Mortality among dentists in Taiwan, 1985–2009

Shang, Tung-Fu; Chen, Pau-Chung; Wang, Jung-Der

BACKGROUND/PURPOSE: Controversy exists in the literature regarding whether dentists with multiple occupational exposures suffer from premature mortality. A cohort mortality study was conducted to evaluate the survival outcome and determine if potential exposure to harmful agents leads to premature mortality among dentists. METHODS: Using the Life Table Analysis System, we calculated standardized mortality ratios (SMRs) for a cohort of 11,700 dentists affiliated with the Taiwan Dental Association. These dentists were followed from 1985–2009. Reference rates were derived from cause-, gender-, and age-specific mortality rates of the general population of Taiwan and 18,664 Taiwanese internists, who were considered to be more socioeconomically proximal to dentists. A Cox proportional hazard model was also constructed to determine multiple risk factors associated with mortality. RESULTS: Compared with the general population, dentists in Taiwan consistently demonstrated reduced from all-cause mortality. However, compared with internists, significant and excess mortality were observed in dentists for overall mortality (SMR = 1.13; 95% confidence interval [CI] = 1.00–1.26), drowning (SMR = 6.62; 95% CI = 2.15–15.45), and heart diseases (SMR = 1.66; 95% CI = 1.22–2.21). After adjusting for other risk factors, the Cox model showed an increased hazard ratio of 1.17 (95% CI = 1.01–1.37) for dentists. CONCLUSION: Taiwanese dentists demonstrated significant elevated SMRs for overall causes, drowning, and heart diseases. Careful precaution should be taken to reduce these trends. Future studies are also needed for in-depth exploration of the mechanisms regarding how professional stress and exposure contribute to the increased risk of mortality in Taiwanese dentists.