health in workplace

Background

Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health.

Methods

From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health.

Results

The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03–5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN.

Conclusion

Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

A cross-sectional study on oral health status of battery factory workers in Chennai city

Aim and Objective:

Some occupational exposures are associated with oral changes in both hard and soft tissues. Presence of oral lesions can interfere with speech, swallowing, and general health of a patient. The present cross-sectional study was conducted to evaluate the oral health status of battery factory workers in Chennai city.

Materials and Methods:

A total of 600 subjects were selected in battery factory out of 3500 workers using statistical sample selection formula 4pq/l² and divided into study and control groups based on acid exposure. The data were recorded on a modified World Health Organization 1997 pro forma. The data were evaluated using Chi-square test and Mann–Whitney U-test.

Materials and Methods:

A total of 600 subjects were selected in battery factory out of 3500 workers using statistical sample selection formula 4pq/l² and divided into study and control groups based on acid exposure. The data were recorded on a modified World Health Organization 1997 pro forma. The data were evaluated using Chi-square test and Mann–Whitney U-test.

Results:

Oral symptoms such as disturbed taste, dry mouth, oral ulcers, and foul breath were statistically significant between the groups (<0.001). Dental erosion was statistically significant with the duration of working years. Dental erosion was significant among study group compared to control (0.001).

Conclusion:

The present study showed that selected samples had various oral conditions due to exposure to acids from battery. It was observed that oral health problems were directly related to the duration of acid exposure in the study group. Implementing exhaust ventilation and monitoring the devices help in reducing the acid exposure. Implementation of oral hygiene education and nutritional supplementation helps in improving their oral health.

Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

Occupational exposure to acid mists and periodontal attachment loss

This study investigated the hypotheses that occupational exposure to acid mists is positively associated with periodontal disease, assessed by periodontal attachment loss. The study sample included 530 male workers at a metal processing factory. Data were obtained from interviews and oral examinations. Periodontal attachment loss was defined as >or= 4mm at probing, in at least one tooth. A job exposure matrix was utilized for exposure evaluation. Exposure to acid mists was positively associated with periodontal attachment loss >or= 4mm at any time (prevalence ratio, PR(adjusted) = 2.17), past (PR(adjusted) = 2.11), and over 6 years of exposure (PR(adjusted) = 1.77), independently of age, alcohol consumption, and smoking, and these results were limited to workers who did not use dental floss. Exposure to acid mists is a potential risk factor for periodontal attachment loss, and further studies are needed, using longitudinal designs and more accurate exposure measures.