Delphi assessment of occupational hazards in Spanish dentists positions modern dental practice as a high-exposure occupational setting where technological progress has not eliminated core hazards. The paper frames “occupational hazards” broadly, spanning chronic chemical exposure, bioaerosols, ionizing radiation, excessive noise, and a combined ergonomic and psychosocial burden that can compromise clinicians’ health and well-being (Anaya-Aguilar et al., 2026). Rather than treating these as isolated threats, the article’s logic is managerial and systems-oriented: if dentistry is to build a stronger occupational health and safety culture, clinics need a structured way to prioritize risks that persist in daily workflows (Anaya-Aguilar et al., 2026).
The study’s practical motivation is explicit: risk prevention in clinics is not merely an ethical or professional issue but also a governance and organizational capability issue, tied to prevention planning obligations and to decision-making under uncertainty (Anaya-Aguilar et al., 2026). The authors contextualize the Spanish dental sector as sizeable and economically relevant, which increases the salience of systematic prevention efforts at scale (Anaya-Aguilar et al., 2026). This framing matters because it shifts the conversation from “individual dentist compliance” to “clinic-level risk governance,” where prioritization is a prerequisite for investing in training, equipment, and workflow redesign.
Methodologically, the paper uses the Delphi method to convert expert judgment into a ranked risk profile for dental clinics. Experts were recruited across Spain with strict inclusion criteria: at least 10 years of professional experience and formal training in occupational risk prevention, with a final panel size of 18 (Anaya-Aguilar et al., 2026). The instrument operationalizes occupational risk using 33 items grouped into six dimensions: accident location, worker occupation, type of work, physical activity, deviation (event), and contact; each item is scored on a 5-point Likert scale from very low to very high risk (Anaya-Aguilar et al., 2026). The analysis emphasizes consensus building, using medians and interquartile ranges (IQR) and repeating a second round to tighten agreement, which is a classic strength of Delphi designs when measurement depends on informed expert synthesis rather than direct incident surveillance (Anaya-Aguilar et al., 2026).
The results deliver a clear hierarchy of what experts perceive as the most consequential hazards, and the pattern is not subtle: dentistry’s biggest risks cluster around exposure-generating instruments and contact events that plausibly enable infection transmission. “Rotary dental instruments (e.g., turbines, contra-angle handpieces)” are rated as the highest-risk physical-activity item, with a mean of 3.50 in both Delphi rounds (Anaya-Aguilar et al., 2026). In the deviation (event) dimension, the top-rated issue is “risk of SARS-CoV-2 transmission due to inappropriate PPE use,” with high mean scores that remain elevated even after consensus tightening (Anaya-Aguilar et al., 2026). In the contact dimension, “exposure to sharp, cutting, or abrasive instruments/materials” is the highest-rated category (Anaya-Aguilar et al., 2026). This trio is analytically coherent: rotary instruments and sharp tools are not only frequent in routine care, they also sit at the intersection of mechanical injury and biological hazard amplification.
A useful nuance in the findings is that “high risk” is not limited to a single role or setting, but the distribution is not uniform either. Administrative work is consistently rated far lower than direct-care roles, while dentists, hygienists, and dental nurses cluster above the “3” level, indicating that risk is structurally tied to proximity, procedure type, and instrument handling (Anaya-Aguilar et al., 2026). This matters for prevention strategy because it implies that broad, undifferentiated training will underperform compared with role-tailored control measures, especially for tasks involving aerosol generation and sharps.
The discussion is strongest where it treats prevention as a trade-off problem rather than a simplistic compliance story. The authors conclude that rotary instruments and sharp tools materially contribute to the generation of potentially pathogenic bioaerosols and elevate infection risk, but they also note that strict protocols can degrade working conditions by reducing visibility, fogging protective eyewear, limiting breathability, and increasing humidity, which can decrease efficiency and increase stress (Anaya-Aguilar et al., 2026). In other words, “more protection” can produce operational friction that may itself become a latent safety threat if it pushes clinicians toward shortcuts or increases cognitive and physical strain. That is the paper’s most practical insight: infection control cannot be divorced from human factors and ergonomics, because the usability of protective measures shapes real-world adherence.
From an occupational health management perspective, the article’s contribution is a prioritized risk map built from high-credibility expert profiles, using a transparent consensus method. This is especially useful for clinics that need to structure a prevention plan around what is most likely to harm staff, and to do so without waiting for severe adverse outcomes or incident spikes to “prove” the risk. The paper implicitly argues that dental safety leadership should focus first on instrument-mediated exposure pathways (rotary and aerosol-generating procedures) and on sharps contact controls, while simultaneously investing in protective solutions that reduce the usability penalties of PPE (Anaya-Aguilar et al., 2026). If you wanted to summarize the managerial message with a dark joke: in dentistry, the danger is not only what you inhale, but also what your goggles won’t let you see.
Mini glossary of key concepts (terms defined as used in the paper, with the paper cited as the source)
Delphi method: A structured expert-elicitation technique used to obtain and refine group judgments through iterative survey rounds, typically feeding back summary statistics to participants to increase convergence. In this study it is used to prioritize occupational hazards in dental clinics and strengthen consensus across two rounds (Anaya-Aguilar et al., 2026).
Occupational risk assessment: A systematic approach to identifying, analyzing, and prioritizing hazards in work processes to support prevention planning and informed managerial decisions. The study treats risk assessment as the core tool for turning daily clinical exposures into actionable prevention priorities (Anaya-Aguilar et al., 2026).
Bioaerosols: Airborne particles of biological origin, potentially containing microorganisms and biological material, generated during dental procedures and relevant to infection transmission risk. The article links bioaerosol generation strongly to rotary instrument use and aerosol-generating procedures (Anaya-Aguilar et al., 2026).
Rotary dental instruments: Powered tools such as turbines and contra-angle handpieces that are routinely used in operative dentistry and are perceived by experts as the highest-risk physical-activity category. Their risk relevance is tied to aerosol production and the plausible dissemination of infectious material in clinical airspace (Anaya-Aguilar et al., 2026).
Aerosol-generating dental procedures: Clinical actions that produce aerosols, often involving handpieces or ultrasonic scalers, and that elevate biological exposure risk in the operatory environment. The paper’s risk profile treats these as central to understanding infection hazards in routine dental care (Anaya-Aguilar et al., 2026).
Personal protective equipment (PPE): Protective items worn to reduce exposure to hazards, emphasized in the paper mainly in relation to infection control and SARS-CoV-2 transmission risk. The study highlights that inappropriate PPE use can be perceived as a top “deviation event,” meaning that protection depends not just on availability but also on correct use in real workflows (Anaya-Aguilar et al., 2026).
Deviation (event) dimension: A risk category in the questionnaire capturing events or departures from normal conditions that can precipitate harm, including pandemic-related transmission risks. The highest-rated item in this dimension is SARS-CoV-2 transmission risk due to inappropriate PPE use (Anaya-Aguilar et al., 2026).
Contact dimension: A risk category focused on harmful contact mechanisms, such as exposure through inhalation/skin/eyes and contact with sharp or abrasive instruments. The experts rate contact with sharp, cutting, or abrasive instruments/materials as the highest-risk contact item (Anaya-Aguilar et al., 2026).
Sharps exposure: Occupational exposure arising from sharp instruments that can cause injuries and facilitate transmission of infectious agents. In this paper, sharps-related contact is a top-ranked hazard, signaling that classic “needle-stick logic” remains central in dentistry despite technological modernization (Anaya-Aguilar et al., 2026).
Interquartile range (IQR) as consensus indicator: A dispersion metric used here to evaluate agreement among experts and to identify outlier responses as potential non-consensus. The study uses IQR reduction across rounds as evidence of increasing convergence in risk judgments (Anaya-Aguilar et al., 2026).
Usability costs of safety protocols: Negative operational side effects of protective measures, such as reduced visibility, fogging, limited breathability, and humidity discomfort, which can reduce efficiency and increase stress. The paper treats these as consequential because they may indirectly shape adherence and performance in high-risk clinical work (Anaya-Aguilar et al., 2026).
Reference
Anaya-Aguilar, C., Rosel, E., Rodríguez-Archilla, A., Anaya-Aguilar, R., Bravo, M., & Martínez-Beneyto, Y. (2026). Delphi assessment of occupational hazards in Spanish dentists. Safety Science, 196, 107091. https://doi.org/10.1016/j.ssci.2025.107091