Abstract
Objectives: The aims of this study were to investigate the prevalence and nature of some health and lifestyle problems among dentists in United Arab Emirates (UAE). Method: A cross-sectional study with a one-stage complex sampling technique using a self-reported questionnaire distributed to all 844 dentists, working in three cities (Abu Dhabi, Dubai and Sharjah) in UAE. Results: Seven hundred and thirty-three (87%) dentists, aged 22–70 years, responded. More than half (n = 442, 61%) of dentists do not exercise regularly. Around one-seventh of the dentists are smokers. One hundred and eighteen dentists (16%) reported having some known systemic problem. The most common systemic health problems were cardiovascular diseases (n = 56, 8%). Conclusion: The present study indicates that the prevalence of exercise among dentists in UAE is relatively low and some systemic health problems, especially cardiovascular diseases, are present among dentists practicing in UAE. Cigarette consumption is relatively high in this population of dentist. Further continuing education and investigation of the appropriate intervention to improve rates of exercise and reduce the level of smoking among dentists in UAE is needed, and this may help reduce the level of systemic disease.
Key words: Health, exercise, smoking, dentists, UAE
INTRODUCTION
Dentistry can be a stimulating and rewarding occupation but is also physically and mentally demanding1. It has been suggested that dentists lack awareness and knowledge about managing their stress2., 3., 4.. The most common stressors reported include time-related pressure, heavy workloads, financial concerns, anxious patients, staff problems, poor working conditions, medical emergencies in the surgery and the routine nature of the job2., 5.. Failure to adapt to or contend with the working environment can predispose to illness6. The most frequent causes of premature retirement among dentists are musculoskeletal disorders (29.5%), cardiovascular disease (21.1%) and neurotic symptoms (16.5%), as reported by Burke et al.7; therefore, practicing dentists should be aware of these illnesses and take steps to avoid them, especially musculoskeletal problems and cardiovascular disease7. Despite anecdotal evidence of these conditions, little has been published on systemic problems specifically in relation to dentists.
Self-awareness and the benefits of regular exercise are important needs. Various studies have recorded self-perceived health and health-related behaviours of dentists in various countries but little is known about the health of dentists in United Arab Emirates (UAE). This study was designed to investigate the prevalence and nature of some health and lifestyle problems of dentists in UAE, including occupational issues that relate to exercise, cigarette smoking and systemic diseases.
METHODS
The present study was approved by the ethics committee of Ajman University of Science and Technology (AUST), the General Authority for Health Services for the Emirate of Abu Dhabi, Department of Health and Medical Services of government of Dubai, and Ministry of Health in UAE. This research was conducted in full accordance with the World Medical Association Declaration of Helsinki and written consents were obtained from all participants in this study.
The questionnaire used in this study consists of 21 closed-ended questions that provided information on individual characteristics such as age, gender, marital status, number of years since graduation and number of hours worked per week. Furthermore, information on a range of health issues of dentists was sought, including exercise, cigarette smoking and systemic diseases. A total of 844 dentists (general dental practitioners and specialists) working in three cities (Abu Dhabi, Dubai and Sharjah) in both private and public sectors in UAE were selected for inclusion in this study. Participants had to have at least 1 year of work experience in the current position to be included in the study.
The clinics were selected from the membership register of Ministry of Health for emirates of Abu Dhabi, Dubai and Sharjah. This includes dental clinics, medical centres, polyclinics and hospitals. The purpose of the questionnaire and how the questions should be answered was explained and, whenever necessary, further information was provided to the participant. The questionnaires were distributed by the researchers between July 2005 and February 2006. All the data entered into a Microsoft Excel spreadsheet. Data were then transferred into spss windows version 11.0 (SPSS Inc., Chicago, IL, USA) for analysis. The chi-square test was used were appropriate and the level of statistical significance was set at P < 0.05. Univariate and bivariate analysis were used when appropriate.
RESULTS
This cross-sectional study examined the prevalence of, and some factors associated with, health problems among dentists in UAR. Questionnaires were completed by 733 dentists from Abu Dhabi, Dubai and Sharjah from both public and private sectors with a total response rate of 87%. Missing data were excluded from the analysis. Of the 733 dentists, 445 (61%) were male and 288 (39%) were female, with an age range of 22–70 years (mean ± SD 38.1 ± 10.3). Background data on age, number of years since graduation (or in clinical practice) and working hours per week are summarized in Table 1. Male dentist were found to work for longer hours than female dentists.
Table 1.
Age, number of years since graduation and working hours by sex
| Male (n = 445) (Mean ± SD) | Female (n = 288) (Mean ± SD) | |
|---|---|---|
| Age (years) | 40.8 ± 9.2 | 36.4 ± 7.5 |
| Number of years since graduation | 16.7 ± 9.2 | 13.5 ± 8.1 |
| Working hours per week (hours) | 30.5 ± 15.5 | 26.6 ± 14.5 |
More than one-third of the dentists (39%) reported exercising on a regular basis (Table 2). Male dentists were significantly more likely to report exercising on a regular basis (P < 0.05). A variety of reasons for not excising regularly were given (Table 2), with the most common reason being lack of time (43%). Not exercising on regular basis was more common among dentists in the public sector than in the private sector (P < 0.05; data not presented).
Table 2.
Number (percentage) of dentists reported to be exercising regularly and reported reasons for not exercising classified by sex
| Male n (%) | Female n (%) | Total n (%) | |
|---|---|---|---|
| Exercise regularly | |||
| Yes* | 205 (46) | 80 (28) | 285 (39) |
| No | 236 (54) | 206 (72) | 442 (61) |
| Total | 441 (100) | 286 (100) | 727 (100) |
| Reasons for not exercising | |||
| Not a sports person** | 24 (5) | 30 (10) | 54 (7) |
| No time** | 167 (38) | 147 (51) | 314 (43) |
| Too tired** | 61 (14) | 78 (27) | 139 (19) |
| Others | 26 (6) | 24 (8) | 50 (7) |
P < 0.05.
P < 0.01.
As shown in Table 3 more than one-fifth of the male dentists are smokers, and there were significant differences between regular smoking and gender (P < 0.05). There was a clear association between having systemic disease and regular smoking (P < 0.01; data not presented).
Table 3.
Number (percentage) of dentists reporting smoking on a weekly basis by sex
| Smoking on a weekly basis | Male n (%) | Female n (%) | Total n (%) |
|---|---|---|---|
| Non-smoker | 351 (79) | 277 (98) | 628 (86) |
| Smoker* | 92 (21) | 7 (3) | 99 (14) |
P < 0.05.
The prevalence of reported systemic problems have been summarized in Table 4. One hundred and eighteen dentists (16%) reported having some known systemic problem at some time since graduation. The most commonly reported systemic illnesses included cardiovascular diseases (n = 56, 8%), gastrointestinal conditions (n = 38, 5%), neurological symptoms (n = 14, 2%) and respiratory problems (n = 9, 1%), with the remainder reporting a variety of different conditions. There were significant difference in the prevalence of cardiovascular disease and sex (P < 0.05).
Table 4.
Prevalence of reported systemic problems by sex
| Male n (%) | Female n (%) | Total n (%) | |
|---|---|---|---|
| With systemic problem | 74 (17) | 44 (15) | 118 (16) |
| Type of systemic problems | |||
| Cardiovascular* | 42 (9) | 14 (5) | 56 (8) |
| Gastrointestinal | 22 (5) | 16 (6) | 38 (5) |
| Symptoms of neurosis | 8 (2) | 6 (2) | 14 (2) |
| Respiratory problems | 4 (1) | 5 (2) | 9 (1) |
| Others | 22 (5) | 15 (5) | 37 (5) |
P < 0.05.
DISCUSSION
This cross-sectional study examined the prevalence of, and some factors associated with health problems in dentists in UAE by means of a self-administered questionnaire. To our knowledge, this is the first study to report on health problems among dentists working in UAE. Although the response rate for this study was good, one of the major limitations of this type of research is that people may not accurately report what they actually do.
In most studies the dentists are reported to be relatively inactive and very few took any form of physical exercise although they acknowledged the benefits of physical exercise4. The prevalence of exercise in this population of dentists was relatively low, particularly given the relatively high rates of musculoskeletal problems seen in this population8. The present investigation showed that only 39% of dentists reported exercising on a regular basis. Similar findings were reported in Thailand9. It has been noted that poor general physical fitness has been associated with musculoskeletal symptoms. This finding is in line with the study of Leggat et al.9. Conversely, a study conducted in Poland10 reported no significant relationship between the practice of physical activity and the number of musculoskeletal disorders.
A significant association was found between lack of regular exercise and the gender of the participant: being a female dentist was significantly associated with not exercising regularly. The main reason reported for this was lack of time, which could be attributed to home and family responsibilities. However, those who reported not exercising regularly because of time limitation were working more than 35 hours per week. This indicates that those dentists could adjust their working time in order to exercise regularly and improve their physical fitness.
In addition, it was noted that dentists working in the public sector exercised much less regularly than dentists in the private sector. This might be attributed to the working times for the dentists. Dentists working in the public sector in UAE have a fixed working time for 8 hours continuously, while dentists in the private sector work on average two 4-hours shifts (4 hours in the morning and 4 hours in the evening); therefore, they have more a flexible working time healthy lifestyle habits such as exercise.
It is surprising that almost 14% of dentists smoke in UAE, as this rate of smoking appears to be much higher than that reported in other populations of dentists1., 11., specifically male dentists. This high prevalence of dentists who reported smoking is of particular concern; therefore, continuing education in the avoidance of smoking would be beneficial. Further studies are needed to identify the causes of this high rate of smoking and to identify the appropriate interventions that would reduce its prevalence among dentists in UAE.
In general, it would be expected that the prevalence of disease among dentists would be lower compared with averages from other groups within the population because dentists belong to a higher socioeconomic grouping12., 13., and higher socioeconomic status affords better dietary habits, better living conditions and the ability to transform health information into action14. In this respect, the prevalence of illnesses such as cardiovascular disease, tumours and respiratory disease is higher within the general population than in the dental profession15. The present study shows that around one-sixth of the dentists (16.1%) have systemic diseases, and these were mainly cardiovascular problems. This percentage is lower than that reported in a study conducted by Leggat et al.9 in Thailand where they found that 27.8% of dentists had a systemic diseases.
It was noted that the prevalence of systemic problems among dentists in the public sector were higher than among dentists in the private sector. This is could be caused by the different position of public sector dentists in the in the workplace hierarchy, with possibly more stress over work activities compared with private practitioners, or it might be attributed to the fact that dentists in the private sector exercise more regularly. Although a cross-sectional study cannot show causality, the results imply that physical exercise is a buffer against systemic problems. This finding is supported by a study conducted in Finland16. Lehto et al.16 suggested that poor general physical fitness may be partly responsible for these problems and there is certainly scope for further decreasing the prevalence and severity of these problems by performing regular specific exercises17., 18.. Therefore, measures should be investigated to improve participation rates in exercise amongst this group of dentists. In addition, male dentists reported having more systemic problems compared to their female colleagues. Notably, the prevalence of systemic diseases was higher among smokers and smoking is a well-known hazard to health.
Consideration of occupational and individual risk factors, prevalence, symptoms and consequences of these disorders, and implementing the recommended health and safety measures can enable a long and healthy career. It is therefore essential to provide background information for dentists regarding the magnitude of the problem, particular risk factors and recommendations for prevention 19.
CONCLUSION
The present study indicates that some systemic health problems, especially cardiovascular diseases, are present among dentists practicing in UAE. Lack of time was cited as the most common reason for dentists not exercising, especially among female dentists. Cigarette consumption was relatively high in this population of dentists. Further continuing educational and investigation of appropriate interventions to improve rates of exercise and reduce the level of smoking among dentists in UAE is needed, and this may help reduce the level of systemic diseases.
Acknowledgement
The authors acknowledge all the dentists who participated in this study. This study was not supported or funded by any research grants.
Conflict of interest
None declared.
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