Occupational lung diseases among dental technicians

Our plain-English summary of Occupational lung diseases among dental technicians, by D. Choudat (Tubercle and Lung Disease, 1994).

The study

• Author: D. Choudat
• Journal: Tubercle and Lung Disease
• Published: 1994;75(2):99-104
• Type of article: Review
• Cited by: 30 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Dental technicians are exposed to various dusts including silica, alloys, and acrylic plastics which may induce pneumoconiosis and probably other occupational lung diseases. The prevalence of pneumoconiosis is very high and related to the duration of exposure: 3 epidemiological studies have found a prevalence of pneumoconiosis 1/0 or greater of about 15% in technicians with 20 or more years' exposure. However, silica is probably not the sole causative agent. In addition to pneumoconiosis, this occupational exposure may induce minor lung function impairment, especially among smokers. However, the effect of cigarette smoking on lung function is greater than the effect of occupational exposure. Cases of occupational asthma, bronchial cancer and mesothelioma, and connective tissue diseases have been reported and are suspected to be work related, but epidemiological studies are needed. Pneumoconiosis is a frequent risk among dental technicians and compensation should be paid to those suffering from this work-related disease. Information about occupational lung diseases and adequate technical prevention measures are necessary for dental technicians.

In plain English

This was a review article by a single author from Paris, France, on lung disease among dental technicians, who make dental prostheses. The author described their exposure to dusts including silica, aluminium oxide, metal alloys (some containing beryllium) and acrylic plastics. The author also noted that asbestos was no longer used in France. The review compared six epidemiological studies of pneumoconiosis, a dust-related lung disease, from Switzerland, the United States, Germany, Denmark and France. In the author's own earlier Paris study, 11.8% of technicians had chest X-ray small opacities of 1/0 or greater, for a mean exposure of 28.4 years. Among technicians with 20 or more years' exposure, the figure was 15.4% in France and 16.7% in Utah. The author cautioned that recruitment differed between studies and that silica was probably not the only cause. Smoking affected lung function more than work exposure did. A few cases of bronchial cancer and mesothelioma had been described, possibly due to asbestos and perhaps silica or alloys, but the author said epidemiological studies were needed. The author concluded that compensation should be paid to those with pneumoconiosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: review article
• Who was studied: Dental technicians, as described in published case reports and in six epidemiological studies of pneumoconiosis from five countries: Lausanne (Switzerland), Salt Lake City (USA), Frankfurt and Hamburg (Germany), Copenhagen (Denmark) and Paris (France). These included the author's own earlier study of 102 dental technicians in Paris.
• Exposure: Dusts from making dental prostheses: silica (in abrasive powders and refractory materials), aluminium oxide, plastics such as methyl methacrylate, and alloys including precious metals and nickel-chromium-cobalt alloys, some containing beryllium. Asbestos was mentioned as a past exposure no longer used in France.
• Main results:
  • In the author's own Paris study, the prevalence of small opacities of 1/0 or greater was 11.8% for a mean exposure of 28.4 years
  • Among technicians with 20 or more years' exposure, pneumoconiosis prevalence was 15.4% in France and 16.7% in Utah
  • Lung biopsy did not always find silicotic nodules. The author considered that silica was probably only one of several factors behind dental technicians' pneumoconiosis.
  • In the studies reviewed, cigarette smoking had a greater effect on lung function than occupational exposure
  • Few cases of bronchial cancer and mesothelioma had been described in dental technicians. The author suggested these may be due to asbestos, and perhaps silica or metallic alloys, and said studies accounting for smoking were needed to determine the risk.
  • Separately, the author noted that one case of mesothelioma related to asbestos exposure had been reported in a dentist (not a dental technician)
• The authors' conclusion: The author concluded that pneumoconiosis is a frequent risk among dental technicians and that compensation should be paid to those suffering from it. The author also concluded that information and adequate technical prevention measures are necessary. Other diseases, including cancers, were suspected to be work-related but needed epidemiological confirmation.
• Limitations the authors state:
  • The prevalences found by different studies varied widely, possibly because of differences in how subjects were recruited, in type and duration of exposure, and in diagnostic criteria
  • Recruitment bias may be large, since only two studies reported response rates: 55.8% in Utah and 32.9% of self-employed technicians in Paris
  • The risk of cancers such as mesothelioma among dental technicians was not established; epidemiological studies taking smoking into account were needed

Topics

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease, Pneumoconiosis, Occupational Exposure, Mesothelioma.

Related studies

• Dental technician's pneumoconiosis. A report of two cases — P. De Vuyst, R. Vande Weyer, et al. (1986)
• Respiratory morbidity in a population of French dental technicians — S. Radi, J.C. Dalphin, et al. (2002)
• Exposure to methyl methacrylate and its subjective symptoms among dental technicians, Tehran, Iran — F. Golbabaei, M. Mamdouh, et al. (2005)
• Pleural malignant mesothelioma in dental laboratory technicians: A case series — C. Mensi, F. Ciullo, et al. (2017)
• Surveillance of respiratory diseases among construction and trade workers at Department of Energy nuclear sites — J.M. Dement, L. Welch, et al. (2003)
• WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to dusts and/or fibres and of the effect of occupational exposure to dusts and/or fibres on pneumoconiosis — D. Mandrioli, V. Schlünssen, et al. (2018)

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