Ingrid Åkesson

Status of Mercury and Selenium in Dental Personnel: Impact of Amalgam Work and Own Fillings

Urinary mercury (U-Hg) and plasma mercury (P-Hg) levels were higher in 244 dental personnel than in 81 matched referents (U-Hg: 1.8 and 1.1 mumol/mol creatinine, respectively; p less than .001; P-Hg: 6.7 and 6.2 nmol/l, respectively; p = .03). The amalgam in the mouth influenced mercury levels in whole blood (B-Hg), plasma, and urine. The association was nonlinear: the more amalgam, the larger the relative increase in mercury levels. The number of amalgam surfaces accounted for more of the variance in blood and urine mercury levels than did the number of fillings (e.g., U-Hg: 44% and 36%, respectively). The estimated increases in mercury level with rising amalgam load were 3.0%, 2.0%, and 0.8% per filled surface for U-Hg, P-Hg, and B-Hg, respectively (p less than .0001 in all cases). The impact of occupational exposure on U-Hg in the dental personnel corresponded to approximately 19 amalgam surfaces. Ceramo metallic restorations were associated with higher (31%) U-Hg.

Risk of musculoskeletal disorders among females and males in repetitive/constrained work

This paper combines epidemiological data on musculoskeletal morbidity in 40 female and 15 male occupational groups (questionnaire data 3720 females, 1241 males, physical examination data 1762 females, 915 males) in order to calculate risk for neck and upper limb disorders in repetitive/constrained vs. varied/mobile work and further to compare prevalence among office, industrial and non-office/non-industrial settings, as well as among jobs within these. Further, the paper aims to compare the risk of musculoskeletal disorders from repetitive/constrained work between females and males. Prevalence ratios (PR) for repetitive/constrained vs. varied/mobile work were in neck/shoulders: 12-month complaints females 1.2, males 1.1, diagnoses at the physical examination 2.3 and 2.3. In elbows/hands PRs for complaints were 1.7 and 1.6, for diagnoses 3.0 and 3.4. Tension neck syndrome, cervicalgia, shoulder tendonitis, acromioclavicular syndrome, medial epicondylitis and carpal tunnel syndrome showed PRs > 2. In neck/shoulders PRs were similar across office, industrial and non-office/non-industrial settings, in elbows/hands, especially among males, somewhat higher in industrial work. There was a heterogeneity within the different settings (estimated by bootstrapping), indicating higher PRs for some groups. As in most studies, musculoskeletal disorders were more prevalent among females than among males. Interestingly, though, the PRs for repetitive/constrained work vs. varied/mobile were for most measures approximately the same for both genders. In conclusion, repetitive/constrained work showed elevated risks when compared to varied/mobile work in all settings. Females and males showed similar risk elevations. This article enables comparison of risk of musculoskeletal disorders among many different occupations in industrial, office and other settings, when using standardised case definitions. It confirms that repetitive/constrained work is harmful not only in industrial but also in office and non-office/non-industrial settings. The reported data can be used for comparison with future studies.

Neuropathy in female dental personnel exposed to high frequency vibrations

OBJECTIVE--To evaluate early neuropathy in dental personnel exposed to high frequency vibrations. METHODS--30 dentists and 30 dental hygienists who used low and high speed hand pieces and ultrasonic scalers were studied, and 30 dental assistants and 30 medical nurses not exposed to vibration (all women). Vibrotactile sensibility, strength, motor performance, sensorineural symptoms and signs, and vascular symptoms in the hands, as well as mercury concentrations in biological samples and cervicobrachial symptoms, were studied. RESULTS--The two groups exposed to vibration had significant impairments of vibrotactile sensibility, strength, and motor performance, as well as more frequent sensorineural symptoms. In the dentists there were significant associations between the vibrotactile sensibility and strength, motor performance, superficial sensibility, and sensorineural symptoms. There were no associations between these findings and cervicobrachial symptoms, mercury concentrations, or smoking. There was no increase of vascular symptoms of the hands in the groups exposed to vibration. CONCLUSION--Dental hygienists and dentists had a slight neuropathy, which may be associated with their exposure to high frequency vibrations, and which may be detrimental to their work performance. Thus, development of safer equipment is urgent.

Physical workload in neck, shoulders and wrists/hands in dental hygienists during a work-day.

Physical workload was recorded by electromyography, inclinometry and goniometry for twelve female dental hygienists during authentic work. Their work was, in relation to other types of work, characterised by pronounced head flexion (90th percentile 46°), high loads on the forearm extensor muscles (90th percentile 23% and 18% of maximal EMG (MVE), for the right and left sides, respectively), average loads on trapezius muscles (90th percentile 15% and 14% MVE), average arm elevation (99th percentile 83° and 72°) and average wrist flexion and velocities (50th percentiles 17° of extension and 7.3°/s, for the right side). Manual scaling and machinery (use of ultrasonic scaling and hand-pieces) showed higher loads on the trapezius muscles, regarding muscular rest, as well as the 10th and 50th percentiles, than the other tasks, and for the forearm extensor muscles, an almost complete lack of muscular rest (0.1% time), and much higher loads regarding the 10th and 50th percentiles. Further, more pronounced head flexion and lower head and upper arm velocities were found, indicating more constrained postures for the neck and shoulders for the manual scaling and machinery. Use of ultrasonic scaler reduced the 50th percentile loads on the right forearm extensor muscles, but had no effect on the fraction of muscular rest and on the 10th percentile load. These findings are consistent with the high prevalences of musculoskeletal disorders among dental hygienists.

Wrist movements among females in a repetitive, non-forceful work.

Wrist positions and movements were measured and a physical examination was conducted in 12 female operators in an industrial quality-control work. The handled products are of very low weight, thus, the work can be considered as non-forceful. The work was highly repetitive; 0.54Hz for the right wrist/hand and 0.41Hz for the left. The angular velocities were also high; for the right wrist/hand median value was 30 degrees /s and peak value 108 degrees /s, for the left wrist/hand 24 degrees /s and 88 degrees /s, respectively. The frequency of musculoskeletal disorders was high, especially for the right wrist/hand. Although the work was non-forceful and there were minor extreme positions in the wrists, the results are consistent with reported exposure-response relations in other high-risk jobs. Thus, the repetitiveness and the high velocities are the likely causes for the high prevalence of disorders in the wrists/hands among the operators.

Evaluation of a Workplace Redesign of a Grocery Checkout System

The aim of this study was to evaluate the effects on the working postures and movements of a cashier when two different locations of the scales (one to the left of the cashier, the other under the conveyer belt in front of the cashier) were used in a grocery checkout system. Two cashiers (of average stature and short stature) were videotaped while working, in both sitting and standing working positions. Analysis of the video tapes was performed using the WOPALAS method and video observations. The results of the study show that the design of the checkout system with the scales under the conveyer belt provides a more favourable working position for both the taller and the shorter cashier. Additionally, the results indicate that a standing position is more favourable than a sitting one for the taller cashier while for the shorter cashier the sitting position is better.