Polymer waste and pollution in oral healthcare clinics: a systematic review

口腔医疗诊所中的聚合物废弃物和污染:系统性综述

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Abstract

BACKGROUND: Modern oral healthcare extensively uses polymer items and devices derived from various monomeric compounds. These materials are essential for personal protective equipment, infection barriers, packaging, and intraoral devices. The COVID-19 pandemic has led to an increased reliance on single-use polymer items, causing supply chain disruptions and higher costs. This systematic review explores the extent of polymer waste and pollution generated in oral healthcare clinics. MATERIALS AND METHODS: A systematic review protocol was registered with PROSPERO and was formatted according to PRISMA guidelines and SWiM recommendations. Eligibility criteria included studies that provided quantified estimates of polymer waste or pollution in air or wastewater from oral healthcare clinics. Comprehensive electronic searches were conducted across several bibliometric databases, followed by data extraction and risk of bias assessments performed by two independent reviewers. RESULTS: A total of thirty studies were included in the review. Sixteen papers reported on waste audits that detailed polymer waste data, while eight studies focused on pollution caused by polymer nano- and microparticles in clinical settings. Additionally, six experimental studies investigated potential leakage of monomeric eluates or polymer particles from landfill waste. There was significant variation in the amount of polymer waste generated per patient, ranging from 81 to 384 g per operatory room per day. On-site sampling revealed the presence of polymer nano- and microparticles in the clinic air, which was influenced by dental procedures and the equipment used. CONCLUSIONS: This review highlights critical knowledge gaps about polymer waste and pollution in oral healthcare clinics. The variability of study designs limited the feasibility of meta-analysis. Current evidence indicates substantial polymer waste generation, particularly from single-use items, as well as potential environmental impacts from monomeric eluates and polymer microparticles. Future research should focus on sustainable polymer waste management solutions to reduce environmental pollution in oral healthcare settings.

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