Accepted Manuscript Insights into ergonomics among dental professionals of a dental institute and private practitioners in Hubli – dharwad twin citiess, India Shrivardhan R. Kalghatgi, MDS K.V.V. Prasad, MPH, Professor and Head Kumar Gaurav Chhabra, MDS, Assistant Professor Shravani Deolia, MDS, Assistant Professor Chaya Chhabra, MDS, Assistant Professor PII:
S2093-7911(14)00069-9
DOI:
10.1016/j.shaw.2014.09.001
Reference:
SHAW 62
To appear in:
Safety and Health at Work
Received Date: 26 May 2014 Revised Date:
29 August 2014
Accepted Date: 1 September 2014
Please cite this article as: Kalghatgi SR, Prasad KVV, Chhabra KG, Deolia S, Chhabra C, Insights into ergonomics among dental professionals of a dental institute and private practitioners in Hubli – dharwad twin citiess, India, Safety and Health at Work (2014), doi: 10.1016/j.shaw.2014.09.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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ORIGINAL RESEARCH INSIGHTS INTO ERGONOMICS AMONG DENTAL PROFESSIONALS OF A DENTAL INSTITUTE AND PRIVATE
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PRACTITIONERS IN HUBLI – DHARWAD TWIN CITIESs, INDIA
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Running title: Awareness and practice of ergonomics among dentists
Shrivardhan Kalghatgi, KVV Prasad, Kumar Gaurav Chhabra, Shravani Deolia,
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Chaya Chhabra
Shrivardhan R Kalghatgi, MDS, Department of Public Health Dentistry, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India. Email id
[email protected]
K.V.V. Prasad, MPH, Professor and Head, Department of Public Health Dentistry,
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SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India. Email id-
[email protected]
Kumar Gaurav Chhabra, MDS, Assistant Professor, Department of Public Health Dentistry, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India. Email
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id-
[email protected]
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Shravani Deolia, MDS, Assistant Professor, Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India. Email
[email protected] Chaya Chhabra, MDS, Assistant Professor, Department of Pedodontics and Preventive Dentistry, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India. Email id-
[email protected]
Address for correspondence Shrivardhan Kalghatgi, MDS Department of Public Health Dentistry,
ACCEPTED MANUSCRIPT SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India Phone no- +91-9886598874
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Email
[email protected]
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ORIGINAL RESEARCH INSIGHTS INTO ERGONOMICS AMONG DENTAL PROFESSIONALS OF A DENTAL INSTITUTE AND PRIVATE
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PRACTITIONERS IN HUBLI – DHARWAD TWIN CITIESs, INDIA
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ABSTRACT
Objective: To assess the knowledge, attitude and practice of ergonomics among
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dental professionals of Hubli- Dharwad twin cities, India..
Materials and methods: Investigator developed, self-administered, close ended questionnaire assessing knowledge, attitude and practices regarding ergonomics during dental practice was filled by under graduates, house surgeons, post graduates
Dharwad twin cities.
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and faculty members of dental institution and private practitioners from Hubli –
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Results: Data was collected from a total of 250 subjects, 50 belonging to each academic group. Overall mean knowledge, attitude and practice scores were 52%,
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75% and 55% respectively. Significant correlation was found for age with attitude (χ2 = 10.734, P = 0.030) and behavior (χ2 = 12.984, P = 0.011). Marital status was significantly associated with all the three domains; knowledge (χ2 = 29.369, P = 0.000), attitude (χ2 = 29.023, P = 0.000) and practices (χ2 = 13.648, P = 0.009). Conclusions: Subjects had considerable awareness and behavior towards ergonomics in dental practice. The
high attitude score indicate stronger acceptance of
ergonomics principles and guidelines during routine dental procedures. The current
ACCEPTED MANUSCRIPT study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude and practices. Keywords: Ergonomics, Dental professionals, India, Private practitioners
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Introduction Ergonomics is the scientific study of people and their working conditions, especially done in order to improve effectiveness.[1] In Greek, “Ergo,” means work and,
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“Nomos,” means natural laws or systems. Ergonomics, therefore, is an applied science concerned with designing products and procedures for maximum efficiency
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and safety.[2] Dentistry is a profession that generally produces various musculoskeletal pains and soreness, which are slow to appear, consequently, the symptoms are usually ignored until they become chronic and permanent lesions become evident.[3] It is very important to maintain an adequate work posture and that
characteristics.[4]
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the instruments and furniture that the dentist is working with have adequate working
Among the wide range of musculoskeletal disorders, back–pain was the most
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common among dentists followed by neck pain, high muscle tension on trapezoids, tendonitis, carpel tunnel syndrome, nerve trapping, early arthrosis, myopia, auditive
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alterations.[5]
Pargali in 2010 reported that 73 percent of dentists complained of back and neck pain. [6]. Even though the practice of four handed dentistry and ergonomically well adjusted equipments are on the rise, literature reports have reported a rise in back, neck, shoulder and arm pain, in almost 81 percent of dental professionals. [6]. Work related stress, tension and awkward postural positions can add on to back and neck problems to the dentist.[7-11] There is always a neutral zone of movement for every
ACCEPTED MANUSCRIPT joint and muscle. Injury risks increase whenever work requires a person to perform tasks with body segments outside of their neutral range in a deviated posture.[12] In Indian scenario there is abrupt mushrooming of many dental institutions. Total number of dental institutions in India is currently 300. The number of students
across India is approximately 24,700[13] and is still counting.
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enrolling for Bachelor of Dental Surgery (BDS) degree in various dental institutions
According to the syllabus for BDS proposed by the Dental Council of India (DCI),
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undergraduates are exposed to clinical working conditions for the very first time during the 3rd year of course during which every student undergoes training in various
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subjects on rotatory basis for certain fixed amount of time. This is the time during which ergonomics, as a part of regular curricular practice should be taught to students, right from its importance in practice and various guidelines to be followed. Considering same reason in mind, undergraduates i. e. both 3rd and 4th year BDS
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students were included as study participants.
Most of the graduates might end up in private practice and few are involved in academics, the faculties of dental colleges are also engaged in private practice.[14]
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Hence, the dentists who are into private practice need to place special consideration to
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ergonomics habits to improve their longevity. Needless to say that age of the dentist is closely related with how many years the dentist has been practicing. A study observed increasing years of practice to be related to an increased prevalence of musculoskeletal problems.[15] Female dentists have outnumbered males in dentistry [16] and literature suggests that they are more prone to develop musculoskeletal pain than men.[17] Hence it becomes the need of the hour to educate them regarding various musculoskeletal problems arising due to unhealthy postural habits at the time of delivering oral health services, and promote preventive and corrective measures for
ACCEPTED MANUSCRIPT promoting healthy life styles during their professional practice. In the Indian set-up there is severe dearth of literature evaluating knowledge, awareness and practices among dental professionals regarding optimal postures at the time of rendering oral health services. Therefore, the present observational survey was conducted to evaluate
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the awareness, attitudes and practice of ergonomics during routine dental procedures among under-graduates, house surgeons, post graduates, faculty of Sri Dharmasthala Manjunatheshwara (SDM) College of Dental Sciences and Hospital, Dharwad,
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Karnataka, India and private practitioners of Hubli – Dharwad twin cities, India. MATERIALS & METHODS
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The study was conducted among undergraduates (3rd and 4thyear BDS students), house surgeons, post–graduates and faculty members and private practitioners of aforementioned private dental college and cities. Ethical clearance was obtained from the Ethical Review Committee of the Institutional Review Board of SDM College of
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Dental Sciences and Hospital, Dharwad, Karnataka, India. The head of the institution and other faculty members were informed about the purpose of the study and their permissions obtained. The study population consisted of 50 each from group of
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undergraduates, house surgeons, post-graduates and staff attending the institution and
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private practitioners, practicing in Hubli – Dharwad twin cities, through convenient sampling method.
The questionnaire was investigator developed, self administered and closed ended. The under graduates, house surgeons, post-graduates and staff were gathered in the lecture hall together and one of the authors gave instructions regarding the purpose of the survey and filling of survey questionnaire. Study participants were given a format consisting of informed consent, instructions and questionnaire. They were given 1 hour to complete the questionnaire.
ACCEPTED MANUSCRIPT Private practitioners, were approached by the same author who gave the instructions to rest of the study subjects (SK) at their clinics. The purpose of the survey was explained and those who gave consent for participation in the study were included. The items for the questionnaire were generated from four sources: theory, research,
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observation, and expert opinion.[18] The questionnaire consisted of a total of 37 items with 21, 8 and 8 items assessing knowledge, attitude and behavior respectively. Attitude was assessed on a five-point Likert scale: definitely yes, yes, neutral, no and
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definitely no. The response options for behavior were also a five-point Likert scale as follows:< 1month, 1-6 months, 6-12 months, > 1year and never (for first 2 items) and
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always, very often, often, rarely and never (for items 3-8). Knowledge was assessed by a total of 21 questions on ergonomics which focused on principles of ergonomics in routine dental procedures such as cavity preparation, extraction of teeth and various complications.. Questions related to attitude included whether ergonomics should be
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part of the dental curriculum, dentists should follow the ergonomic principles in routine dental practice, dental chair, instruments play any role in following ergonomic principles in routine dental practice, dentist should alternate between sitting and
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standing posture in between two patient appointments, various dental institutions
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should conduct continuing dental education. Questions pertinent to behavior assessed how frequently the respondents obtained information related to ergonomics in dentistry either from internet or scientific journals, used dental loups for magnification purpose, make an effort to maintain neutral posture while working, attended any workshop/lecture on ergonomics in dental career, performed stretching exercises in between patient appointments. The range of possible scores for knowledge, attitude, and behavior were 0-21, 8-40, and 8-40, respectively. Correct answers for knowledge questions were given a score of “1”and wrong answers were
ACCEPTED MANUSCRIPT given a score of “0.” Attitude scores ranged from 5 (definitely yes) to 1(definitely no), and behavior scores ranged from 5 (
