The Effects of Indoor Pollutants on Health Care Workers, Patients, and Caregivers in Dental Clinics: A Systematic Review.

Most of the pollution inside a dental clinic comes from the external environment; therefore, the location of the building affects the air quality, as well as the work activity and the type of natural or mechanical ventilation. In the dental sector, pathologies caused by pollutants are increasing, mainly because of methyl methacrylate, 2-hydroxyethyl methacrylate, ethylene glycol dimethacrylate, and triethylene glycol dimethacrylate. However, there are still gaps in the literature regarding the potential effects of all environmental pollutants, and particularly the long-term effects on healthcare workers. A comprehensive search was conducted across PubMed, Embase, Web of Science, and Cochrane Library databases, without time limits, resulting in a total of 155 scientific articles. After the removal of the duplicates, 86 single papers remained for further analysis. The titles of these articles were manually reviewed to include relevant references related to the presence of indoor pollutants in the air of dental clinics. Following this screening process, 10 studies were identified as relevant to the topic of the systematic review. Seven scientific articles were selected to be included in this review. The seven experimental studies reported various air pollutants related to diseases affecting dental health. In particular, the levels of volatile organic compounds, carbon dioxide, and temperature were analyzed in a university dental clinic. Levels of environmental pollutants are much higher during working hours, particularly during dental procedures such as prosthetic and conservative dentistry, due to the chemical nature of the materials used. However, no study reported exceeding the limits set by national environmental regulations. Due to the heterogeneity of the studies, the variety of molecules, the variety of clinical facilities and their geographical location subject to different regulations, as well as the variety of measurement methods, including the variety of traditional and/or technological ventilation systems used in dental departments, a meta-analysis was not performed. Despite the limitations of this systematic review, it was possible to identify some key points that are useful for further in vivo studies aimed at developing specific guidelines to protect health care workers.