In the dissertation one of the urgent tasks of health protection of Ukraine is solved – scientific substantiation of risk-directed measures of prevention of work-related morbidity of dental staff, in conditions of application of modern medical technologies. The complex hygiene, medical-social and epidemiological studies were based on the necessity to improve preventive measures for work-related and occupational pathology. Іt has been found out that doctors-dentists (therapists, surgeons, orthodontists, orthopedists) and dental technicians in their workplace apply 230 means and materials that form 59 subgroups of chemical substances. It has been brought to light that the main factors that define harmfulness and hazard of the working conditions of dentists and dental technicians are: biological factors (HIV/AIDS, hepatitis viruses B/C, mycobacterium tuberculosis, as well as pathogens of purulent-inflammatory diseases); (2) the nanodispersed dust (d< 100 nm); the physical factors: illumination, noise, microclimate, air ionization; labor severity; labor intensity. It has been first established that the work activity of doctors-dentists and dental technicians is accompanied by the emission into the air of the work zone of nanoparticles (NPs) (d<100 nm). Nanoaerosols are represented by 14 chemical elements (Si, As, Mg, Ca, Al, Pb, Ti, Cr, Mn, Fe, Ni, Zn, Ag, Cd), which belong to II and III classes of danger. At all the researched workplaces, the emission of NPs into the working area air exceeds the recommended safe levels (for NPs of the 3rd-class of danger) in 2,0–2,4 times. It has been revealed that the mental health of the investigated workers in general is assessed as "good" and "satisfactory". The part of workers have signs of psychopathological syndromes (% of employees): (1) occupational burnout (reduction of occupationalism – 45,4%, depersonalization – 25,4%, emotional exhaustion – 10,2%); (2) depression (44,1%); (3) stress resistance reduction (2,9%) determined by age, sex and the complex influence of harmful occupational factors. It has been defined that the incidence with temporary disability of the dental staff is "very low" (34.1 cases per 100 workers, 250.3 days per 100 workers, the average duration of one case is 7.3 days), mainly due to acute respiratory viral infections (52.0 %) and exacerbation of the existing chronic pathology (29.0 %) (p<0.05).There is a significant excess of population levels in the disease spread among the workers for: the pathology of the upper respiratory tract (rhinitis, pharyngitis, laryngitis, etc.) (SIR=22.9); viral hepatitis B/C (SIR=16.1); radiculitis (SIR=10.7); bronchial asthma (SIR=8.2); infertility (male) (SIR=7.6); tuberculosis (SIR=7.4); arthritis and arthrosis (SIR=6.0); pancreatitis (SIR=5.5); diseases of the thyroid gland (SIR=5.3) (p<0.001). It has been established that occupational factors involved in the emergence and progression of pathological conditions of the dental staff are the application of filling materials, alkali, metals, disinfectants, plastics, acids, medicines; work in conditions of insufficient ventilation, the influence of ultrasound, ionizing radiation, noise, unfavorable microclimate; infectious patients’ assistance, which is accompanied by industrial accidents; prolonged stay in an uncomfortable, forced posture, load and fatigue of the body, legs, arms, hands, shoulders, lifting and moving the loads; necessity of solving difficult tasks, heuristic (creative) activity, taking responsible decisions, work in conditions of time deficit (p<0.001 – 0.05). The complex of risk-directed measures of prophylaxis of work-related pathology of the dental staff is scientifically substantiated and based on the modern concepts of "Hazard prevention and control" and the strategy of "Industrial hygiene engineering controls" recommended by the ILO and WHO. The efficiency of the use of dust reduction technologies (wet system of tooth tissue processing, sealing materials, orthopedic and orthodontic constructions etc.) and the application of sanitary measures (through aeration, wet cleaning of workplaces) has been proved which allows to significantly reduce the emanating concentration of dispersed nanoparticles and finely dispersed metal aerosols in air in the working area (from 1.8 to 3.8 times). The efficiency of using the filtering respirators with an exhalation valve (not less than the 1st and 2nd stages of protection) as an individual respiratory protection has been proved to ensure safe concentrations in the under-mask space of dispersion nano (d <100 nm) and small (d=101–200 nm) aerosols. The program of secondary prevention of work-related and occupational pathology by conducting medical examinations of dental staff has been unified. It is based on a clear organizational algorithm and a modern evidence base for the detection of human pathological conditions and includes three stages: (1) screening; (2) early diagnosis; (3) differential diagnosis.
