By Dr. Helen Rees, B. Sc.. (Hons)
The use of nail drills by Podiatrists/Chiropodists to improve patient toe nail conditions and therefore their ‘quality of life’ is a plauditory aim but what effect is it having on our health?
Exposure to nail dust and the inhalation risk was first described in the early 70′s as an “Occupational Hazard”. Using a drill to reduce onychauxis nails generates finely divided nail particles. This airborne material could consist of keratin, fungal elements (eg Trichophyton rubrum) , bacteria, moulds and other microbial debris.
As far back as 1975, two female UK Podiatrists were diagnosed with allergy hypersensitivity to nail dust. Research by Millar (2000) suggested that, within podiatry, there was four times the UK prevalence of asthma, giving cause for concern. Breathing in respiratory sensitizers at work can cause occupational asthma. In the same study, podiatrists frequently reported problems with rhinitis and conjunctivitis, suggesting occupational health risks. As recently as February 2014 a study by Tinley et al showed podiatrists had an increased prevalence of nose microbes, most commonly Aspergilus, compared to a control group.
Obviously, exposure to nail dust and the associated risk will vary in offices due to the polices and practices in place, type of drill/burr, personal protection used and extraction/ventilation systems. However, with many more podiatrists complaining of or presenting with symptoms should we still be using drills?
Should we be developing our skills to move away from nail drills? What should we be teaching the next generation? If we know the risk to our health should we be changing our practices and policies?