Study on measurement of infectious environmental contamination of dental office-Hygienic management with the use of Adenosine Tri-Phosphate as a contamination index-

建立了用三磷酸腺苷测定牙科办公环境污染的“拭子-冲洗法”。以发光仪(LUMITESTER K-210)在样品液100毫升和三磷酸腺苷提取试剂100毫升加有三磷酸腺苷发光试剂(荧光素-荧光素酶)制成的溶液上发光测定三磷酸腺苷作为污染指数。被测区域是仪器设备的尖端和手柄部分，操作者、助手和病人的面部和胸部，以及操作者和助手的左右前臂，ATP浓度越低，发光测量值(RLU)越低。以消毒蒸馏水的参考值(小于10)为参照，测量检查对象区域的污染程度。结果，高速手持机头、HVE刀尖和刮刀均记录到了10^4以上的数值。部分操作者和患者的面部超过10^3，部分病例的前臂超过10^2。据报道，在食品生产和加工行业，“切菜板的清洁度”是确定安全性的标准，它小于10^2，但在发光水平小于10^2的情况下，微生物被检测到的机会很小。另一方面，牙科实践中产生的切割粉尘在患者的血液和唾液中含有各种不同种类和数量的细菌和病毒，通过培养很难鉴定这些微生物。因此，有必要收紧安全标准，以防止发生二次感染。

"Swab-rinse method" has been established with the use of ATP to measure the contamination of dental office environment. As a contamination index, ATP measurement was taken by luminescence with a luminometer (lumitester K-210) on the solution made of lOOmul of specimen liquid and lOOmul of ATP extract reagent with addition of ATP luminescent reagent (luciferin - luciferase) Areas measured were tip and handle portions of instruments and equipment, the face and chest surface of the operator, assistant and patient, and left and right forearms of the operator and assistant.The lower the ATP concentration ( = the degree of pollution) is, the lower the luminescent measurement value (RLU) is. The degree of contamination was measured in subject areas for inspection with a reference value of sterilized distilled water (less than 10) . As a result, values over 10^4 were recorded with the head of high-speed handpiece, HVE tip and scaler. Some of the faces of the operators and patients exceeded l0^3. Some cases showed over 10^2 in the forearms of the operator and assistant. In the food manufacturing and processing industry, " Cleanliness of cutting board" is reportedly the standard to determine the safety, which is less than 10^2, however, there is little chance for microbes to be detected at the luminescent level of less than 10^2. Cutting dust produced in the dental practice, on the other hand, contains various kinds and amounts of bacteria and viruses in blood and saliva from the mouths of patients, and it is quite difficult to identify these microbes by culturing. Therefore, it is considered to be necessary to tighten the safety standard to prevent from occurrence of secondary infection.