Athraa Final.doc J Bagh College Dentistry Vol. 26(2), June 2014 Occupational dental Orthodontics, Pedodontics and Preventive Dentistry 135 Occupational dental wear among El-Kubasis cement factory workers - An observational study Mohammed I. Abdulla, B.D.S. (1) Athraa M. Al-Waheb, B.D.S., M.Sc. (2) ABSTRACT Background: Loss of tooth structure may be due to tooth to tooth contact and presence of abrasive components in the work environment. The aim of study was planned to evaluate the occurrence of dental attrition among Cement factory workers. Material and Method: The Sample included all workers chronically exposed to cement dust in the EL-Kubaisa cement factory (95 workers). A comparative group of workers (97) were non-exposed to cement dust was selected. All workers were males in gender with age range (25-55) years. The assessment of tooth wear was based on the criteria of smith and knight, 1984. Results: The maximum tooth wear score for exposed workers was 84.2% while non exposed workers was 38.1%,with statistical differences between two groups was highly significant (P<0.01). The maximum tooth wear score among workers exposed to cement dust according to duration (<10years), (10-20 years) and >20 years) was (52.2 %), (92.3%) and (100%) respectively, with statistical differences was highly significant (P< 0.001). While the maximum tooth wear score among workers exposed to cement dust according to wearing mask was found to be statistically not significant (P> 0.05). Conclusion: Work environment was related to dental wear. Key word: Attrition, Cement dust, Cement factory worker. (J Bagh Coll Dentistry 2014; 26(2): 135-137). : الخالصة إن الھدف من ھذه الدراسة ھو تقییم وقوع تآكل األسنان بین . إن فقدان بنیة األسنان قد یكون سببھ الرئیسي ھو تآكل األسنان مع وجود مواد تساعد على االحتكاك في بیئة العمل : المقدمة .عمال مصنع االسمنت جمیع العمال . غیر معرضین للغبار ) عامال 97( مقارنة مع ) . عامال 95(غبار االسمنت في مصنع اسمنت كبیسة لمزمن شملت العینة جمیع العمال المعرضین بشكل :المواد و العمل . 1984واستند تقییم تآكل األسنان على معاییر سمیث و نایت ، . سنة) 55- 25( ذكور و في الفئة العمریة ٪ ، مع فروق ذات داللة إحصائیة بین مجموعتین 38.1٪ بینما العمال غیر المعرضین للغبار كان 84.2ضین للغبار كان الحد األقصى لدرجة تآكل األسنان للعمال المعر :النتائج 52.2( ھو ) نةس 20اكبر من ( و ) سنة20 -10(, ) سنة10اقل من ( وكان أقصى درجة تآكل األسنان بین العمال المعرضین لغبار األسمنت وفقا لمدة ) . P<0.01(كان كبیرا للغایة في حین تم العثور على الدرجة القصوى لتآكل األسنان بین العمال المعرضین لغبار األسمنت وفقا ) . P 0.01>(على التوالي ، بفروق إحصائیة عالیة ) ٪ 100( و ) ٪ 92.3( ، %) .)P>0.05(الرتداء الكمامات مع فرق غیر معنوي .تآكل األسنان بیئة العمل متعلقة بحالة: االستنتاج .غبار االسمنت ، عمال مصنع االسمنت, تآكل األسنان :كلمات مفتاحیھ INTRODUCTION Oral cavity injuries which occur as a direct result of an occupation are rather common. The injurious effects of occupational hazards may manifest themselves in the teeth, jaw bones, periodontal tissue, tongue, lips and oral mucosa. The effect of the various etiological agent depend on their specific chemical and physical properties (1). Occupational hazards are major contributors to additional risk factors for disease. Industrialization of nations exposes its population to this risk. The working environment influences the health of an individual. The occupational diseases are caused by a pathologic adaptation of the individual to his working environment (2). As abrasive components exist in several work environments, wasting diseases of teeth may be considered as an occupational dental disease. This dental condition has been reported in workers of Granite industry. Loss of tooth structure may be due to tooth to tooth contact and presence of abrasive components in the work environment (2). (1)M.Sc. student, Department of Pedodontics and Preventive dentistry, College of Dentistry, Baghdad University. (2)Professor, Department of Pedodontics and Preventive dentistry, College of Dentistry, Baghdad University. As cement factory workers are exposed to cement dust and this dust contain different minerals like Silica, Iron and others elements, therefore, the present study was planned to evaluate the occurrence of dental attrition amongst Cement factory workers. MATERIALS AND METHODS Sample The survey took place in 2012-2013. The present study was conduct in EL-Kubaisa cement factory located in AL-Anbar governorate. The Sample included all workers chronically exposed to cement dust in the EL-Kubaisa cement factory (95 workers) and who were working in department where cement dust exposure was present with duration at least 5 years. A comparative group of (97) workers who were non- exposed to cement dust was selected randomly from other department non-expose to cement dust. All workers were males in gender with age range (25-55) years. Methods Oral examination of all workers was done in room in cement factory using artificial light. The J Bagh College Dentistry Vol. 26(2), June 2014 Occupational dental Orthodontics, Pedodontics and Preventive Dentistry 136 assessment of tooth wear was based on the criteria of smith and knight, 1984. This index was chosen due to easily comparable and widely use. The present study was carried out according to duration in work and wearing mask. Data analysis Data were translated into a computerized data base structure. The data base was examined for errors using range and logical data cleaning methods. Statistical analyses were done using SPSS version 20 computer software (Statistical Package for Social Sciences) in association with Excel version 5. Pearson’s chi-square test was used to test the differences between different groups. For all of the tests, a p value of < 0.05 was considered to be statistically significant. RESULTS The study sample consisted of 192 workers (95 exposed to cement dust) and (97 non- exposed). The study subjects were ranging from ages (25-55) years. Tooth wear was assessed using criteria of Smith and Knight 1984. Result concerning the maximum tooth wear score of the total sample (exposed and non-exposed) illustrated in Table (1). The maximum tooth wear for exposed workers was 84.2% while non exposed workers was 38.1%, with statistical differences between two groups was highly significant (P< 0.01). Table (2, 3) shows that the maximum tooth wear score among exposed workers according to duration of current employment (<10years), (10-20 years) and (>20 years) was (52.2 %), (92.3%) and (100%) respectively and according to wearing mask (never), (sometime) and (always) was (76.2%), (86.2%) and (88.9%) respectively. With statistical differences among exposed workers according to duration was highly significant (P<0.001) and no significant differences according to wearing mask (P> 0.05). Table 1: Distribution of study subject (workers exposed and non-expose to cement dust) according to maximum tooth wear score. Maximum Tooth wear Score Expose to cement dust P (Chi- Square) Non expose Expose No. % No. % Score – 0 24 24.7 5 5.3 0.001* Score – 1 2 2.1 0 0.0 NS** Score – 2 34 35.1 9 9.5 0.001 Score – 3 37 38.1 80 84.2 0.001 Score – 4 0 0.0 1 1.1 NS *High Significant at P<0.01, df=1, **Not Significant at P>0.05 ** Table 2: Distribution study subjects (workers exposed to cement dust) according to maximum tooth wear score and duration of current employment. Duration of current employment Maximum TW Score <10years 10-20years >20years P (Chi- Square) No. % No. % No. % Score 0 5 21.7 0 0.0 0 0.0 0.001* Score 1 0 0.0 0 0.0 0 0.0 ** Score 2 6 26.1 3 5.8 0 0.0 0.001 Score 3 12 52.2 48 92.3 20 100 0.001 Score 4 0 0.0 1 1.9 0 0.0 NS Total 23 100 52 100 20 100 - *High Significant at P<0.01, df=2 , ** Can not calculated Table 3: Distribution of study subject (workers exposed to cement dust) according maximum tooth wear score and wearing mask Maximum TW Score Never Sometime Always P (Chi- Square) No. % No. % No. % Score 0 1 4.8 4 6.2 0 0.0 NS* Score 1 0 0.0 0 0.0 0 0.0 ** Score 2 3 14.3 5 7.7 1 11.1 NS Score 3 16 76.2 56 86.2 8 88.9 NS Score 4 1 4.8 0 0.0 0 0.0 NS Total 21 100 65 100 9 100 *Not Significant at P> 0.05, ** Can not calculated DISCUSSION The Smith and Knight (3) Index was used in this study for the assessment of the prevalence of tooth wear among workers of EL-Kubasia cement factory. This index was chosen for its easily comparison and it’s also widely use. In present study maximum tooth wear score among workers exposed to cement dust in EL-Kubasia cement factory was found to be much higher (84.2%) compared to non exposed (38.1%). Statistically high significant differences between exposed and non-exposed workers were shown in the present study. This is may be due to that the workers may develop disorder of teeth because of exposure to chemical substance, organic or inorganic, specific to their occupation (4). The cement factories provide an environment which may contain abrasive particles in form of silica and other minerals dust. Abnormal tooth surface loss in form attrition or abrasion could be squealed to occupational exposure. Petersen and Gormsen have termed such effect on dentition as occupational disease (5). The result of present J Bagh College Dentistry Vol. 26(2), June 2014 Occupational dental Orthodontics, Pedodontics and Preventive Dentistry 137 study is agreed with study done by EL-Ghandour (6) on Rabak cement factory workers in Sudan the prevalence of attrition was 84.85% and study reported by Sood et al (2) on ceramic factory workers the prevalence of attrition was 84.36% and higher than recorded by Tuominen (7) on stone and cement factory attrition was 72.2 %. The differences in these finding may be related to wide range of tooth wear indices used and the variation in diagnostic criteria (8). Currently there is no agreed consensus on universally acceptable tooth wear index for quantifying tooth wear (9). These factors complicate the evaluation of whether a true increase in prevalence is being reported. Therefore conclusion from prevalence studies should be considered with caution (10). In present study maximum tooth wear score among exposed workers was found (84.2%). Statistically high significant differences (P<0.01), this is may be due to dust of abrasive quality such as cement may collect on occlusal surface of teeth, produce friction and cause damage to the teeth and generalized attrition. Such condition found among cement stand workers, grinders, stone cutters and miners (4). Excessive dental wear reported in a study in Danish Granit Industry (11), which has been attributed to the abrasive component of the work environment. In present study dental wear increase with increase duration of current employment among exposed workers. Less than 10 years was 78%, 10-20 years was 97% and more than 20 years was 100%. This relation was found to be statistically high significant in present study (P<0.01). This agreed with study done by Ptersen and Henmar (11) on Danish Granit workers they reported workers with duration less than 10 years tooth wear was 64% while the workers with duration more than 10 years tooth wear was 87%. The increase severity of tooth wear attributed to increase duration of exposure to cement dust. Maximum tooth wear among exposed workers according to wearing mask was no significant (P< 0.05), this may be attributed that wearing mask not protect the mouth from dust of cement, because of the mask that wearing in factory not systemically (not manufactory for this purpose) therefore it isn't affective to prevent tooth wear. As conclusion; dental wear among workers exposed to cement dust higher than non exposed workers statistically high significant differences between two groups. The prevalence and severity of tooth wear increased with increasing duration and this relation was found to be statistically highly significant. Work environment was related to dental wear. REFERENCES 1. Lammert K, Seifert H. Stomatologie and Arbeitsmedizin VEB Verlag Volk and Gesundheit, Berlin 1979. 2. Sood M, Blaggama A, Blaggama V, Sharma N. 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