Hygienic assessment of occupational factors at rural dentists' working places

In connection with rough development of the medical industry recently there was a sharp change a working condition in dentists clinics. The new engineering, technology, toolkit, the equipment and medicines constantly take root into dentists practice. On the one hand, it raises quality of treatment and facilitates work of the doctor, with another - puts it in new operating conditions, it is not enough or at all not investigated from the point of view of hygiene of work. Earlier in dentists studies such adverse factors of the industrial environment, as a unsatisfactory condition of air, insufficient illumination of studies, danger of application amalgam stopping, an opportunity of infection from patients and some other were marked basically [1].

Now the attention of hygienists should be switched to influence of new kinds of the dentists equipment new stopping materials, allergic influence of the chemical substances used in dentist, on pollution of the air environment in premises dental surgery and disease of dentists and dental techniques.

Studying of hygiene of work of medical workers in general, and workers of dentists polyclinics in particular till now has not received necessary development. If earlier a trade of the doctor counted more or less free from industrial harmful factors now any more the secret, that on an organism of doctors can influence up to 500 various harmful factors [2]. There are only data on existence of adverse professional factors of work of dentists to which are carried the compelled working pose, influence of applied medicines, influence of physical and chemical factors of the production environment in literature [3, 4, 5].

If influence of noise on doctors of all other specialties does not represent the big problem for dentists influence of noise is an actual problem. Already about fifty years in dentists practice it is applied high-speed drill and turbines. Their application eliminates painful sensations at the patient at manipulations in carious cavities of a teeth, accelerates grinding and other processing's of a teeth, reduces loading on hands of the doctor. At the same time air or water cooling, obligatory at work of a pine forest, promotes dispersion in air of an aerosol from an oral cavity of the patient where the pathogenic micro flora quite often contains. It has caused to life a question on preliminary processing an oral cavity of the patient with the purpose of destruction of a source of an infection. Allocation in air of pathogenic flora from a mouth of the patient, finally, will result to pollution of dentist studies. The question on struggle with pollution of dentist studies till now to the right degree is not developed.

At work of the dentist equipment, in particular, the highspeed turbines, accelerating momentum rotations up to 200-400 thousand revolutions one minute, the maximal energy of a sound fall to frequency of 8000 hertz.

Concerning an opportunity of occurrence of pathology of hearing workers of dentist studies still do not have common opinion. One researchers deny cause a role of noise in occurrence disease of an ear at doctors - dentists, others cite the data on occurrence of left-hand relative deafness at the dentists working on turbines. As if to vibration as harmful production factor at dentists still there are no convincingly proved data neither for the benefit of pathogenicity, nor for the benefit of indifference of vibration in conditions of dentist studies.

Feature of work of the dentists and dental technicians is that in each industrial premise(room) dental laboratories are marked specific the harm, connected with air pollution by various chemical substances in various modular conditions (a dust, pairs, gases) among which are found out toxic: mercury, cadmium, lead, carbon oxide, an acid and alkali, SiO2, acrylate etc. [6]. Except for the named substances, is present also set of others, which influence in conditions dental surgery remains while obscure. During manufacturing metal dental artificial limbs gold, silver, platinum, chrome, nickel, the titan, molybdenum, cobalt etc. which pairs are formed in time swimming trunks, a dust - is used about 20 metals, for example during machining artificial limbs. In this connection the purpose of the present researches was studying influence of chemical factors on working conditions and disease of dentists in a number of rural dentists' working places. The preliminary data show, that take place and nevertheless till now in sanitary normative documents are not established concentration of some harmful substances in air dental surgery. The problem of an allergy in dentist is especially actual. On the literary data in this area of medicine it is used more than 500 chemical substances, capable to cause allergic reactions not only at patients, but also at doctors. On the literary data of 15 % of dentists suffer from allergenic influence of medicines and materials. Long time in hygiene of work of dentists remained conducting a "mercury" problem in connection with wide application of an amalgam [7].

Now in modern dentist studies at us in the country the amalgam is not applied, though in foreign countries it still finds wide application.

It is not carried out yet researches which results would spill light on character of the combined action of materials and the preparations used in dental surgery practice and capable in this or that measure to harm health of dentists and dental technicians. In this plan wide prospect for experimental and epidemiological researches open.

Thus, hygiene of work of doctors of dentists and dental technicians remains yet not solved, but very actual problem.

REFERENCES

1. Донская Л.В., Лингевский Э.Э. Психо-физиологические аспекты труда работников сферы обслуживания. - Л.: 1979.
2. Минаков В.Ф. Труд и здоровья медицинских работников/ Минаков В.Ф., Г.И.Кучеренко, Е.И.Сошников и др.// Под.ред.В.К.Овчаров. - М.: Медицина, 1985. – 216 c.
3. Вартиковский А.М. Стоматология. - 1993. - №2. - С. 83-84.
4. Иващенко Г.Н. Стоматология. - 1993. - №2. - С. 84-89.
5. Schobel R. Stomat. DDR. - 1994. - Bd 24. - P 845-849.
6. Капцов В.А. Методические подходы к созданию системы комплексной оценки условий труда и состояния здоровья медицинских работников /В.А.Капцов, Л.П.Коротич, Т.С.Алферов и др./ Труд и здоровье медицинских работников. Тез.докл. Всесоюзконф. «Труд и здоровье медицинских работников» под.ред. В.А.Капцова.-Ереван: 3-5 октября 1984г.- М.:2004. - C.52-56.
7. Дегтерева, Э.П. Гигиена труда стоматологов-ортопедов медицинских учреждений различной формы собственности: автореф. дис. кандидат мед. наук / Дегтерева Э.П. – Волгоград: 2004. – 19с.