Gussgard Anne Margrete, Jokstad Asbjørn
Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
BDJ Open. 2025 May 25;11(1):52. doi: 10.1038/s41405-025-00342-8.
Modern oral healthcare extensively uses polymer items and devices derived from various monomeric compounds. These materials are essential for personal protective equipment, infection barriers, packaging, and intraoral devices. The COVID-19 pandemic has led to an increased reliance on single-use polymer items, causing supply chain disruptions and higher costs. This systematic review explores the extent of polymer waste and pollution generated in oral healthcare clinics.
A systematic review protocol was registered with PROSPERO and was formatted according to PRISMA guidelines and SWiM recommendations. Eligibility criteria included studies that provided quantified estimates of polymer waste or pollution in air or wastewater from oral healthcare clinics. Comprehensive electronic searches were conducted across several bibliometric databases, followed by data extraction and risk of bias assessments performed by two independent reviewers.
A total of thirty studies were included in the review. Sixteen papers reported on waste audits that detailed polymer waste data, while eight studies focused on pollution caused by polymer nano- and microparticles in clinical settings. Additionally, six experimental studies investigated potential leakage of monomeric eluates or polymer particles from landfill waste. There was significant variation in the amount of polymer waste generated per patient, ranging from 81 to 384 g per operatory room per day. On-site sampling revealed the presence of polymer nano- and microparticles in the clinic air, which was influenced by dental procedures and the equipment used.
This review highlights critical knowledge gaps about polymer waste and pollution in oral healthcare clinics. The variability of study designs limited the feasibility of meta-analysis. Current evidence indicates substantial polymer waste generation, particularly from single-use items, as well as potential environmental impacts from monomeric eluates and polymer microparticles. Future research should focus on sustainable polymer waste management solutions to reduce environmental pollution in oral healthcare settings.
现代口腔医疗广泛使用源自各种单体化合物的聚合物物品和器械。这些材料对于个人防护装备、感染屏障、包装以及口腔内器械至关重要。新冠疫情导致对一次性聚合物物品的依赖增加，造成供应链中断和成本上升。本系统评价探讨了口腔医疗诊所产生的聚合物废物和污染程度。
一项系统评价方案已在PROSPERO注册，并根据PRISMA指南和SWiM建议进行编排。纳入标准包括提供口腔医疗诊所空气中或废水中聚合物废物或污染量化估计值的研究。在多个文献计量数据库中进行了全面的电子检索，随后由两名独立评审员进行数据提取和偏倚风险评估。
本评价共纳入30项研究。16篇论文报告了废物审计情况，详细说明了聚合物废物数据，而8项研究聚焦于临床环境中聚合物纳米颗粒和微粒造成的污染。此外，6项实验研究调查了垃圾填埋场废物中单体洗脱液或聚合物颗粒的潜在泄漏情况。每位患者产生的聚合物废物量差异显著，每个手术室每天从81克到384克不等。现场采样显示诊所空气中存在聚合物纳米颗粒和微粒，这受到牙科操作和所用设备的影响。
本评价突出了口腔医疗诊所聚合物废物和污染方面的关键知识空白。研究设计的多样性限制了荟萃分析的可行性。目前的证据表明产生了大量聚合物废物，特别是来自一次性物品，以及单体洗脱液和聚合物微粒对环境的潜在影响。未来的研究应侧重于可持续的聚合物废物管理解决方案，以减少口腔医疗环境中的环境污染。
