Occupational diseases are diseases caused by occupational exposures at the workplace, while diseases related to work are diseases caused by many factors, wherein the harmful work conditions are one of the possible causes. Dental medicine is a profession with a high risk of developing occupational diseases. The aim of this paper was to present the results of a survey about occupational health risks and health related habits among dental students at the School of Dental Medicine University of Zagreb and to show how this survey led to an improvement in education by introducing a new course into the dental curriculum.
Students of all years at the School of Dental Medicine University of Zagreb (total of 663) were offered to participate in a survey about occupational health risks and health related habits.
A questionnaire was completed by 351 students. 28.0% of male students and 22.5% of female students were smokers. During the first two years of study, up to 84.6% of students consumed alcoholic beverages at least once a week. Prior to enrollment in the university, 85.3% male and 77.6% female students were engaged in sports. The significant drop in the number of students who participated in sports was noticed in the first study year in both sexes. Student awareness of the health risks related to dental profession increases with the year of study. Most students believe that occupational diseases can be prevented.
The results have shown that students enter the School of Dental Medicine with a relatively low level of awareness of the health hazards of dental profession. Although the level of awareness increases with years of study, harmful habits such as smoking, alcohol consumption, and the lack of physical activity also remain present in the later years of study.
Although dentistry is considered to be a profession with a high risk for development of occupational diseases and diseases related to work, education on occupational health is not a standard part of the curriculum of dental schools in many countries (
Health risks of the dental profession are well known, but availability of data about prevalence of some occupational diseases and diseases related to work is limited and usually available only for countries with large populations and many dental practitioners. The data for small countries are often insufficient.
Croatia is the newest member of the European Union, has a population of 4.28 million and about 4.000 active dental practitioners. There are three institutions (University of Zagreb School of Dental Medicine, University of Rijeka School of Medicine and University of Split School of Medicine) educating doctors of dental medicine with a six year curriculum. There about 100 – 150 new doctors of dental medicine each year. Preliminary studies showed that the prevalence of occupational diseases and diseases related to work among Croatian dentists is high due to increased professional, business and administrative requirements in last decade (
Previous studies conducted among dental students around the world have shown that their knowledge of professional related health risk factors was insufficient. Thus, many authors have concluded that the education of students on occupational health risks is the first and crucial step in the prevention of occupational diseases in the future (
The aim of this paper was to present the results of a survey about occupational health risks and health related habits among dental students at the School of Dental Medicine University of Zagreb and to show how this survey led to an improvement in education by introducing a new course in the dental curriculum entitled “Occupational diseases in dental medicine”.
Croatian dental students have never before been surveyed on their knowledge and attitude regarding occupational health hazards and diseases. Croatia is the youngest member of the European Union and probably one of the few EU member countries without relevant data about occupational diseases and diseases related to work for the dental profession. This paper is an attempt to provide a basis for further improvements in this field.
In the academic years 2014/2015, students of all years at the School of Dental Medicine University of Zagreb (total of 663) were offered to participate in a survey about occupational health risks and health related habits. For this purpose, a questionnaire with questions about health related habits and occupational diseases was made. Participation in the survey was voluntary and anonymous. The research was approved by the Ethics Committee of the School of Dental Medicine, University of Zagreb.
Statistical analysis was made using the computer program „MS Excel2003“(Microsoft Office 2003, Microsoft, and Redmond, WA) and „SPSS Statistics 17.0 for Windows“(SPSS Inc., Chicago, IL). Descriptive and nonparametric statistical analysis was made and chi- square test and the Kruskal-Wallis test were applied.
The questionnaire was filled out by 351 students, which was 52.9% of the total number of students at the School of Dental Medicine, University of Zagreb in the academic year 2014/2015. The percentage of students who filled the questionnaire ranged from 38.4% in the first year to 61.2% in the 3rd year, which means that the average for all years of study was 53.6%. Distribution of the surveyed students according to gender and year of study is given in
Year of study | Male | Female | Total | % of number of total enrolled students | ||
---|---|---|---|---|---|---|
N | % | N | % | N | ||
1 | 11 | 22.9 | 37 | 77.1 | 48 | 38.4 |
2 | 13 | 21.3 | 48 | 78.7 | 61 | 49.6 |
3 | 12 | 19.0 | 51 | 81.0 | 63 | 61.2 |
4 | 12 | 18.8 | 52 | 81.3 | 64 | 58.2 |
5 | 11 | 19.6 | 45 | 80.4 | 56 | 58.9 |
6 | 16 | 27.1 | 43 | 72.9 | 59 | 55.1 |
Total | 75 | 21.4 | 276 | 78.6 | 351 | Average: 53.6 |
N – Number of subjects
The analysis of the number of smokers among students showed that 28.0% of males out of the total number of interviewed students were smokers as opposed to 22.5% of female smokers. No statistically significant difference was found among students regarding their smoking habits, gender and the year of study.
Distribution of smokers among students regarding gender
Distribution of students regarding the year of study and frequency of alcohol consumption is shown in
Distribution of the students regarding alcohol consumption
The results of the analysis of the frequency of students who participate in sports have shown that male students do sports more often than female students (
Distribution of students participating in sports before and during study
Students travel around the city mostly using public transportation while scooters are rarely used. Male students are more likely to walk than female students. On average, 45.9% of male students walk around the city whereas only 36.5% of female students do the same. Female students use bicycles as a means of transport more often than male students (8.1% female students, 5.7% male students). In senior academic years, there is an increase of car users particularly among male students.
Academic year | Male | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Walking | Bike | Public transport | Scooter | Car | ||||||
N | % | N | % | N | % | N | % | N | % | |
1 | 5 | 45.5 | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 0 | 0.0 |
2 | 5 | 41.7 | 0 | 0.0 | 6 | 50.0 | 1 | 8.3 | 1 | 8.3 |
3 | 5 | 45.5 | 0 | 0.0 | 5 | 45.5 | 1 | 9.1 | 1 | 9.1 |
4 | 8 | 80.0 | 0 | 0.0 | 2 | 20.0 | 0 | 0.0 | 2 | 20.0 |
5 | 2 | 20.0 | 2 | 20.0 | 6 | 60.0 | 0 | 0.0 | 1 | 10.0 |
6 | 6 | 42.9 | 2 | 14.3 | 6 | 42.9 | 0 | 0.0 | 2 | 14.3 |
Academic year | Female | |||||||||
Walking | Bike | Public transport | Scooter | Car | ||||||
N | % | N | % | N | % | N | % | N | % | |
1 | 9 | 24.3 | 0 | 0.0 | 28 | 75.7 | 0 | 0.0 | 0 | 0.0 |
2 | 20 | 41.7 | 0 | 0.0 | 28 | 58.3 | 0 | 0.0 | 0 | 0.0 |
3 | 11 | 21.6 | 1 | 2.0 | 39 | 76.5 | 0 | 0.0 | 0 | 0.0 |
4 | 25 | 48.1 | 4 | 7.7 | 22 | 42.3 | 0 | 0.0 | 1 | 1.9 |
5 | 16 | 38.1 | 1 | 2.4 | 25 | 59.5 | 0 | 0.0 | 3 | 7.1 |
6 | 19 | 45.2 | 1 | 2.4 | 22 | 52.4 | 0 | 0.0 | 1 | 2.4 |
N- Number of subjects
When asked if they considered that dental medicine could harm their health, it was noticed that the higher the academic year, the higher the level of awareness of health issues that come with practicing dental medicine. There was a statistically significant difference considering the level of awareness among different academic years (p<0.05) regardless of the gender. In the first academic year, 29.7% of female students were aware of health issues while none of the male students were aware of them (0.0%). On the other hand, in the sixth academic year, the number of male students who were aware of harmful effects that practicing dental medicine could have, was 87.6% while 79.1% of female students were aware of the same problem (
Percentage of students who consider dental medicine as a profession harmful for their health
The results of the questionnaire considering the attitude of students towards the prevention of occupational diseases are shown in
Attitude of students towards prevention of occupational diseases
Occupational diseases are diseases caused by occupational exposures, while diseases related to work are diseases caused by many factors, where the harmful work conditions are one of the possible causes. Dental medicine is a profession with a high risk of developing occupational diseases or work-related diseases (
A relatively high number (52.9%) of students who were willing to fill out the anonymous and voluntary questionnaire pointed to their readiness to be informed on this subject. This is especially seen in senior years of study where the percentage of students who filled out the questionnaire was 61.2%, indicating that students with some experience in preclinical and clinical dental practice are more aware of the problem of occupational diseases and work related health hazards.
This research has shown that there were 28.0% of male smokers and 22.5% of female smokers. These results match the ones from the study of Šimat at al. who found that the frequency of smokers among the students of the School of Dental Medicine University of Zagreb was 23.8% (
It was shown that almost half of the male and female students alike consumed alcohol at least once a week; regardless of their academic year and that this percentage was as high as 80% in some academic years. This fact should be investigated individually (a means to cope with stress) but also on a social level (socially acceptable situation for alcohol consumption). In Amemoria research from 2011, the highest recorded percentage of alcohol consumption among students was 23.8% on a monthly basis (
It is a positive fact that before commencing their studies, 85.3% percent of male students and 77.6% of female students of the School of Dental Medicine University of Zagreb participated in sports at least once a week. On the other hand, the most unfavorable fact is that in the first years of study, only 36.4% of male students and 32.4% of female students partake in sports at least once a week. Naturally, this decrease can simply be explained by new surroundings and new life circumstances which a young person has to manage while simultaneously meeting the requirements of schooling which are very extensive and demanding at the beginning. Physical education course and regular partaking in sports are basic preconditions for the prevention of health issues in students of dental medicine, especially regarding musculoskeletal problems (
A low level of awareness of students, especially ones at the beginning of university, about occupational diseases and work related diseases points to the fact that some level of education should be implemented in high schools to inform the students about the risks that are involved with certain professions. On the other hand, dental medicine students should have the possibility to enroll in a course that would give them theoretical and practical knowledge on occupational diseases among doctors of dental medicine, their etiology, pathogenesis, treatment and prevention (
Motivated by the results of this survey which indicated a low degree of awareness of students about occupational and work related diseases, high frequency of some bad health-related habits such as smoking and alcohol consumption, insufficient number of students who are regularly involved in sports and a lack of ergonomic education, establishing a new course in the dental curriculum was taken into consideration. After careful analysis of health related issues reported by Croatian dentists, the results of the student survey and program of other dental courses at the School of Dental Medicine University of Zagreb, it was decided to start a new course entitled “Occupational diseases in dental medicine”. The course was planned as a multidisciplinary course based on lectures and practical lessons for students of the 6th semester. At the School of Dental Medicine University of Zagreb, the 6th semester is the last semester before students start clinical work with patients lasting the next 6 semesters. This semester was considered to be ideal for teaching students about health hazards, occupational and work related diseases because students have some preclinical experience and insights into everyday work in a dental office allowing them to understand the importance of a correct working position, ergonomics, physical activity, mental health and stress managing techniques etc. Teachers of the course are doctors of dental medicine and physicians of different specialties such as otorhinolaryngologists, dermatologists, ophthalmologists, immunologists, cardiologists, orthopedic specialists etc. During 15 lectures students have an opportunity to learn about almost all health risks related to dental profession and how to prevent the health related problems. During the practical lessons students are introduced to dental ergonomics and shown how to avoid musculoskeletal disorders by applying special exercises for dentists.
The results have shown that students enroll into the School of Dental Medicine University of Zagreb with a relatively low level of awareness of the health hazards of the dental profession. Students are capable of identifying harmful and health endangering factors that can occur while practicing dental medicine as well as possible ways of prevention and protection. Although the level of awareness increases with years of study, harmful habits such as smoking, alcohol consumption and the lack of physical activity still remain present in the later years of study. Preventive measures should be applied during the years of study in order to avoid occupational diseases and maintain the health of new generations of doctors of dental medicine. Students should be aware of these problems and learn how to prevent health issues when they finish university and start practicing dental medicine on their own.
None declared