Sunday, February 23, 2014

Contaminants in human nail dust: an occupational hazard in podiatry?

Studies carried out in the UK have shown large amounts of nail dust become airborne during the human nail drilling procedure during routine podiatry session. These remain present in the air for up to 10 hours after a clinical session. The potential risk of Respiratory Tract (RT) infection for practitioners is ever present but to date there have been limited research indicating podiatrists' health may be at risk from exposure to human nail dust. A recent small study published in the Journal of Foot and Ankle Research used a nasal swabbing technique and fungal culture to determine whether podiatrists (n = 50) had the same microbes present in their nasal cavities as non-podiatry health professional control group (n = 45). All swabs were cultured, counted and identified for each subject. Survey data of use and type of nail drill, type of mask used and frequency of change were also recorded over a two week period. The results showed podiatrists had a greater range of microbes in their nasal cavities although the controls had greater overall numbers of organisms. The known pathogen and common mould, Aspergillus fumigatus was most commonly found fungus within the podiatric group with 44% of the group having the fungus present. All nail drills used by the podiatrists had some form of dust extraction (except one). Of concern was 17% (n = 8) of the podiatrists did not use a mask at all whilst drilling and seemed unaware of any infection control issues. Simple disposable masks were the most frequently worn with only half being changed after each patient further increasing the cross infection risk. The researchers concluded the high levels of Aspergilus contamination is a significant finding in the podiatry group as this fungus is small enough to enter the tissue of the nasal cavity and as a small particle will stay airborne in the room for up to 16 hours. Aspergilus has been shown to cause brain and soft tissue tumours in extreme cases. The high levels of upper respiratory track problems reported in the literature may well be caused by this fungal agent. The non use and use of inappropriate masks by podiatrists is clearly an occupational hazard to their health and well being.

Tinley PD, Eddy K and Collier P. 2014 Contaminants in human nail dust: an occupational hazard in podiatry? Journal of Foot and Ankle Research, 7:15

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