STHMA IN THE WORKPLACE AA DENTAL HYGIENE PREVENTION FACT SHEET RF-534
A SIGNIFICANT GET THE FACTS AND WORK SMARTER If you re in the denta hygiene profession, there are heath risks you shoud know about. Getting the facts wi hep you work smarter and avoid certain practices that coud ead to occupationa asthma and rhinitis. Using commercia products, incuding atex goves, is one of the main risk factors that can cause or aggravate these respiratory diseases. READ THE SAFETY DATA-SHEETS FOR THE PRODUCTS YOU USE. MAKE SURE YOU UNDERSTAND WHAT S IN THEM. STUDY A study of 122 denta hygiene students in Québec reveaed that, from start to finish of their training: 1.8 % 6.4 % 4.5 % have symptoms of rhinitis on contact with atex goves. have deveoped an aergic sensitization to atex. have deveoped probabe occupationa asthma. FIND OUT ABOUT ASTHMA Asthma is a chronic respiratory disease that makes breathing especiay exhaing difficut. Asthma usuay resuts from aergies to certain substances in your environment. Its main symptoms are coughing, shortness of breath, wheezing and tightness in the chest. Asthma can aso be accompanied by symptoms of rhinitis and conjunctivitis. Asthma in the workpace can be: Caused by exposure to aergenic or irritant substances found in the earning or work environment; or Aggravated in somebody who is aready asthmatic by these irritant substances or physica factors (e.g., extreme ambient temperatures). In both cases, the symptoms get worse when the person performs training or work-reated tasks that carry a risk of exposure. They decrease or disappear outside the earning or work environment. ABOUT RHINITIS Rhinitis is a respiratory disease that causes infammation of the mucous membranes in the nose, stuffy nose, runny nose and eyes, and sneezing. UNDERSTAND THE RISK FACTORS As a denta hygiene student, you perform very simiar tasks to those in a denta cinic. The commercia products and raw materias you use coud cause or aggravate asthma. These products and materias are the major source of dust and vapor that irritate or sensitize the respiratory tract. You coud aso be directy exposed to a chemica substance through skin contact. Some fiing composites, disinfectant products and wearing atex goves, among other things, can ead to a heath risk. * Gautrin, D. et a, Rapport IRSST R-494, 2007
Insertion of fiing composite Production of impressions for mouth guards and trays Ceaning and steriization of instruments Ceaning of equipment and surfaces It is important to understand which are the hazardous tasks and potentiayharmfu substances, and how to contro exposure. CHEMICAL HAZARD Inhaation of irritant or sensitizing dust Inhaation of irritant sensitizing vapours Skin contact with irritant or sensitizing substances EXAMPLE OF PRODUCTS Fiing materias (composites) Materias for impressions Paster products Disinfectant Antiseptic ceaner Latex goves EXAMPLE OF SUBSTANCES Acryate famiy Crystaine siica Cacium suphate Quaternary ammoniums Latex proteins MEANS OF CONTROL Substitution Work method Capture at source Genera ventiation Respiratory protection Skin protection Informing and training students, apprentices and empoyees on the risks of exposure to substances in their earning or work environment, the sources of emission, the most hazardous tasks, methods of contro (incuding work practices and methods) and persona protective equipment are key to controing exposure.
PROTECT YOURSELF RESPONSIBLY Protecting your respiratory tract Use a respirator if you cannot contro exposure any other way. The N95 fitering haf-facepiece respirator is recommended to protect against dust. You coud aso use other respirators depending on the intensity of exposure, the nature of the task and the degree of effort. A respirators have a protection factor (PF) that indicates how effective they are and that refects the theoretica concentration of the contaminant in the environment compared to that inside the mask. So, a factor of 10 indicates that the concentration inside the respirator is 10 times ess than that in the earning or work environment. For a respirator to offer appropriate protection against a particuar substance, you have to ook at the permissibe exposure vaue (PEV) for that substance, as stated in the Reguation on occupationa heath and safety (ROHS). Choosing a respirator to suit the intensity of dust you are exposed to* Intensity Under 10 times the PEV Over 10 times the PEV Types of respirators* N95 fitering haf-facepiece Haf-facepiece with N95, P95 or P100 fiter cartridges Fu-facepiece with N95, P95 or P100 fiter cartridges Powered air-purifying respirator (PAPR) with HEPA fiter cartridges PF 10 100 The teaching institution must aso set up a training program so that apprentices know how to use a respirator, its imitations and maintenance, and arrange for a persona fitting to adjust the respirator in accordance with the reguations in Quebec. 1 A surgica mask is not a respirator Unike the N95 fitering haf-facepiece respirator, a surgica mask is not designed to fiter dust. It is not effective or airtight enough to meet reguations. Protecting your skin As you go about your training or professiona work in denta hygiene, irritant or sensitizing substances (such as atex, quaternary ammoniums) may contact your skin. Wearing nitrie goves wi reduce this type of risk. However, they are ony appropriate for some mixes. So, it is important to check how effective your choice of protection is with the manufacturer before adopting it. * These recommendations do not appy to a work situations. You must check the respirator s efficiency with the manufacturer or with the person responsibe for the respiratory heath program. 1 www.irsst.qc.ca/fr/_pubicationirsst_862.htm
CONTROL THE RISK TO YOUR HEALTH Substitute products First, consider repacing a potentiay harmfu product with one that reduces or eiminates the risk. Some exampes are: Wear nitrie goves instead of atex goves; Repace the quaternary ammonium famiy of disinfectants with ammonium-free equivaents. Work practices Good work practices and habits can prevent exposure or hep to reduce the duration and intensity of exposure. Some exampes are: Capture at source This reduces exposure to the dust generated by equipment. It protects you and the peope near your workstation. Sand and machine impressions and paster modes using an instrument equipped with a oca exhaust system or with running water to reduce exposure to dust. Ventiation Genera, natura or mechanica ventiation reduces the ambient eve of substances and so reduces direct and secondary exposure to irritants or aergenic substances associated with hazardous tasks. Spray antiseptic ceaners carefuy, using containers in good condition; Stay away from the source of the contaminant and its trajectory. Cic Research www.irsst.qc.ca
BE INFORMED BE CAREFUL Other heath and safety risks reated to the denta hygiene profession* Category Bioogica Chemica Risk Bioaerosos Contact with bioogica fuids Sanding and poishing denta impressions and paster modes (crystaine siica of quartz and cristobaite) * This ist is not exhaustive and does not appy to a workpaces. Methods of contro Wear respiratory protection Adopt appropriate persona hygiene measures Adapt work methods Protect your skin Loca exhaust system System with fowing water on the machine Wear respiratory protection Information IRSST CSST IRSST CSST (crystaine siica)a TO LEARN MORE Guide d utiisation d une fiche signaétique, CSST http://www.csst.qc.ca/portai/fr/pubications/dc_200_338_5.htm Asthme CSST http://www.asthme.csst.qc.ca/ IRSST http://www.irsst.qc.ca REPTOX http://www.reptox.csst.qc.ca/ Québec Lung Association http://www.pq.ung.ca Center for Asthma in the Workpace http://asthma-workpace.com/en REFERENCES Gautrin, D. et a. Surveiance de asthme professionne chez des travaieurs dans des secteurs à risque, IRSST, R-494, 2007, 45 pages. http://www.irsst.qc.ca/fies/documents/pubirsst/r-494.pdf Nationa Institute for Occupationa Safety and Heath (NIOSH). NIOSH Aert: Preventing aergic reactions to natura rubber atex in the workpace (97-135). NIOSH. 1997, 16 pages. http://www.cdc.gov/niosh/atexat.htm Hagberg, S. Exposure to voatie methacryates in denta personne, App. Occup. Environ. Hyg., 2003, 18: 1031-1047. Lara, J. and Vennes, M. Guide pratique de protection respiratoire, IRSST, R-319, 2002, 56 pages. http://www.irsst.qc.ca/fr/_pubicationirsst_862.htm AUTHORS Brigitte Roberge, IRSST Éric Audet and Denyse Gautrin, Asthma in the Workpace Center and Respiratory Heath Research Theme, Hôpita du Sacré-Cœur de Montréa IRSST Communications Division, 505 De Maisonneuve Bvd. West, Montréa (Qc) H3A 3C2 Teephone: 514 288-1551 ISBN: 978-2-89631-204-7 (PDF) ISSN: 0820-8395 Apri 200