New federal rules mandate reducing people’s risk of exposure to some fine particulates common to dental practices and labs. Here’s a primer.
By Jill Obrochta, RDH, BS
NOT LONG AGO, the Occupational Safety and Health Administration—yes, OSHA, everyone’s nosy neighbor—updated its strictures regarding dental offices and laboratories, and the presence of silica and beryllium dust therein.
Both of these, of course, are commonly found in a range of dental materials. Why the sudden concern? Well, some complex recent longitudinal studies have shown higher incidence of lung cancer and heavy-metal poisoning in not just dental practices’ and labs’ employees but their family members as well. Casting, sandblasting and grinding porcelain are the primary culprits, but even diligent cleaning up after these activities won’t eliminate the risk.
That’s because beryllium and silica particles, needless to say, are tiny— some 1,000 times finer than a grain of sand, enabling them to become airborne and inhaled with only the slightest provocation. They also settle on clothing, which explains why family members are susceptible as well. OSHA’s new rules aim to protect, to the greatest degree possible, anyone at risk of primary or secondary exposure. The final regulation was promulgated last June; compliance is mandatory as of this June 23—and you can be certain that dental practices and labs will be heavily audited.
The most effective method of control, of course, is substitution. Eliminate materials that contain crystalline silicates and beryllium and you’ve also eliminated the main trigger of silicosis, an incurable respiratory ailment that in the worst case can lead to kidney dam- age, lung cancer and tuberculosis. One common replacement is aluminum oxide, though there are others.
If you can’t rid your practice or lab of these particulates outright—OSHA’s rule doesn’t mandate this, but it does require doctors to “implement protective measures” that mitigate the risk—it’s important that you focus on ventilation at the source of the grinding and blasting to help carry away airborne dust before it’s inhaled or settles on clothing. Respirators for lab staff are a good idea as well, but their fit must be tested by a qualified team member or third party.
Finally, housekeeping: Daily wet mopping with disposable mop heads, wet wiping or vacuuming with a HEPA filter—a high-efficiency particulate absorber—is very much recommended to keep dust from becoming airborne. Don’t use a compressed-air blaster. You’ve seen how it scatters the gunk in your keyboard; you don’t want it doing that to harmful particles. Double-bag all mop heads and wipes in zip-lock plastic, and take them immediately to an exterior trash can, as the material can reintroduce itself to the air once it dries.
For more information, visit osha.gov/berylliumrule. Yes, it’s yet another thing to keep track of. (OSHA forecasts the annual net benefit of the regulation to be $560.9 million nationwide; your own mileage may vary.) Regardless, the fitness of your patients and staff—and, of course, your own health as well—are certainly worth it.
JILL OBROCHTA is the Florida-based founder of Dental Enhancements, an OSHA and HIPAA solutions company. She offers no-obligation consultations and can be reached anytime at 941-587-2864 or firstname.lastname@example.org.