|Year : 2017 | Volume
| Issue : 2 | Page : 131-134
Prevalence and severity of dental erosion among jeep battery manufacturing workers at Metagalli, Mysore: A cross-sectional study
Jyothi Chavan1, Anjan Giriraju2
1 Department of Public Health Dentistry, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
2 Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
|Date of Web Publication||13-Jun-2017|
Room No. 8, Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru - 560 074, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: Majority of people employed in various industries are exposed to hazardous environment. Exposure to chemical agents in the workplace can result in adverse effects on workers. This exposure deteriorates the general and oral health of people, working in industries for long hours. Aim: The aim is to assess the prevalence and severity of dental erosion among battery manufacturing factory workers at Metagalli, Mysore, Karnataka, India. Materials and Methods: A total of 175 jeep battery manufacturing factory workers were enrolled and divided into study and comparison groups based on acid exposure. Demographic details of workers were recorded. Severity of dental erosion was calculated using Smith and Knight tooth wear index. The data were analyzed using Statistical Package for the Social Sciences version 17.0 software. Chi-square test was used to compare the categorical variables. Results: The prevalence of dental erosion among the jeep battery manufacturing factory workers was 80%. Majority of the participants in the study group had severe degree of dental erosion (scores of 3 and 4) when compared to the comparison group. Conclusion: Dental erosion was more prevalent among the jeep battery manufacturing factory workers. Study participants were the more affected group with dental erosion when compared to comparison group.
Keywords: Acid fumes, factory, oral health, tooth wear, workers
|How to cite this article:|
Chavan J, Giriraju A. Prevalence and severity of dental erosion among jeep battery manufacturing workers at Metagalli, Mysore: A cross-sectional study. J Indian Assoc Public Health Dent 2017;15:131-4
|How to cite this URL:|
Chavan J, Giriraju A. Prevalence and severity of dental erosion among jeep battery manufacturing workers at Metagalli, Mysore: A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2019 Feb 23];15:131-4. Available from: http://www.jiaphd.org/text.asp?2017/15/2/131/207915
| Introduction|| |
The surface loss of dental hard tissues other than by caries, trauma, or developmental aberration is termed tooth wear. The condition is irreversible and cumulative with age. Although tooth wear is a natural consequence of aging, the process can be considered “pathological” if the rate of loss is excessive and causes esthetic, functional, or sensitivity problems. Based on etiological factors, tooth wear has traditionally been divided into three categories: attrition, abrasion, and erosion. Among the three categories, dental erosion is known to cause more damage to tooth structure.,,
Dental erosion is defined as the loss of tooth structure usually caused by acids, without the involvement of bacteria. Dental erosion is caused by extrinsic factors (acidic foodstuffs and drugs), intrinsic (acid regurgitation), and occupational hazards.,, Airborne acid affects upper and lower anterior teeth.,, Industrial environmental factors may be considered responsible for dental erosion among battery workers since they were exposed to sulfuric acid mists. The ready response of enamel to acids makes it vulnerable to decalcification. The crowns of the teeth disintegrate with prolonged exposures. However, behavioral and biological factors, such as tooth position, quality of dental hard tissues, and salivary factors such as composition, buffer capacity, and flow rate may exert an influence on the development and progression of erosions.
There are few studies done on factory workers and their oral health status in Indian scenario.,,, Among the majority of the studies, there was very little information about tooth wear which constitutes major occupational hazard among the factory workers in Indian scenario. Further, there was very little information particularly on the dental erosion status of individuals working in factories where they are exposed to acidic environment, particularly in battery manufacturing, rubber manufacturing, and lead factories. There was a need to explicitly assess the effect of acid exposure on the dental health (resulting in dental erosion) of the factory worker. Thus, a study was conducted to assess the prevalence and severity of dental erosion among battery manufacturing factory workers at Metagalli, Mysore, Karnataka, India.
| Materials and Methods|| |
A cross-sectional, comparative study was conducted at Metagalli, Mysore, Karnataka, from November 5, 2014 to December 5, 2014. Prior permission was obtained from the in-charge authority (manager) of battery factory to conduct the oral examination of battery factory workers. Before starting the survey, the ethical clearance was obtained from the Institutional Ethical Committee of dental institution. The study population were duly informed about the purpose of the study and written informed consent was obtained from them before their participation in the study according to the WHO informed consent criteria for qualitative research.
All required and relevant information regarding the battery factory was obtained from personnel manager of jeep battery manufacturing factory, K.R.S. Road, Metagalli, Mysore, Karnataka, India. There were a total of 175 workers employed at jeep battery manufacturing factory. All the workers were invited to participate in the study. The battery units had two types of workers, those exposed to acid fumes or mists (113 [64%]) (working in battery production site) and those who are not exposed to acid fumes (62 [36%]) (working in maintenance, administration, purchase, and engineering office) which formed the basis for division into study and comparison group. Battery factory workers of all ages, available at the time of examination, were included in this study.
The examiners (two in number) and recording assistants (two in number and pursuing internship training) were trained and calibrated in the Department of Public Health Dentistry, under the supervision of the staff members. Inter- and intra-examiner correlation coefficient values measured through Cohen's kappa coefficient statistic (k) were found to be 0.84 and 0.9, respectively.
A detailed blueprint of the survey was prepared well in advance. The investigators visited the study area during the prescheduled time frame in the study period and obtained necessary permission from the factory authority. Information regarding departments in the battery factory, duration of the job, and exposure to various working conditions were recorded along with the demographic details. Smith and Knight tooth wear index was used to assess dental erosion., Clinical examination was done by the investigators with the study participants seated on an ordinary chair using natural daylight. All the data were recorded by recording assistants calibrated for the study. The interview and examination of a single participant took on an average of about 10–12 min. Sufficient numbers of sterile instruments were made available for the examination during the study. Those workers who needed any care were referred to dental college.
The data were tabulated using the Microsoft Excel spreadsheet software (Microsoft). The data were analyzed using Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 17.0. Chi-square test was used to compare the categorical variables for proportions. P ≤ 0.05 was considered statistically significant.
| Results|| |
The prevalence of dental erosion among the jeep battery manufacturing workers was 80%. All the study participants in the study were males. Majority of workers in the comparison group were aged between 25 and 34 years (85%), whereas among study group, 46.9% of workers were aged above 45 years. The difference was found to be statistically significant (P < 0.01) [Table 1].
As compared to study group, in the comparison group, the period of exposure was statistically significantly lower (P < 0.001). It was seen that in the comparison group more than two-third (65.5%) of the respondents had up to 5 years of experience, whereas in study group, the period of exposure was more than 10 years in 90% of participants [Table 2]. The difference was statistically significant (P < 0.001).
None of the participants in the study group had erosion score of 0 as compared to comparison group where 35 (56.5%) participants had erosion score of 0 in comparison group. Of the remaining 27 comparison participants, 16 (59.2%) had erosion score of 1, whereas 11 (40.7%) had erosion score of 2. In contrast, 58 (51.3%) study participants had erosion score of 3 and around 20 (17.6%) had erosion score of 4 [Table 3]. Statistically, a significant difference was observed between the two groups (P < 0.001).
|Table 3: Distribution of participants according to dental erosion index scores|
Click here to view
| Discussion|| |
This study was undertaken to assess the prevalence and severity of dental erosion among jeep battery workers at Metagalli, Mysore, Karnataka, India. The survey was carried on battery workers at jeep battery manufacturing factory. The response rate in the survey was 100%. All the workers surveyed on the day of examination were males.
Majority of workers in the comparison group were aged between 25 and 34 years (85%), whereas among study group, 46.9% of workers were aged above 45 years. Our study results are in line with the studies of ten Bruggen Cate  and Petersen and Gormsen, Khurana et al., and Patel et al.
Majority of the participant in the study group (about 90%) had more than 10 years of experience working in the battery factory when compared to comparison group, where majority of workers had a maximum work experience of about 5 years. Our study results are supported by the studies conducted by Khurana et al., Malcolm and Paul, Amin et al., and Petersen and Gormsen.
In our study, dental erosion was observed on the surfaces of the teeth most exposed to the atmosphere that is incisal one-third to one-half of the labial surfaces of the front teeth. No erosion of the posterior teeth was seen. About 55% of the study group had Grade-3 erosion and 20% had Grade-4 erosion. In the comparison group, majority of about 85% had only Grade-1 dental erosion and remaining 15% had Grade-2 dental erosion. Similar results were observed in studies conducted by Malcolm and Paul, Amin et al., ten Bruggen Cate, Tuominen et al., and Petersen and Gormsen.
Limitations of the study
In the present study, the exposure level of the participants to the acid fumes was not measured quantitatively and grouping the participants into study and comparison group was done based on the working site of the study participants. (1) Sample size of the present study was small; studies on larger samples would help to better understand the dental erosion prevalence and severity. (2) The cross-sectional design of the present study can provide a glimpse of the possible association existing between dental erosion and exposure of individuals to acid fumes at the factory environment. To understand the cause-effect dynamics between these variables, analytical epidemiological studies are required.
In the light of the present alarming finding associated with excessive exposure to acid fumes in the workplace resulting in dental erosion, the management of the factory are invited to implement effective safety measures, including: efficient surveillance and routine monitoring of acid fumes in workplace air; installation of efficient ventilation and exhaust systems of the worksites; implementation and mandatory use of protective masks, mouth guards, goggles, and face guards; and providing medical and dental care services at regular intervals.
| Conclusion|| |
Majority of the study participants had higher prevalence and higher scores of dental erosion when compared to the comparison group.
We would like to express our sincere gratitude to Dr. C. V. K. Reddy, professor and head, Department of Public Health Dentistry, for his constant guidance and support throughout the course of our study. We would also thank all the participants of Gillette Jeep Factory and their management, Metagalli, Mysore, for their participation and support during the study. We would like to thank interns and all paradental staffs who helped during the study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kidd EA, Smith BG. Toothwear histories: A sensitive issue. Dent Update 1993;20:174-8.
Smith BG, Bartlett DW, Robb ND. The prevalence, etiology and management of tooth wear in the United Kingdom. J Prosthet Dent 1997;78:367-72.
Hattab FN, Yassin OM. Etiology and diagnosis of tooth wear: A literature review and presentation of selected cases. Int J Prosthodont 2000;13:101-7.
Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology. Philadelphia: WB Saunders; 1983. p. 318-23.
Järvinen VK, Rytömaa II, Heinonen OP. Risk factors in dental erosion. J Dent Res 1991;70:942-7.
Tuominen M, Tuominen R, Ranta K, Ranta H. Association between acid fumes in the work environment and dental erosion. Scand J Work Environ Health 1989;15:335-8.
Tuominen ML, Tuominen RJ, Fubusa F, Mgalula N. Tooth surface loss and exposure to organic and inorganic acid fumes in workplace air. Community Dent Oral Epidemiol 1991;19:217-20.
Petersen PE, Gormsen C. Oral conditions among German battery factory workers. Community Dent Oral Epidemiol 1991;19:104-6.
Milosevic A. Toothwear: Aetiology and presentation. Dent Update 1998;25:6-11.
Raj JB, Gokulraj S, Sulochana K, Tripathi V, Ronanki S, Sharma P. A cross-sectional study on oral health status of battery factory workers in Chennai city. J Int Soc Prev Community Dent 2016;6:149-53.
Bansal M, Veeresha KL. Oral health status and treatment needs among factory employees in Baddi-Barotiwala-Nalagarh industrial hub, Himachal Pradesh, India. Indian J Oral Sci 2013;4:105-9. [Full text]
Gupta VV, Asawa K, Bhat N, Tak M, Bapat S, Chaturvedi P, et al.
Assessment of oral hygiene habits, oral hygiene practices and tooth wear among fertilizer factory workers of Northern India: A Cross sectional study. J Clin Exp Dent 2015;7:e649-55.
Sharma A, Thomas S, Dagli RJ, Solanki J, Arora G, Singh A. Oral health status of cement factory workers, Sirohi, Rajasthan, India. J Health Res Rev 2014;1:15-9. [Full text]
Smith BG, Knight JK. An index for measuring the wear of teeth. Br Dent J 1984;156:435-8.
Erosion of the teeth by acid. Lancet 1980;2:353.
ten Bruggen Cate HJ. Dental erosion in industry. Br J Ind Med 1968;25:249-66.
Khurana S, Jyothi C, Dileep CL, Jayaprakash K. Oral health status of battery factory workers in Kanpur city: A cross-sectional study. J Indian Assoc Public Health Dent 2012;12:80-7.
Patel R, Bhat N, Singh J, Oza S, Gohil S, Singh M. Assessment of tooth erosion among chemical factory workers: A pilot study. Indian J Stomatol 2014;5:127-32.
Malcolm D, Paul E. Erosion of the teeth due to sulphuric acid in the battery industry. Br J Ind Med 1961;18:63-9.
Amin WM, Al-Omoush SA, Hattab FN. Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan. Int Dent J 2001;51:169-74.
[Table 1], [Table 2], [Table 3]