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Tian M, Zhu X, Ren L, Zhou X, Gu L, Meng K, Tian Y, Cai H, Liu X, Ding J. HE4-based nomogram for predicting overall survival in patients with idiopathic pulmonary fibrosis: construction and validation. Eur J Med Res 2024; 29:238. [PMID: 38627872 PMCID: PMC11020350 DOI: 10.1186/s40001-024-01829-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a life-threatening interstitial lung disease. Identifying biomarkers for early diagnosis is of great clinical importance. The epididymis protein 4 (HE4) is important in the process of inflammation and fibrosis in the epididymis. Its prognostic value in IPF, however, has not been studied. The mRNA and protein levels of HE4 were used to determine the prognostic value in different patient cohorts. In this study, prognostic nomograms were generated based on the results of the cox regression analysis. We identified the HE4 protein level increased in IPF patients, but not the HE4 gene expression. The increased expression of HE4 correlated positively with a poor prognosis for patients with IPF. The HR and 95% CI were 2.62 (1.61-4.24) (p < 0.001) in the training set. We constructed a model based on the risk-score = 0.16222182 * HE4 + 0/0.37580659/1.05003609 (for GAP index 0-3/4-5/6-8) + (- 1.1183375). In both training and validation sets, high-risk patients had poor prognoses (HR: 3.49, 95%CI 2.10-5.80, p = 0.001) and higher likelihood of dying (HR: 6.00, 95%CI 2.04-17.67, p = 0.001). Analyses of calibration curves and decision curves suggest that the method is effective in predicting outcomes. Furthermore, a similar formulation was used in a protein-based model based on HE4 that also showed prognostic value when applied to IPF patients. Accordingly, HE4 is an independent poor prognosis factor, and it has the potential to predict IPF patient survival.
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Affiliation(s)
- Mi Tian
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Xiaohui Zhu
- Department of Respiratory, The Fourth Affiliated Hospital of Nanjing Medical University, 298 Nanpu Road, Nanjing, 211899, China
| | - Lijun Ren
- Department of Pulmonary and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xuan Zhou
- Department of Respiratory, The Fourth Affiliated Hospital of Nanjing Medical University, 298 Nanpu Road, Nanjing, 211899, China
- Phase I Clinical Trials Unit, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 359 Pu Zhu Middle Road, Nanjing, 210031, China
| | - Lina Gu
- Department of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Kaifang Meng
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yaqiong Tian
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Hourong Cai
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
| | - Xiaoqin Liu
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
| | - Jingjing Ding
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
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Li YG, Li JC, Yu XY, Hu J, Li Z, Cao JC. Quantitative assessment of aerosol contamination generated during tooth grinding with a speed-increasing handpiece. J Dent 2023; 139:104631. [PMID: 37495202 DOI: 10.1016/j.jdent.2023.104631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVES Tooth grinding produces a significant amount of aerosol particles. The aim of this study was to quantitatively assess particle contamination produced from tooth grinding with a speed-increasing handpiece across a real-world clinical setting. METHODS All molar crowns were pretreated into cylinders with a uniform size. A novel computer-assisted numerical control system was used to parametrically study the bur speed: from 20,000 (20 K) to 200 K rpm at 20 K rpm intervals. 5-minute tooth grinding was performed in triplicate at each speed setting. Three online real-time particle counters (ORPC; TR-8301, TongrenCo.) were placed at 3 positions (0.5, 1, and 1.5 m) to evaluate particle production. All experimental instruments were controlled remotely. The data obtained were statistically analyzed using descriptive statistics and non-parametric tests (Scheirer-Ray-Hare and Kruskal-Wallis/ Dunn-Bonferroni tests, p < 0.05). RESULTS The concentration level of aerosol particles production during the grinding experiment was elevated above the control group for all conditions, and increased with bur speed at any location (the maximum peak, reaching 5.59 × 107 particles/m3, at 200 K and 1 m), with differences between conditions. The effect of speed on the increment of particles across different channels compared to the control group was statistically significant among locations (p < 0.001). CONCLUSIONS Statistically significant particle contamination was produced using a speed-increasing handpiece, but the contamination level for each experimental condition was reduced to baseline within 30 min, and most particles with a diameter greater than 1üm produced at low speeds (80 K or lower) tended to settle within 1 m. CLINICAL RELEVANCE Our study suggested that the use of a speed-increasing handpiece below 80 K and 30 min of fallow time may lead to an adequate reduction in the health effects of particle contamination.
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Affiliation(s)
- Yu-Gang Li
- School of Mechanical Engineering, Guizhou University, Guiyang, China; Guizhou Equipment Manufacturing Polytechnic, Guiyang, China
| | - Jia-Chun Li
- School of Mechanical Engineering, Guizhou University, Guiyang, China.
| | - Xiao-Yan Yu
- Guiyang Hospital of Stomatology, Guiyang, China
| | - Jie Hu
- School of Mechanical Engineering, Guizhou University, Guiyang, China
| | - Zhe Li
- School of Life Sciences, Guizhou Normal University, Guiyang, China
| | - Ji-Chao Cao
- College of Mechanical and Vehicle Engineering, Hunan University, Changsha, China
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Ding J, Li J, Qi J, Fu L. Characterization of dental dust particles and their pathogenicity to respiratory system: a narrative review. Clin Oral Investig 2023; 27:1815-1829. [PMID: 36773127 PMCID: PMC9918839 DOI: 10.1007/s00784-023-04910-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES Dental professionals are exposed to large amounts of dust particles during routine treatment and denture processing. This article provides a narrative review to investigate the most prevalent dust-related respiratory diseases among dental professionals and to discuss the effects of dental dust on human respiratory health. MATERIALS AND METHODS A literature search was performed in PubMed/Medline, Web of Science, and Embase for articles published between 1990 and 2022. Any articles on the occupational respiratory health effects of dental dust were included. RESULTS The characterization and toxicity evaluation of dental dust show a correlation between dust exposure and respiratory system injury, and the possible pathogenic mechanism of dust is to cause lung injury and abnormal repair processes. The combination use of personal protective equipment and particle removal devices can effectively reduce the adverse health effects of dust exposure. CONCLUSIONS Dental dust should be considered an additional occupational hazard in dental practice. However, clinical data and scientific evidence on this topic are still scarce. Further research is required to quantify dust in the dental work environment and clarify its pathogenicity and potential toxicological pathways. Nonetheless, the prevention of dust exposure should become a consensus among dental practitioners. CLINICAL RELEVANCE This review provides dental practitioners with a comprehensive understanding and preventive advice on respiratory health problems associated with dust exposure.
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Affiliation(s)
- Jiaxin Ding
- grid.64924.3d0000 0004 1760 5735Hospital of Stomatology, Jilin University, Changchun, China
| | - Junxuan Li
- grid.64924.3d0000 0004 1760 5735Hospital of Stomatology, Jilin University, Changchun, China
| | - Junnan Qi
- grid.64924.3d0000 0004 1760 5735Hospital of Stomatology, Jilin University, Changchun, China
| | - Li Fu
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130021, China.
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Idiopathic Pulmonary Fibrosis and Telomeres. J Clin Med 2022; 11:jcm11236893. [PMID: 36498467 PMCID: PMC9740997 DOI: 10.3390/jcm11236893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Idiopathic pulmonary fibrosis is an interstitial lung disease of unknown etiology with a highly compromised prognosis and a significant mortality rate within a few years of diagnosis. Despite being idiopathic, it has been shown that telomeric shortening could play an important role in its etiopathogenesis. Mutations in telomere-related genes have been identified, but they are not always present despite telomere shortening. On the other hand, this telomeric shortening has been linked to a worse prognosis of the disease independently of other clinical factors, implying it may serve as a biomarker.
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Lee CT, Feary J, Johannson KA. Environmental and occupational exposures in interstitial lung disease. Curr Opin Pulm Med 2022; 28:414-420. [PMID: 35838370 DOI: 10.1097/mcp.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW We highlight recent advances in the understanding of how environmental and occupational exposures increase the risk of developing interstitial lung disease (ILD), and how to evaluate a patient for potential exposures. RECENT FINDINGS A review of emerging literature suggests that environmental and occupational exposures can be directly causal, as in the case of the pneumoconioses and smoking-related ILDs, or one of many contributors to disease, as in the case of idiopathic pulmonary fibrosis (IPF). Regardless of the level of association, exposures are clearly prevalent across all ILD subtypes studied. SUMMARY Inhalational exposures are increasingly recognized as an important component in the development of ILDs, and novel exposure-disease associations continue to be discovered. These exposures represent potential opportunities for further understanding the pathobiology of disease and for the prevention of these often progressive and debilitating disorders. Prospective, comprehensive data collection regarding occupational and environmental exposures are needed in ILD patients to fully elucidate specific antigens and their relationships to disease incidence and outcomes. Systematically collected exposure information will also inform potential interventions to remediate exposures and thus mitigate the course of frequently progressive and fatal diseases.
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Affiliation(s)
- Cathryn T Lee
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Johanna Feary
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Kerri A Johannson
- Department of Medicine
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Blackley BH, Anderson KR, Panagakos F, Chipps T, Virji MA. Efficacy of dental evacuation systems for aerosol exposure mitigation in dental clinic settings. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:281-294. [PMID: 35289720 PMCID: PMC9365099 DOI: 10.1080/15459624.2022.2053140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Dental personnel are ranked among the highest risk occupations for exposure to SARS-CoV-2 due to their close proximity to the patient's mouth and many aerosol generating procedures encountered in dental practice. One method to reduce aerosols in dental settings is the use of intraoral evacuation systems. Intraoral evacuation systems are placed directly into a patient's mouth and maintain a dry field during procedures by capturing liquid and aerosols. Although multiple intraoral dental evacuation systems are commercially available, the efficacy of these systems is not well understood. The objectives of this study were to evaluate the efficacy of four dental evacuation systems at mitigating aerosol exposures during simulated ultrasonic scaling and crown preparation procedures. We conducted real-time respirable (PM4) and thoracic (PM10) aerosol sampling during ultrasonic scaling and crown preparation procedures while using four commercially available evacuation systems: a high-volume evacuator (HVE) and three alternative intraoral systems (A, B, C). Four trials were conducted for each system. Respirable and thoracic mass concentrations were measured during procedures at three locations including (1) near the breathing zone (BZ) of the dentist, (2) edge of the dental operatory room approximately 0.9 m away from the mannequin mouth, and (3) hallway supply cabinet located approximately 1.5 m away from the mannequin mouth. Respirable and thoracic mass concentrations measured during each procedure were compared with background concentrations measured in each respective location. Use of System A or HVE reduced thoracic (System A) and respirable (HVE) mass concentrations near the dentist's BZ to median background concentrations most often during the ultrasonic scaling procedure. During the crown preparation, use of System B or HVE reduced thoracic (System B) and respirable (HVE or System B) near the dentist's BZ to median background concentrations most often. Although some differences in efficacy were noted during each procedure and aerosol size fraction, the difference in median mass concentrations among evacuation systems was minimal, ranging from 0.01 to 1.48 µg/m3 across both procedures and aerosol size fractions.
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Affiliation(s)
- Brie Hawley Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Kimberly R. Anderson
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Fotinos Panagakos
- School of Dentistry, West Virginia University, Morgantown, West Virginia
| | - Tammy Chipps
- School of Dentistry, West Virginia University, Morgantown, West Virginia
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Tiraboschi MM, Sala E, Ferroni M, Tironi A, Borghesi A, Gilberti ME, Ceruti P, Sansone E, De Palma G. Early signs of pneumoconiosis in a dental technician in Italy: a case report. BMC Pulm Med 2021; 21:352. [PMID: 34743717 PMCID: PMC8572569 DOI: 10.1186/s12890-021-01721-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 10/28/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Dental technicians are at high risk of pneumoconiosis, usually driven by inhalation of mixed dusts, including metals. An etiological diagnosis is not easy to be performed, particularly in advanced stages. CASE PRESENTATION We describe the case of an early pneumoconiosis occurring in a 47-year-old dental technician who developed respiratory symptoms shortly after beginning work. She described the work environment as dusty and lacking relevant primary prevention tools. A chest CT showed multiple peripheral pseudonodular lesions in both lower lobes; bronchoalveolar lavage and bronchial aspirate evidenced numerous macrophages with reflective metal bodies included into the cytoplasm, that at scanning electron microscopy coupled to Energy Dispersive X-Ray Analysis resulted Zirconium and Aluminum, whereas Tungsten (W) was localized outside cells. End of shift urinary concentrations of W were substantially raised as compared to pre-shift (1.1 vs. 0.2 µg/L). CONCLUSIONS We concluded for diagnosis of early work-related pneumoconiosis due to abnormal occupational exposure to metals. The case demonstrates the need also for dental professionals to comply with industrial hygiene standards and to be monitored by occupational health physicians.
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Affiliation(s)
- Mara Maria Tiraboschi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, Brescia, Italy
| | - Emma Sala
- Occupational Health, Occupational Hygiene, Toxicology and Prevention Unit, University Hospital "Spedali Civili Di Brescia", Brescia, Italy
| | - Matteo Ferroni
- CNR-Institute of Microelectronics and Microsystems, Bologna, Italy.,Department of Civil, Environmental, Architectural Engineering and Mathematics, University of Brescia, Brescia, Italy
| | - Andrea Tironi
- Pathology Department, University Hospital "Spedali Civili Di Brescia", Brescia, Italy
| | - Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Radiological Sciences, University of Brescia, Brescia, Italy
| | - Maria Enrica Gilberti
- Occupational Health, Occupational Hygiene, Toxicology and Prevention Unit, University Hospital "Spedali Civili Di Brescia", Brescia, Italy
| | - Paolo Ceruti
- Pulmonology Department, University Hospital "Spedali Civili Di Brescia", Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, Brescia, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, Brescia, Italy. .,Occupational Health, Occupational Hygiene, Toxicology and Prevention Unit, University Hospital "Spedali Civili Di Brescia", Brescia, Italy.
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Geisinger ML, Iaonnidou E. Up in the Air? Future Research Strategies to Assess Aerosols in Dentistry. JDR Clin Trans Res 2021; 6:128-131. [PMID: 33719672 DOI: 10.1177/2380084420982506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT Recent reports on the airborne transmission of respiratory diseases, including COVID-19, have highlighted a need for investigation of dental aerosols and their infectious potential.
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Affiliation(s)
- M L Geisinger
- Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA
| | - E Iaonnidou
- Department of Periodontology, University of Connecticut College of Dental Medicine, Farmington, CT, USA
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Stoeva I. Respiratory symptoms of exposure to substances in the workplace among Bulgarian dentists. Community Dent Oral Epidemiol 2020; 49:128-135. [PMID: 33104273 DOI: 10.1111/cdoe.12584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 09/17/2020] [Accepted: 09/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Dentists are exposed to a variety of airborne chemicals that can act as irritants and sensitizers and may give rise to work-related respiratory symptoms. The aim of this study was to estimate the prevalence of respiratory symptoms of exposure to substances in the workplace and associated risk factors in Bulgarian dentists. METHODS A cross-sectional study was performed among Bulgarian dentists by using a self-report questionnaire. A direct acyclic graph (DAG) was elaborated to illustrate the direct and indirect causal pathways between exposure to irritants and/or allergens from dental environment and work-related respiratory symptoms among dentists. Multiple logistic regression analysis was conducted in order to investigate the relationship between sex, work experience, daily exposure to chemicals from dental environment, history of atopic disorder and work-related respiratory symptoms. RESULTS A total of 4675 dentists completed the questionnaire (response rate 48.1%). The prevalence of self-reported work-related respiratory symptoms was 20.7%. The most common repeated causes of respiratory reactions were disinfectants (65.7%) and materials based on acrylic resins (29.7%). Factors associated with work-related respiratory symptoms are personal history of asthma (odds ratio (OR) 2.50, 95% confidence interval [CI]: 1.71-3.64), work experience >20 years (OR 2.17, 95% CI: 1.74-2.70) and female gender (OR 2.14, 95% CI: 1.81-2.56). CONCLUSION Work-related respiratory symptoms are frequent among dentists and indicate a need for efforts to establish effective programmes and techniques of reducing or eliminating direct exposure to airborne chemicals in the dental environment.
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Affiliation(s)
- Iliyana Stoeva
- Department of Diagnostic Imaging, Dental Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
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Arsal Yıldırım S, Pekey B, Pekey H. Assessment of occupational exposure to fine particulate matter in dental prosthesis laboratories in Kocaeli, Turkey. ENVIRONMENTAL MONITORING AND ASSESSMENT 2020; 192:667. [PMID: 33006063 DOI: 10.1007/s10661-020-08620-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Dental prosthesis laboratories (DPLs) are among the workplaces where predominantly manual production takes place. In such working environments, during the manual manufacturing process, which involves fine smoothing and polishing of dental prostheses, fine particulate matter is released into the ambient air. In this study, the particulate matter (PM) concentrations and elemental content of the fine particles in the working ambient air were identified in six DPLs in Kocaeli, Turkey. PM2.5 mass concentrations, measured in all the DPLs, ranged between 80.8 and 1645 μg/m3 (mean 414 ± 406). As a result of the analyses performed with an ICP-MS device (Perkin Elmer Elan®DRC-e), trace elements of Be, Cd, Hg, and, notably, Co, Cr, Mo, and Ni were found. The researchers calculated the excess lifetime cancer risks and total hazard indexes. The average total cancer risk for all the DPLs was 8 × 10-3, which is higher than the acceptable limit of 1.0 × 10-6, and the total hazard index was 187, which is greater than the acceptable limit of 1.0. Considering these high-level risks, the study concluded that there is a need for new production methods, and strict application of occupational health and safety measures, to reduce the fine particle exposure of the workers in the laboratories. In addition, there are prescribed limit values for particulate matter only for respirable particles in working environments. The establishment of limit values, especially for PM2.5 concentrations, is important for the protection of the health of the employees.
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Affiliation(s)
- Serap Arsal Yıldırım
- Vocational School of Kocaeli Health Sciences, Kocaeli University, Kocaeli, Turkey.
| | - Beyhan Pekey
- Department of Environmental Engineering, Kocaeli University, Kocaeli, Turkey
| | - Hakan Pekey
- Department of Environmental Engineering, Kocaeli University, Kocaeli, Turkey
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11
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Safety in dental care: Where is our surveillance imperative? J Am Dent Assoc 2020; 151:381-383. [PMID: 32450973 DOI: 10.1016/j.adaj.2020.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 01/05/2023]
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12
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Otoupalova E, Smith S, Cheng G, Thannickal VJ. Oxidative Stress in Pulmonary Fibrosis. Compr Physiol 2020; 10:509-547. [PMID: 32163196 DOI: 10.1002/cphy.c190017] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Oxidative stress has been linked to various disease states as well as physiological aging. The lungs are uniquely exposed to a highly oxidizing environment and have evolved several mechanisms to attenuate oxidative stress. Idiopathic pulmonary fibrosis (IPF) is a progressive age-related disorder that leads to architectural remodeling, impaired gas exchange, respiratory failure, and death. In this article, we discuss cellular sources of oxidant production, and antioxidant defenses, both enzymatic and nonenzymatic. We outline the current understanding of the pathogenesis of IPF and how oxidative stress contributes to fibrosis. Further, we link oxidative stress to the biology of aging that involves DNA damage responses, loss of proteostasis, and mitochondrial dysfunction. We discuss the recent findings on the role of reactive oxygen species (ROS) in specific fibrotic processes such as macrophage polarization and immunosenescence, alveolar epithelial cell apoptosis and senescence, myofibroblast differentiation and senescence, and alterations in the acellular extracellular matrix. Finally, we provide an overview of the current preclinical studies and clinical trials targeting oxidative stress in fibrosis and potential new strategies for future therapeutic interventions. © 2020 American Physiological Society. Compr Physiol 10:509-547, 2020.
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Affiliation(s)
- Eva Otoupalova
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sam Smith
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Guangjie Cheng
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Victor J Thannickal
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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13
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Ranzieri S, Illica Magrini E, Mozzoni P, Andreoli R, Pelà G, Bertorelli G, Corradi M. Idiopathic pulmonary fibrosis and occupational risk factors. LA MEDICINA DEL LAVORO 2019; 110:407-436. [PMID: 31846447 PMCID: PMC7809935 DOI: 10.23749/mdl.v110i6.8970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/22/2019] [Indexed: 12/28/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a rare lung disease of unknown origin that rapidly leads to death. However, the rate of disease progression varies from one individual to another and is still difficult to predict. The prognosis of IPF is poor, with a median survival of three to five years after diagnosis, without curative therapies other than lung transplantation. The factors leading to disease onset and progression are not yet completely known. The current disease paradigm is that sustained alveolar epithelial micro-injury caused by environmental triggers (e.g., cigarette smoke, microaspiration of gastric content, particulate dust, viral infections or lung microbial composition) leads to alveolar damage resulting in fibrosis in genetically susceptible individuals. Numerous epidemiological studies and case reports have shown that occupational factors contribute to the risk of developing IPF. In this perspective, we briefly review the current understanding of the pathophysiology of IPF and the importance of occupational factors in the pathogenesis and prognosis of the disease. Prompt identification and elimination of occult exposure may represent a novel treatment approach in patients with IPF.
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Affiliation(s)
- Silvia Ranzieri
- Dipartimento di Medicina e Chirurgia - Università di Parma .
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14
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Wang M, Gauthier A, Daley L, Dial K, Wu J, Woo J, Lin M, Ashby C, Mantell LL. The Role of HMGB1, a Nuclear Damage-Associated Molecular Pattern Molecule, in the Pathogenesis of Lung Diseases. Antioxid Redox Signal 2019; 31:954-993. [PMID: 31184204 PMCID: PMC6765066 DOI: 10.1089/ars.2019.7818] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/07/2019] [Indexed: 12/11/2022]
Abstract
Significance: High-mobility group protein box 1 (HMGB1), a ubiquitous nuclear protein, regulates chromatin structure and modulates the expression of many genes involved in the pathogenesis of lung cancer and many other lung diseases, including those that regulate cell cycle control, cell death, and DNA replication and repair. Extracellular HMGB1, whether passively released or actively secreted, is a danger signal that elicits proinflammatory responses, impairs macrophage phagocytosis and efferocytosis, and alters vascular remodeling. This can result in excessive pulmonary inflammation and compromised host defense against lung infections, causing a deleterious feedback cycle. Recent Advances: HMGB1 has been identified as a biomarker and mediator of the pathogenesis of numerous lung disorders. In addition, post-translational modifications of HMGB1, including acetylation, phosphorylation, and oxidation, have been postulated to affect its localization and physiological and pathophysiological effects, such as the initiation and progression of lung diseases. Critical Issues: The molecular mechanisms underlying how HMGB1 drives the pathogenesis of different lung diseases and novel therapeutic approaches targeting HMGB1 remain to be elucidated. Future Directions: Additional research is needed to identify the roles and functions of modified HMGB1 produced by different post-translational modifications and their significance in the pathogenesis of lung diseases. Such studies will provide information for novel approaches targeting HMGB1 as a treatment for lung diseases.
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Affiliation(s)
- Mao Wang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Alex Gauthier
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - LeeAnne Daley
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Katelyn Dial
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Jiaqi Wu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Joanna Woo
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Mosi Lin
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Charles Ashby
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
| | - Lin L. Mantell
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, New York
- Center for Inflammation and Immunology, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
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Pulmonary Function Testing in Dentists Versus Controls: A Pilot Study Exploring the Potential Respiratory-Related Occupational Hazards of Dentistry. J Occup Environ Med 2019; 61:924-926. [PMID: 31464815 DOI: 10.1097/jom.0000000000001702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Minimal research exists evaluating respiratory-related occupational hazards associated with dentistry in the United States. The purpose of this study was to evaluate the pulmonary function of dentists as compared with controls. METHODS This is a case-control study evaluating pulmonary function in dentists versus controls. Outcomes included measurements of percent predicted FEV1 (FEV1%), percent of predicted FVC (FVC%), and forced expiratory volume in one second (FEV1)/forced vital capacity (FVC). RESULTS Our findings indicate that dentists had a statistically significant lower percent predicted FEV1% (P < 0.05) and FVC% (P < 0.05) compared with controls. The prevalence of abnormal FVC% and FEV1% was greater among dentists, but only the increase in abnormal FEV1% approached significance. CONCLUSIONS Dentists had lower percent predicted values for FVC% and FEV1% versus controls. More research is required to further investigate the association between the dental profession and pulmonary function in dentists.
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16
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Nilsen BW, Jensen E, Örtengren U, Bang B, Michelsen VB. Airborne exposure to gaseous and particle-associated organic substances in resin-based dental materials during restorative procedures. Eur J Oral Sci 2019; 127:425-434. [PMID: 31313386 DOI: 10.1111/eos.12646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 12/31/2022]
Abstract
Dental composite dust has been shown to act as a vehicle for methacrylates in vivo/in vitro. The objective of this study was to assess airborne exposure of dental personnel to gaseous and particle-associated organic constituents from resin-based dental materials in a simulated clinic. Sampling of total aerosol fractions and gaseous substances was performed by dental students carrying particle filters and gas sorbents attached to a personal pump during preclinical restorative procedures in phantom models (n = 13). Water from the phantoms was sampled. Organic substances were extracted from the sampled water, particle filters, and gas sorbents. Qualitative and quantitative analyses were performed by gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). The methacrylates 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) and the additives camphorquinone (CQ), butylated hydroxytoluene (BHT), and ethyl 4-(dimethylamino)benzoate (DMABEE), were quantified in the gas and particle fractions sampled. A positive-control experiment was conducted. No methacrylates were detected in the gas or particle fractions sampled, whereas strong signals for methacrylates were detected in the positive controls, matching the analysis of the uncured material. In addition, TEGDMA and DMABEE were quantified in the sampled water. Airborne exposure to constituents in resin-based dental materials was below the detection limit. However, the extent of exposure is probably dependent on the procedure, preventive measures, and type of materials used.
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Affiliation(s)
- Bo W Nilsen
- Department of Clinical Dentistry, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Einar Jensen
- Department of Pharmacy, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Ulf Örtengren
- Department of Clinical Dentistry, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Cariology, Institute of Odontology/Sahlgrenska Academy, Gothenburg, Sweden
| | - Berit Bang
- Department of Medical Biology, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
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Lamster IB. A recently identified respiratory hazard affecting dentists. Int Dent J 2018; 68:297-298. [PMID: 30255940 DOI: 10.1111/idj.12438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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