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CDC reports ‘cluster’ of dental professionals diagnosed with lung disease

March 13, 2018

The Centers for Disease Control and Prevention reported March 9 on a cluster of a patients composed of dentists and dental workers treated at a specialty clinic in Virginia with chronic, progressive lung disease.

The epidemiological review finding, according to the CDC, underscores a need for dentists and other dental personnel to wear adequate respiratory protection when exposed to respiratory hazards at work.

According to the CDC’s Morbidity and Mortality Weekly Report, from 1996 through 2017, 894 patients were diagnosed with idiopathic pulmonary fibrosis, a lung disease of unknown cause and associated with a poor prognosis, at a tertiary care center in Virginia. Of those patients, nine worked in the dental profession, seven of whom have died.

“During 2016, dentists accounted for an estimated 0.038 percent of U.S. residents, yet represented 0.89 percent of patients undergoing treatment for IPF at one tertiary care center — nearly a 23-fold difference,” according to the report. A collection of cases that is suspected to be greater than the number expected is referred to as a “cluster.”

The one surviving patient in the cluster who was interviewed reported occupational exposure to silica and other materials used in dental practice as well as other work-related and environmental exposures to dust, the report said.  The patient also reported not wearing a National Institute for Occupational Safety and Health-certified respirator during dental activities throughout his 40-year dental practice and wore a surgical mask for the last 20 years of his dental practice, according to the CDC report.

In addition, in terms of tobacco use, three patients were former smokers, one had never smoked and the smoking history was unknown for the other five patients.

While no clear cause for the diagnosis was identified, the CDC said occupational exposure is a possibility.

“Dental personnel are exposed to infectious agents, chemicals, airborne particulates, ionizing radiation and other potentially hazardous materials,” according to the CDC report. “Inhalational exposures experienced by dentists likely increase their risk for certain work-related respiratory diseases.”

The CDC added that the cluster of idiopathic pulmonary fibrosis cases reinforces the need to better understand the occupational exposures of dental personnel and the association between these exposures and the risk for developing pulmonary fibrosis. This understanding may provide strategies to prevent potentially harmful exposures.

The ADA has stated that it takes very seriously the issue of occupational hazards. In a statement, the Association said, “The ADA works in collaboration with [the Occupational Safety and Health Administration] and the CDC to ensure the best possible guidance is available for dental professionals.”