Sir, we read the BDJ article by Brown et al. with interest.1 As occupational physicians (OP), it was disheartening to read that 92% of respondents who did not receive occupational health (OH) input would have liked to have been offered this service. Furthermore, only 28% of respondents were offered OH advice before ill health retirement, despite over 90% of respondents feeling that their ill health was work-related. Considering the high proportion of work-related ill-health (WRIH) reported in the paper, we wish to share some information regarding OH.
The Occupational Physicians Reporting Activity (OPRA) Network is the only UK-wide OP diagnosed data source of individual incident case reports of all WRIH.2 Between 2001–2014, 15,822 cases of WRIH were reported to OPRA, out of which 33 were in dentists. After taking into account sampling, a total of 253 estimated cases were reported in dentists, 174 cases (69%) of which were work-related mental ill-health (WRMIH). Occupational stress with high risks of burnout is widely acknowledged amongst dental practitioners, especially in those who work in the NHS.3,4,5
Although musculoskeletal diseases were the most commonly reported cause of ill-health retirement in the paper,1 only 12% of cases (n = 30) were so related within the OPRA dataset. Interestingly, 37 cases (15%) that were reported by OPs were cases related to either dermatological or respiratory causes, suggesting different risks leading to a wide range of WRIH conditions. Since not all dental practitioners will readily have access to OH services these findings are likely to be an underestimation of the true extent of WRIH amongst them. While there is a higher OP coverage in the NHS compared to other industries,6 many dental practitioners, even those who are involved in NHS work, may not be employed by the NHS7 and therefore may not be entitled to OH services. Those in private practice may choose to forego OH services due to costs.
The recognition of WRIH and timely preventative steps could not only improve well-being in dental practitioners but could also reduce the risk of premature ill-health retirement.
References
Brown J, Burke F J, Macdonald E B et al. Dental practitioners and ill health retirement: causes, outcomes and re-employment. Br Dent J 2010; 209: E7.
The Occupational Physicians Reporting Activity (OPRA) Network. 2016. Available at: http://research.bmh.manchester.ac.uk/epidemiology/COEH/research/thor/schemes/opra/ (accessed 19 April 2017).
Denton D A, Newton J T, Bower E J . Occupational burnout and work engagement: a national survey of dentists in the United Kingdom. Br Dent J 2008; 205: E13.
Bretherton R, Chapman H R, Chipchase S . A study to explore specific stressors and coping strategies in primary dental care practice. Br Dent J 2016; 220: 471–478.
Hill K B, Burke F J, Brown J et al. Dental practitioners and ill health retirement: a qualitative investigation into the causes and effects. Br Dent J 2010; 209: E8.
Carder M, Money A, Turner S, Agius R M . Workforce coverage by GB occupational physicians and disease incidence rates. Occupational Med (London) 2014; 64: 271–278.
Glickman M . NHS dentistry: A lack of help. Br Dent J 2017; 222: 496.
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Zhou, A., Agius, R. & Carder, M. Occupational health: An underestimation. Br Dent J 222, 832 (2017). https://doi.org/10.1038/sj.bdj.2017.481
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DOI: https://doi.org/10.1038/sj.bdj.2017.481
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