RESUMO
O exercício da Odontologia visa garantir higidez e a plena saúde bucal, entretanto, essa nobre atividade implica na geração de resíduos, os quais devem ser devidamente tratados para que sejam minimizados os impactos negativos sobre o meio ambiente e a sociedade. Muitos dos materiais utilizados na Odontologia são potencialmente danosos ao meio ambiente, caso seu descarte não seja realizado da forma correta. Em virtude disto, mostra-se essencial a conscientização dos cirurgiões-dentistas acerca do manejo e descarte recomendado, com vistas a amenizar, senão anular, os efeitos nocivos ao meio ambiente e à população. O descarte inadequado dos resíduos odontológicos acarreta poluição do solo e das águas, tendo consequências imensuráveis. Diante do enorme risco ocasionado pelo descarte inadequado dos resíduos odontológicos, faz-se necessário apurar quais condutas devem ser tomadas com vistas a minimizar tais riscos bem como quais os órgãos competentes para fixar diretrizes e regulamentar o assunto. Primordial é a consciência do dentista, que é o responsável por manusear diretamente os compostos e descartar seus resíduos. Igualmente importantes são a regulamentação e a fiscalização, as quais podem ser desempenhadas, concorrentemente, pelas diferentes esferas de governo. A nível federal, a Anvisa detém competência legal para tratar do assunto, havendo inclusive penalidades para condutas inadequadas. Entretanto, dada a carência de pessoal, a fiscalização federal nem sempre é realizada a contento, motivo pelo qual uma maior participação das administrações municipais mostra-se fundamental nesse processo. O presente trabalho consistiu em pesquisa realizada com 84 cirurgiões-dentistas do município de Guaratinguetá-SP, cujo objetivo principal foi verificar a destinação que estava sendo dada aos resíduos de reveladores e fixadores odontológicos e, subsidiariamente, também tomar conhecimento da consciência ecológica dos participantes. Ao término da pesquisa, identificou-se que a grande maioria dos cirurgiões-dentistas promovia a destinação de resíduos de maneira incorreta, mediante descarte na rede de esgoto (73,81%) e no meio ambiente (8,33%). Verificou-se também que 82,14% dos participantes não tiveram em sua formação acadêmica nenhuma disciplina que abrangesse o tema descarte de reveladores e fixadores odontológicos e 92,86% jamais presenciaram palestra ou congresso que tratasse do tema. No tocante à composição química de reveladores e fixadores, 78,31% dos entrevistados não detinham tal conhecimento. Conclui-se que apenas pequena parcela dos profissionais procede corretamente quanto ao descarte dos resíduos químicos, mostrando oportuna a inclusão de conteúdo na grade curricular dos cursos de Odontologia(AU)
ABSTRACT The practice of dentistry aims to guarantee hygiene and full oral health, however, this noble activity implies the generation of waste, which must be properly treated in order to minimize negative impacts on the environment and society. Many of the materials used in dentistry are potentially harmful to the environment if their disposal is not performed correctly. Because of this, it is essential to raise the awareness of dentists about the recommended management and disposal, with a view to mitigating, if not annulling, the harmful effects on the environment and the population. Inadequate disposal of dental waste results in pollution of the soil and water, with immeasurable consequences. In view of the enormous risk posed by the inadequate disposal of dental waste, it is necessary to determine which measures should be taken with a view to minimizing such risks as well as which bodies are competent to set guidelines and regulate the subject. Primordial is the awareness of the dentist, who is responsible for handling the compounds directly and discarding their waste. Equally important are regulation and oversight, which can be performed concurrently by different spheres of government. At federal level, Anvisa has legal competence to deal with the matter, including penalties for inappropriate conduct. However, given the shortage of personnel, federal supervision is not always carried out satisfactorily, which is why a greater participation of municipal administrations is fundamental in this process. The present study consisted of a survey carried out with 84 dentists in the city of Guaratinguetá-SP, whose main objective was to verify the destination that was being given to dental developers and dental fixatives, and, in the alternative, also to be aware of the ecological awareness of the participants. At the end of the research, it was identified that the great majority of dental surgeons promoted the disposal of waste in an incorrect manner, by discarding the sewage network (73.81%) and the environment (8.33%). It was also verified that 82.14% of the participants did not have in their academic formation any discipline that covered the discard theme of dental developers and fixators and 92,86% never attended a lecture or congress that dealt with the theme. Regarding the chemical composition of developers and fixatives, 78.31% of interviewees had no such knowledge. It is concluded that only a small number of professionals proceed correctly regarding the disposal of chemical residues, showing timely inclusion of content in the curriculum of the Dentistry courses(AU).
Assuntos
Humanos , Resíduos Odontológicos/classificação , Resíduos/análiseRESUMO
El estudio de la bioseguridad en la gestión de los residuos líquidos del procesado radiográfico en odontología, generados en los Unidades Comunitarias de Salud Familiar (UCSF) de la zona metropolitana de San Salvador, es importante para las investigaciones institucionales en el campo de la odontología. Revisando la literatura existente, se evidencia que es necesaria la correcta manipulación de los elementos químicos peligrosos de desecho, específicamente en el área de odontología, que presenta como parte de su práctica la toma de radiografías mediante el uso de sistemas convencionales de radiología, generando de esta manera sustancias químicas con características tóxicas y corrosivas, volviéndolos un peligro para el medio ambiente y la salud humana. Con este estudio se estableció por observación, el manejo institucional que se le está dando a los líquidos reveladores radiográficos en cada uno de los consultorios odontológicos de las UCSF del área metropolitana de San Salvador, ya que a nivel de Ministerio de Salud es en esta área donde se concentra la mayor cantidad de UCSF que prestan el servicio de toma radiográfica dental a la población; además se establece el nivel de conocimiento que posee el personal odontológico y de salud medio ambiental acerca del protocolo de eliminación de los líquidos reveladores radiográficos y de las técnicas de tratamiento para los mismos con el fin de disminuir su potencial tóxico. La muestra estuvo conformada por UCSF del área metropolitana de San Salvador que poseen aparatología de rayos-x de tipo convencional (12 UCSF), y por profesionales de salud (33 odontólogos e inspectores de salud medio ambiental). En los establecimientos (UCSF) se verificó el protocolo, mediante el uso de guías de observación y con los profesionales se estableció el conocimiento que estos poseen sobre el mismo y sobre técnicas de tratamiento para los líquidos reveladores agotados, mediante el llenado de cuestionarios. Se evidenció que, en el 83.4% de las UCSF se realiza un mal manejo del protocolo de eliminación de los líquidos reveladores, en un 16.6% se realiza un manejo regular y en ningún establecimiento se está realizando un correcto protocolo de eliminación de los líquidos reveladores (segregación, etiquetado, acumulación, transporte interno, almacenamiento temporal, trasporte externo y disposición final). La práctica predominante para la disposición final de los líquidos reveladores fue verterlos en el sistema de alcantarillado público sin previo tratamiento con un 83.4% y solamente un 16.6% los entregaba a una empresa recolectora, pero mezclados con otros elementos de desecho. En cuanto al conocimiento se verificó que el 45.5% posee un nivel de conocimiento bajo sobre ambos temas evaluados, el 42.4% posee un nivel de conocimiento intermedio y solamente un 12.1% posee un nivel de conocimiento alto.
The study of biosafety in the management of liquid waste from the radiographic processed in dentistry, generated in the Community Units of Family health (UCSF) in the metropolitan area of San Salvador, it is important for the institutional researches in the field of dentistry. Reviewing the existing literature, there is evidence that it is necessary the correct handling of the dangerous chemical elements of waste, specifically in the area of dentistry, which presents as part of its practice the taking of radiographies through the use of conventional radiology systems, thus generating chemical substances with toxic and corrosive characteristics, making them a danger to the environment and human health. With this study, it was established by observation, the institutional management that is being given to the radiographic revealing liquids in each of the dental clinics of the UCSF in the metropolitan area of San Salvador, since at the level of Ministry of Healt, it is in this area where it is concentrated the greatest amount of UCSF that offer the service of taking dental radiographic to the population. Also, it is set the level of knowledge that the dental staff and environmental health have about the Protocol of elimination of radiographic revealing liquids and treatment techniques for the same in order to reduce its toxic potential. The sample was formed by UCSF in the metropolitan area of San Salvador, which possess x-ray appliances of conventional type (12 UCSF), and health professionals (33 dentists and environmental health inspectors). In establishments (UCSF) the protocol was verified by using observation guides and with professionals there was established the knowledge that these have on the same one and on treatment techniques for the revealing liquids exhausted, by means of filling out questionnaires. It was demonstrated that in 83.4 % of the UCSF, there is a mishandling of protocol of elimination the revealing liquids, in a 16.6 % a regular handling is performed and in any establishment is being performed a correct protocol of elimination of the revealing liquids (segregation, labeling, accumulation, internal transport, temporary storage, external transport and final disposal). The predominant practice for the final disposal of the revealing liquids was poured them in the public sewer system without prior treatment with an 83.4% and only a 16.6% gave them to a trash company, but mixed with other waste items. With regard to knowledge, it was verified that the 45.5 % has a low degree of knowledge on both evaluated subjects, the 42.4 % has an intermediate level of knowledge and only a 12.1 % possesses a high level of knowledge.
Assuntos
Contenção de Riscos Biológicos , Resíduos , Eliminação de Resíduos Líquidos , OdontologiaRESUMO
Las dermatosis ocupacionales en trabajadores de fotografía son poco frecuentes en la actualidad. Los alergenos habituales son los reveladores de color CD-2, CD-3 y CD-4. Dichos productos pueden producir erupciones liquenoides y eczematosas. El caso que presentamos es el de un paciente varón de 35 años, trabajador de una empresa de revelados de fotografía desde hacía dos años. En el momento de la consulta presentaba lesiones eczematosas que afectaban mano derecha y ambos miembros superiores con intenso prurito. Se realizaron pruebas epicutáneas, con batería estándar del Grupo Español Internacional de Dermatitis de Contacto (GEIDC) y específica para fotografía, observándose resultados muy positivos para los reveladores de color CD-2, CD-3, CD-4 y TSS (4-amino-N, N-dietilalinina sulfato), así como moderado para hidroxilamonio. El tratamiento consistió en corticoides por vía oral y tópica, así como el cese de la actividad laboral relacionada con el contacto con dichas sustancias, lo que permitió la resolución completa de las lesiones cutáneas sin recidiva.
Occupational dermatitis in photography workers are quite rare nowadays. Common allergens are colour developers CD-2, CD-3 and CD-4. These products can cause lichenoid and eczematous eruptions. We present the case of a 35 year old male patient, who had been working in a photography development company for two years. At the time of the consult the patient presented eczemaous lesions involving the right hand and both arms with intense itching. Epicutaneous patch tests were performed with standard battery from the Spanish Group International Contact Dermatitis (GEIDC) and specifi c battery for photography, showing intense positive results for colour developers CD-2, CD-3, CD-4 and TSS (4-amino-N, N-dietilalinina sulfate), as well as moderate positive result to hydroxyl ammonia. Treatment consisted of oral and topic corticotherapy and the cessation of any work related to the contact with these substances, which allowed complete resolution of skin lesions without recurrence.