Dataset Information

Occupational risk for Legionella infection among dental healthcare workers: meta-analysis in occupational epidemiology.

ABSTRACT:

Objective

The occupational risk for Legionella infection among dental healthcare workers (DHCWs) is conjectured because of the risk of routine inhalation of potentially contaminated aerosols produced by the dental instruments. Nevertheless, occupational epidemiology studies are contrasting. This meta-analysis assessed the level of scientific evidence regarding the relative occupational risk for Legionella infection among DHCWs.

Methods

Literature search was performed without time and language restrictions, using broad data banks (PubMed, Scopus, Web of Science, GOOGLE Scholar) and generic keywords ('legionella' AND 'dent*'). Analytical cross-sectional studies comparing prevalence of high serum Legionella antibody levels in DHCWs and occupationally unexposed individuals were considered. The relative occupational risk was assessed through prevalence ratio (PR) with 95%?CI. Between-study heterogeneity was assessed (Cochran's Q test) and was used to choose the meta-analytic method. Study quality (modified Newcastle-Ottawa Scale) and publication bias (Begg and Mazumdar's test, Egger and colleagues' test, trim and fill R₀ method) were assessed formally and considered for the sensitivity analysis. Sensitivity analysis to study inclusion, subgroup analyses (dental staff categories; publication year, before vs after 1998, ie, 5?years after the release by the Centers for Disease Control and Prevention of the infection control guidelines in dental healthcare setting) were performed.

Results

Seven studies were included (2232 DHCWs, 1172 occupationally unexposed individuals). No evidence of publication bias was detected. The pooled PR estimate was statistically non-significant at 95% level (1.7; 95%?CI 0.8 to 3.2), study-quality adjustment did not change the PR considerably (PR, 1.5; 95%?CI 0.5 to 4.1). PR was statistically significant before 1998 and no longer significant after 1998. Subgroup analysis according to DHCW categories was inconclusive.

Conclusions

There is no scientific evidence that DHCWs are at high occupational risk. The differences between former and recent studies could be due to different characteristics of municipal water systems and the infection control guideline dissemination.

SUBMITTER: Petti S

PROVIDER: S-EPMC5734417 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

Occupational risk for <i>Legionella</i> infection among dental healthcare workers: meta-analysis in occupational epidemiology.

Petti Stefano S Vitali Matteo M

BMJ open 20170713 7

<h4>Objective</h4>The occupational risk for <i>Legionella</i> infection among dental healthcare workers (DHCWs) is conjectured because of the risk of routine inhalation of potentially contaminated aerosols produced by the dental instruments. Nevertheless, occupational epidemiology studies are contrasting. This meta-analysis assessed the level of scientific evidence regarding the relative occupational risk for <i>Legionella</i> infection among DHCWs.<h4>Methods</h4>Literature search was performed ...[more]

PMID: 28710211

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