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A3541 - Dental Personnel Treated for Idiopathic Pulmonary Fibrosis at a Specialty Clinic
Author Block: R. J. Nett1, K. Cummings2, B. Cannon3, J. Cox-Ganser4, S. Nathan5; 1Field Studies Branch, NIOSH, Morgantown, WV, United States, 2Respiratory Health Division, CDC/NIOSH, Morgantown, WV, United States, 3Inova Fairfax Medical Campus, Fairfax, VA, United States, 4NIOSH, Morgantown, WV, United States, 5Inova Fairfax Hosp, Falls Church, VA, United States.
Introduction: In April 2016, a dentist undergoing treatment for idiopathic pulmonary fibrosis (IPF) at a specialty clinic contacted the National Institute for Occupational Safety and Health (NIOSH) with concerns that workplace exposures might have contributed. IPF is a progressive lung disease of unknown cause with a median survival of 3-5 years. While IPF is associated with certain occupations, no published data exist regarding dentists and IPF. We aimed to identify dental personnel treated at the specialty clinic and describe pertinent clinical characteristics. Methods: The medical records of all 894 patients undergoing treatment for IPF at the specialty clinic during September 1996-June 2017 were reviewed for evidence the patient had worked in a dental office. Available medical records for identified dental personnel were reviewed and abstracted. We administered a questionnaire that included questions about symptoms, and occupational and non-occupational exposures. The National Occupational Respiratory Mortality System was queried for years 1999, 2003, 2004, and 2007 for dental personnel who had an underlying or contributing cause of death from ‘other interstitial pulmonary diseases with fibrosis’. Results: Nine (1%) of 894 patients treated for IPF were identified as dental personnel, including eight dentists and one dental technician. All patients were male and treated during 2000-2015. Five were white, one black, and three had unknown race. At time of pulmonary consultation, the median age was 64 years (range: 49-81 years). Three patients were former smokers, one was a never smoker, and five had an unknown smoking status. Seven patients had died. The median age of survival from the time of consultation for patients who died was three years (range 1-7 years). The dentist who contacted NIOSH reported not wearing any respiratory protection during dental activities beginning in dental school and through the first 20 years of practice. The second surviving patient was unavailable for interview. Thirty-five decedents were categorized as having worked in the ‘office of dentists’ and 19 decedents categorized as having the occupation ‘dentist’, with proportionate mortality ratios (PMR) = 1.52 (95% confidence interval [CI] = 1.05-2.11) and PMR = 1.67 (95% CI = 1.01-2.61), respectively. Conclusions: We describe the first identified cluster of IPF cases among dental personnel. Dental personnel experience unique occupational exposures that likely increase their risk for certain work-related respiratory diseases. Occupational exposures potentially contributed to this cluster. Further investigation of the risk for dental personnel and IPF is warranted.