南非牙科保健机构内内毒素暴露的工作场所决定因素。

Workplace determinants of endotoxin exposure in dental healthcare facilities in South Africa.

作者信息

Singh Tanusha S, Bello Braimoh, Mabe Onnicah D, Renton Kevin, Jeebhay Mohamed F

机构信息

Immunology and Microbiology Section, National Institute for Occupational Health, PO Box 4788, Johannesburg 2000, South Africa.

出版信息

Ann Occup Hyg. 2010 Apr;54(3):299-308. doi: 10.1093/annhyg/mep095. Epub 2009 Dec 31.

DOI:10.1093/annhyg/mep095

PMID:20044586

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2848299/

Abstract

OBJECTIVES

Aerosols generated during dental procedures have been reported to contain endotoxin as a result of bacterial contamination of dental unit water lines. This study investigated the determinants of airborne endotoxin exposure in dental healthcare settings.

METHODS

The study population included dental personnel (n = 454) from five academic dental institutions in South Africa. Personal air samples (n = 413) in various dental jobs and water samples (n = 403) from dental handpieces and basin taps were collected. The chromogenic-1000 limulus amebocyte lysate assay was used to determine endotoxin levels. Exposure metrics were developed on the basis of individually measured exposures and average levels within each job category. Analysis of variance and multivariate linear regression models were constructed to ascertain the determinants of exposure in the dental group.

RESULTS

There was a 2-fold variation in personal airborne endotoxin from the least exposed (administration) to the most exposed (laboratory) jobs (geometric mean levels: 2.38 versus 5.63 EU m(-3)). Three percent of personal samples were above DECOS recommended exposure limit (50 EU m(-3)). In the univariate linear models, the age of the dental units explained the most variability observed in the personal air samples (R(2) = 0.20, P < 0.001), followed by the season of the year (R(2) = 0.11, P < 0.001). Other variables such as institution and total number of dental units per institution also explained a modest degree of variability. A multivariate model explaining the greatest variability (adjusted R(2) = 0.40, P < 0.001) included: the age of institution buildings, total number of dental units per institution, ambient temperature, ambient air velocity, endotoxin levels in water, job category (staff versus students), dental unit model type and age of dental unit.

CONCLUSIONS

Apart from job type, dental unit characteristics are important predictors of airborne endotoxin levels in this setting.

摘要

目的

据报道，牙科诊疗过程中产生的气溶胶因牙科设备水管受到细菌污染而含有内毒素。本研究调查了牙科医疗环境中空气传播内毒素暴露的决定因素。

方法

研究人群包括来自南非五所牙科学院的牙科工作人员（n = 454）。采集了各种牙科工作岗位的个人空气样本（n = 413）以及牙科手机和水槽水龙头的水样（n = 403）。采用显色-1000鲎试剂法测定内毒素水平。根据个体测量的暴露量和每个工作类别内的平均水平制定暴露指标。构建方差分析和多元线性回归模型以确定牙科组中暴露的决定因素。

结果

从暴露最少的岗位（行政岗位）到暴露最多的岗位（实验室岗位），个人空气中内毒素水平有2倍的差异（几何平均水平：2.38对5.63 EU m(-3)）。3%的个人样本超过了DECOS推荐的暴露限值（50 EU m(-3)）。在单变量线性模型中，牙科设备的使用年限解释了个人空气样本中观察到的最大变异性（R(2) = 0.20，P < 0.001），其次是一年中的季节（R(2) = 0.11，P < 0.001）。其他变量，如机构和每个机构的牙科设备总数，也解释了一定程度的变异性。一个解释最大变异性的多变量模型（调整后R(2) = 0.40，P < 0.001）包括：机构建筑的使用年限、每个机构的牙科设备总数、环境温度、环境空气流速、水中内毒素水平、工作类别（工作人员与学生）、牙科设备型号和牙科设备的使用年限。