The latest endangered species in Australia: a tobacco-smoking veterinarian.

The results of a tobacco smoking survey conducted among veterinarians in Queensland, Australia, during 2007 are presented. Of the 567 participants only 3% reported being current smokers, 24% were ex-smokers and 73% had never smoked. The prevalence of smoking was similar among males and females, and the highest smoking rate was reported among veterinarians aged 31-40 years. However, the rate of never-smokers was strongly and negatively correlated with age, and the proportion of ex-smokers increased with age. Encouragingly, the results from this study suggest that tobacco use has all but disappeared from the Australian veterinary profession in recent years.

Musculoskeletal disorders and psychosocial risk factors among veterinarians in Queensland, Australia.

OBJECTIVE: Although musculoskeletal disorders (MSD) represent one of the most important occupational health issues in contemporary society, few studies have specifically investigated this problem among veterinarians. DESIGN: An anonymous questionnaire survey mailed to all veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006. RESULTS: Almost two-thirds of respondents (63%) had experienced MSD of the lower back, 57% had experienced neck-related MSD, 52% had experienced shoulder-related MSD and 34% had experienced MSD of the upper back during the previous 12 months. MSD was statistically correlated with a range of psychosocial factors, including stress associated with career structure, time pressures, client's attitude, lack of recognition by the public, lack of recognition by colleagues, lack of understanding from family or partners and work stress because of insufficient holidays each year. CONCLUSION: Overall, this study has demonstrated significant correlations between MSD and psychosocial risk factors among a large cohort of veterinarians, apparently for the first time in the published literature. The results also suggest that personal and workplace issues may contribute more to the development of MSD among veterinarians than many of the previously recognised ergonomic risk factors.

An international review of tobacco smoking among medical students.

We conducted a systematic international review of tobacco smoking habits among medical students. Particular attention was paid to countries where smoking rates have been historically well-documented in local journals, but were less often included in larger international review articles. The methodology involved a search of relevant medical subject headings, after which the reference lists of journal papers were also examined to find additional publications. A total of 66 manuscripts met the inclusion criteria. The most common countries previously studied included India, the United States, Australia, Japan, Pakistan, Turkey and the United Kingdom. Overall, our review suggests that the prevalence of smoking among medical students varies widely amongst different countries and also between male and female students within the same areas. Consistently low smoking rates were found in Australia and the United States, while generally high rates were reported in Spain and Turkey. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among medical students are clearly needed worldwide.

Prevalence of percutaneous exposure incidents amongst dentists in Queensland.

BACKGROUND: Percutaneous exposure incidents (PEI) represent an important occupational health issue in dentistry, and one that can incur severe consequences from blood-borne infections. Given the importance of this topic, we considered it necessary to investigate the distribution and cause of PEI among Queensland dentists. METHODS: In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists on the register of the Queensland Branch of the Australian Dental Association. RESULTS: A total of 285 questionnaires (73.1 per cent) were completed and returned. Of the respondents, 73.3 per cent were male and 26.7 per cent female, with a mean age of 45.2 years (SD = 11.9 years). Most were general dentists (89.1 per cent) with the remainder being specialists (10.9 per cent). More than three-quarters (78.5 per cent) reported damaging their gloves at least once during a clinical procedure in the previous 12-month period. Roughly one-quarter (27.7 per cent) had experienced at least one 'sharps' or needlestick injury in the previous 12 months, 16.1 per cent of which involved a contaminated instrument that had been previously used on a patient. The most common devices to cause 'sharps' injury in the previous 12 months were needles (14.4 per cent) and burs (10.2 per cent). CONCLUSIONS: Although PEI clearly remains a major occupational health problem for Queensland dentists, the prevalence of needlestick injuries appears to be lower than other studies from developed countries. The identification of needlestick injuries as a common cause of PEI again stresses the importance of preventive strategies with respect to potential blood-borne infections. Further research is now needed to more carefully identify effective measures for reducing PEI among dental personnel.

Musculoskeletal disorders self-reported by dentists in Queensland, Australia.

BACKGROUND: Musculoskeletal disorders (MSD) represent an important occupational health issue in dentistry. Given the significance of this topic, we considered it necessary to investigate the prevalence and impact of MSD among Australian dentists. METHODS: In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists registered with the Queensland Branch of the Australian Dental Association. RESULTS: A total of 285 questionnaires (73.1 per cent) were completed and returned. Of the respondents, 73.3 per cent were male and 26.7 per cent female, with a mean age of 45.2 years (SD = 11.9 years). Most were general dentists (89.1 per cent), with the remainder being specialists (10.9 per cent). Most dentists (87.2 per cent) reported having experienced at least one MSD symptom in the past 12 months. The most prevalent MSD during the previous 12 months were reported at the neck (57.5 per cent), lower back (53.7 per cent) and shoulder (53.3 per cent). MSD which interfered with daily activities during the previous 12 months were reported at the neck (24.6 per cent), the lower back (22.1 per cent) and the shoulders (21.8 per cent). Over one-third (37.5 per cent) of dentists had sought medical advice or treatment for an MSD during the previous 12-month period. Almost 1 in 10 dentists (9.1 per cent) reported taking leave in the previous 12 months because of an MSD. Among those who took sick leave for an MSD, the mean time taken was 11.5 days (SD = 16.0 days). CONCLUSIONS: Overall, this study suggests that MSD represents a major occupational health issue for Queensland dentists, the occurrence of which is similar to reports from other countries. MSD was shown to interfere with daily activities in some cases, while a considerable proportion of dentists had also sought medical attention for their symptoms. Further research is now needed to more carefully elucidate the impact of MSD in this particular occupational group, especially in relation to cessation or reduction of clinical practice, and also to help identify specific risk factors and effective measures for reducing MSD among dentists in Queensland and elsewhere.

Health of dentists in southern Thailand.

OBJECTIVE: The aims of this study were to investigate the prevalence and nature of some health and lifestyle problems of dentists in southern Thailand. METHOD: The design was a cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. RESULTS: One hundred and seventy-eight 178 (80.9%) dentists aged 22-54 years responded. Only about one third of dentists 65 (36.7%) reported exercising on a regular basis. Almost one fifth of dentists 35 (19.1%) reported that they consumed alcohol on a weekly basis. Few dentists 4 (2.4%) reported regular smoking. Almost all dentists reported that their practice of dentistry has increased stress or stress-related problems 171 (96.1%). More than two thirds of respondents had had some known or unknown systemic health problem since graduation 112 (71.8%), although most dentists reported having no systemic disease at present 104 (59.1%). CONCLUSIONS: The present study has indicated that dentists in southern Thailand report a high career prevalence of stress, a moderate career prevalence of work-related problems which may be related to job satisfaction, and moderate career prevalence of systemic disease. Further continuing education and investigation of appropriate interventions to improve rates of exercise amongst dentists in southern Thailand is needed.

Travel insurance claims made by travellers from Australia for dental conditions.

BACKGROUND: Little is known about dental problems suffered by travellers abroad. This study was designed to investigate travel insurance claims made by travellers from Australia for dental conditions, particularly examining demographic factors, type of travel insurance coverage, nature and duration of travel, when dental treatment was sought during travel, use of emergency assistance, type of treatment, and claim outcome, including cost. METHODS: 1,289 claims submitted during 1998-99 to a major Australian-based travel insurance company were examined for dental claims. RESULTS: 104 (8.1%) claims for dental conditions were submitted, of which 45 (43.3%) were made by male and 59 (56.7%) by female travellers. The majority of claimants were in the 60 years and over age group 54 (52.4%). Dental conditions reported required conservative (mostly fillings) 31 (29.8%), endodontic (mostly root canal treatment) 19 (18.3%), prosthodontic 27 (26.0%), periodontal 8 (7.7%), oral and maxillofacial surgery 2 (1.9%) and other or multiple 17 (16.3%) treatments. Use of the travel insurance emergency telephone service for dental conditions was reported in only seven cases (6.7%). Almost two-thirds 64 (61.5%) of claims were accepted. Claims for prosthodontic treatment were significantly less likely to be accepted. The majority of dental conditions did not require further medical investigations, 74 (71.2%). The mean cost of payouts to claims was AU$238.06 for males and AU$182.58 for females. Claims for endodontic and prosthodontic treatment were significantly more expensive than other types of treatment. CONCLUSIONS: Claims for dental conditions represent a noteworthy proportion of travel insurance claims made by Australian travellers abroad. More than three-quarters of claims for dental conditions were for conservative, endodontic or prosthodontic treatment. Travellers should be advised to have a dental check-up before departure overseas and to take care with pre-existing dental conditions, which may not be able to be claimed on travel insurance.

Occupational hygiene practices of dentists in southern Thailand.

OBJECTIVES: The aims of this study were to investigate the prevalence and nature of infection control, radiation control and handling of mercury, reported by dentists in southern Thailand. METHOD: A cross-sectional study with self-report questionnaire to all 220 dentists working in 14 provinces in southern Thailand in 1997. RESULTS: 178 dentists (80.9%) aged 22-54 years responded. All reported wearing personal protective measures, at least sometimes and using high level disinfection (formerly sterilisation) procedures for handpieces. Most (93.8%) reported changing sterilised handpieces for each patient. The most commonly reported method of high level disinfection was alcohol (37.1%). Just over two-thirds (68.0%) reported having HBV vaccination. Most (94.3%) reportedly took precautions when radiographs were taken and (89.9%) reported protecting their eyes with a UV/blue light shield or filter while using these units. About half of dentists (51.7%) reported storing excess amalgam under water compared with 20.1% that they stored it in a closed box. 77.7% reported using sealed mercury amalgam capsule systems, at least sometimes. Nearly half (47.1%) reported disposing of used capsules in the bin. CONCLUSIONS: The present study has indicated that occupational hygiene practices of dentists in southern Thailand are generally consistent with published guidelines for infection control and also with other populations of dentists studied in the areas of infection control and radiation protection. Further continuing education and investigation of appropriate interventions to promote good occupational hygiene standards may also be needed.

Bacterial aerosols in the dental clinic: a review.

A number of sources of bacterial aerosols exist within and outside the dental clinic. The concentration of bacterial aerosols and splatters appears to be highest during dental procedures, especially those generated by some procedures such as ultrasonic scaling, or using a high speed drill. Several infectious diseases could be transmitted to staff and patients by airborne bacterial and other contaminants in the dental clinic. Air-conditioning and ventilation systems should be regularly maintained to reduce environmental contaminants and to prevent recirculation of bacterial aerosols. Pre-procedural rinsing by patients with mouthwashes as well as vacuum and electrostatic extraction of aerosols during dental procedures could also be employed. Dental staff should also consider appropriate immunizations and continue to use personal protective measures, which reduce contact with bacterial aerosols and splatters in the dental clinic.

Traveling to Australia for the Sydney 2000 Olympic and Paralympic Games.

The modern Olympic Games, conducted only once every 4 years since 1900, will be held in Sydney, Australia, from September 15 to October 1, 2000. There will be approximately 35 competition venues, 5 villages, 100 training venues, a media center, and sponsor hospitality areas.1 There will be about 300 events for 28 sports, involving 10,300 athletes from 200 countries, 5,100 team officials, 50,000 volunteers, 15,000 media, a world wide audience of around 3.5 billion viewers and listeners, and up to several hundred-thousand spectators at any one time.1 The Paralympic Games will also be held in Sydney, after the Olympic Games, from October 18 to 29, 2000, with more than 4,000 athletes competing.1 This paper focuses on health and safety issues for travelers to Australia in general, although it makes specific references to advice for visiting Olympic and Paralympic athletes and team staff, who will be traveling to the games. It must be remembered that travel health advice can change, and that travelers should be advised to seek up-to-date travel health advice for Australia closer to their departure.

Occupational health problems of dentists in southern Thailand.

AIMS: To investigate the prevalence and nature of some occupationally related health problems in dentists in southern Thailand. DESIGN: A cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. PARTICIPANTS: One hundred and seventy-eight dentists aged between 22 to 54 years responded. RESULTS: The most common occupational health problems were musculoskeletal pain (78 per cent) and percutaneous injury (50 per cent). Associated factors were analysed using multivariate analysis. About 22 per cent of these dentists had a history of contact dermatitis mostly caused by allergy to latex gloves, 15 per cent had eye problems, and 3 per cent had hearing problems. CONCLUSIONS: Continuing education in the avoidance of percutaneous injuries would be beneficial, as exposure to potential infectious agents is of concern. Further studies are needed to identify causes of musculoskeletal pain and to identify appropriate interventions to reduce its prevalence, as would similar measures to reduce exposure to agents which may be producing contact dermatitis.

Resources used by general practitioners for advising travelers from New Zealand.

BACKGROUND: The risks of the destination and any specific requirements for travel health advice may be obtained from a variety of resources. This study was designed to investigate the usefulness of various resources available in New Zealand for providing travel health advice and the extent to which GPs used these resources in providing travel health advice. METHOD: Four hundred GPs (400/2830) were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. RESULTS: Three hundred and thirty-two (332/400, 83%) GPs responded. The usefulness of various resources was reported, including Health Advice for Overseas Travellers (277/289, 96%), New Ethicals (256/278, 92%), New Zealand Public Health Report (79/164, 48%), International Travel and Health (41/144, 28%), computerized databases (6/122, 5%), journals (14/130, 11%), and other resources (44/139, 32%). Health Advice for Overseas Travellers was regarded as significantly more useful than International Travel and Health (x2 = 4,68, df = 1, p <.05). Only 23% (70/309) of respondents indicated that they always used these resources in their practice of travel medicine. Fifty percent (154/309) of respondents indicated that they usually used these resources, while 27% (83/309) of respondents indicated that they used these resources sometimes. Only 1% (2/309) of GPs did not use resources at all for their practice of travel medicine. CONCLUSIONS: The most useful resource was Health Advice for Overseas Travellers, which outlines the New Zealand recommendations for medical practitioners providing travel health advice. It may be useful for GPs to gain access to and training in association with a greater range of specialist resources to use in conjunction with the provision of travel health advice. These might include international guidelines, journals, and access to computerized databases and the internet. With the recent introduction of a widely accessible computerized database in New Zealand, follow-up studies could be instituted to determine if GPs' use of computerized databases becomes more widespread and whether access to and use of these computerized databases influences the provision of travel health advice by GPs. Further studies are needed to examine the appropriateness of the advice provided by the various resources used by GPs in New Zealand.

Sources of health advice given to travelers.

One of the biggest problems for health professionals and the travel industry has been getting travelers to present for pretravel health advice from a qualified source. Behrens1 stated that one of the most important factors in whether travelers seek health advice at all was the perceived risk and severity of tropical diseases. Travelers may obtain this health advice from the travel industry itself, or from health professionals in travel clinics, hospitals, public health units, general practices or other centers. They may also obtain advice by telephone directly from these areas. It is likely however that travel agents and the travel industry, especially various publications, are an important source of preliminary information on health and safety for travelers.

Travel insurance and health.

Travel insurance normally underwrites travel, medical, and dental expenses incurred by travelers abroad and arranges aeromedical evacuation of travelers under conditions specified by the travel insurance policy. Because of the costs of medical and dental treatment abroad and the high cost associated with aeromedical evacuation, all travelers should be advised of the need for comprehensive travel insurance and be advised to read their policies carefully to see what is covered and to check for any exclusions. In particular, those travelers who have known preexisting conditions, who are working overseas, or who are going to undertake any form of hazardous recreational pursuit may need to obtain a special travel insurance policy, which may attract a higher premium. Conservatively, it is estimated that between 30-50% of travelers become ill or injured whilst traveling. Relative estimated monthly incidence rates of various health problems have been compiled elsewhere. The risk of severe injury is thought to be greater for people when traveling abroad. These risks should be covered by travel insurance to protect the traveler, however it is not known what proportion of travel agents or airlines give advice routinely on travel insurance. Travel insurance is the most important safety net for travelers in the event of misadventure, and should be reinforced by travel health advisers. Although only 4% of general practitioners (GPs) in a late 1980's study in the United Kingdom would advise a traveler going to Turkey about travel insurance,4 more recent studies have shown about 60% of GPs in New Zealand and 39% of travel clinics worldwide usually advised travelers concerning travel insurance. In addition, 54% of GPs in New Zealand usually also advised travelers about finding medical assistance abroad, but only 19% of GPs recommended travel insurance companies as a source of medical assistance while traveling.