RESEARCH PAPER
Burden of tobacco, kola nut and alcohol consumption and its association with periodontal disease, potentially malignant lesions and quality of life among bus drivers, Lagos State, Nigeria
Afolabi Oyapero 1  
,  
Oyejoke Oyapero 2  
,  
 
 
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1
Lagos State University College of Medicine, Ikeja, Nigeria
2
Department of Paediatrics, Amuwo Odofin Maternal and Child Centre, Festac, Nigeria
3
Department of Oral Pathology and Oral Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria
CORRESPONDING AUTHOR
Afolabi Oyapero   

Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja, Lagos, Nigeria
Publication date: 2020-03-23
Submission date: 2020-01-10
Final revision date: 2020-02-03
Acceptance date: 2020-03-03
 
Popul. Med. 2020;2(March):5
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To improve their performance and alertness, bus drivers are known to abuse alcohol, cigarette, kola nut and other substances that have substantial independent and combined deleterious effects on oral tissues. The study aimed to characterize risk associations between aggregates of alcohol/tobacco use and oral-health outcomes among a group of road transport workers in the Ojota and Berger bus terminals in Lagos State.

Methods:
Data were obtained from a probability sample of 150 commercial drivers from two bus terminals (Ojota and Berger) in Lagos State via face-to-face interviews and oral examination using a validated structured questionnaire. Multistage cluster sampling was conducted through the selection of two clusters from the major registered motor parks at the first stage by simple random sampling; while the selection of drivers was done by simple random sampling (balloting), using the list of registered drivers in the two garages as the sampling frame. Past and present tobacco and alcohol use were self-reported by respondents. Multivariable regression analysis measured the relationship between the outcomes [potentially malignant lesions (Leukoplakia, Erythroplakia, Smokers palate, Lichen planus), periodontal disease (CPITN Scores 3,4) and oral-health-related quality of life, OHRQoL (OHIP-14)] and exposures, controlling for the covariates age, marital status, education status, income level, oral hygiene, dental caries, functional tooth units, and previous treatment.

Results:
All the respondents were male. The prevalence of alcohol ever use was 82%, and 35% were moderate or heavy drinkers (2–4 drinks). Prevalence of tobacco ever use was 71%; while 32% were heavy smokers (>11 cigarettes/ day), 64% had a history of kola nut chewing habit, and 53% ate at least 2 kola nuts daily. Heavy smokers had more potentially malignant lesions (OR=1.89, 95% CI: 1.33–3.27); significantly worse periodontal destruction (OR=3.12, 95% CI: 2.28–5.17); and significantly worse OHRQoL (OR=2.35, 95% CI: 1.42–4.54). For individual OHRQoL domains, Pain 3.03 ( 95% CI: 1.77–4.21], Discomfort 2.89 [ 95% CI: 2.32– 4.17], Speech 3.02 ( 95% CI: 2.32–4.13), Diet 2.77 (95% CI: 1.87–4.28), Embarrassment 1.97 (95% CI: 1.65–3.14) and Self-consciousness 2.34 (95% CI: 1.93–3.48), were significantly associated with heavy smoking, after controlling for covariates.

Conclusions:
This study highlights the role of tobacco and alcohol as modifiable risk factors for periodontal disease and potentially malignant lesions that can impact negatively on OHRQoL. Bus drivers, in Lagos State, Nigeria, are an important target group in controlling tobacco and alcohol use in Nigeria and should receive adequate attention for oral health promotion and other preventive initiatives.

CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (39)
1.
Landsbergis PA, Grzywacz JG, LaMontagne AD. Work organization, job insecurity, and occupational health disparities. Am J Ind Med. 2014;57(5):495-515. doi:10.1002/ajim.22126
 
2.
Gay Anderson D, Riley P. Determining standards of care for substance abuse and alcohol use in long-haul truck drivers. Nurs Clin North Am. 2008;43(3):357-365. doi:10.1016/j.cnur.2008.04.003
 
3.
Zhang X, Chow EP, Wilson DP, Sun X, Zhao R, Zhang J, Jing J, Zhang L. Prevalence of HIV and syphilis infections among long-distance truck drivers in China: A data synthesis and meta-analysis. Int J Infect Dis. 2013;17(1):e2–e7. doi:10.1016/j.ijid.2012.07.018
 
4.
Singh RK, Joshi HS. Sexual behavior among truck drivers. Indian J Public Health. 2012;56(1):53-56. doi:10.4103/0019-557x.96976
 
5.
Nascimento EC, Nascimento E, Silva Jde P. Alcohol and amphetamines use among long-distance truck drivers. Rev Saude Publica. 2007;41(2):290-293. doi:10.1590/S0034-89102007000200017
 
6.
Labat L, Fontaine B, Delzenne C, et al. Prevalence of psychoactive substances in truck drivers in the Nord-Pas-de-Calais region (France). Forensic Sci Int. 2008;174(2-3):90-94. doi:10.1016/j.forsciint.2007.03.004
 
7.
Ebrahimi MH, Delvarianzadeh M, Saadat S. Prevalence of metabolic syndrome among Iranian occupational drivers. Diabetes Metab Syndr. 2016;10(1):S46-S51. doi:10.1016/j.dsx.2015.09.011
 
8.
Saini GK, Gupta ND, Prabhat KC. Drug addiction and periodontal diseases. J Indian Soc Periodontol. 2013;17(5):587–591. doi:10.4103/0972-124x.119277
 
9.
Yanagisawa T, Ueno M, Shinada K, Ohara S, Wright FA, Kawaguchi Y. Relationship of smoking and smoking cessation with oral health status in Japanese men. J Periodontal Res. 2019;45(2):277–283. doi:10.1111/j.1600-0765.2009.01233.x
 
10.
Leung WK Ng DK, Jin L, Corbet EF. Tooth loss in treated periodontitis patients responsible for their supportive care arrangements. J Clin Periodontol. 2006;33(4):265–575. doi:10.1308/135576106778529044
 
11.
da Silva ACF, Luiz RR, Leão AT. The relationship between alcohol dependence and periodontal disease. J Periodontol. 2008;79(6):993–998. doi:10.1902/jop.2008.070525
 
12.
Marr JJ, Spilberg I. A mechanism for decreased resistance to infection by gram-negative organisms during acute alcoholic intoxication. J Lab Clin Med. 1975;86(2):253–258. PMID:807663.
 
13.
Khocht A, Janal M, Schleifer S, Keller S. The influence of gingival margin recession on loss of clinical attachment in alcohol-dependent patients without medical disorders. J Periodontol. 2003;74(4):485–493. doi:10.1902/jop.2003.74.4.485
 
14.
Neville BW, Day TA. Oral cancer and pre-cancerous lesions. CA Cancer J Clin 2002;52(4):195-215. doi:10.3322/canjclin.52.4.195
 
15.
Mello FW, Melo G, Pasetto JJ, Silva CAB, Warnakulasuriya S, Rivero ERC. The synergistic effect of tobacco and alcohol consumption on oral squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig. 2019;23(7):2849-2859. doi:10.1007/s00784-019-02958-1
 
16.
Melrose RJ. Premalignant oral mucosal diseases. J Calif Dent Assoc. 2001;29:593–600. PMID:11577670.
 
17.
Hashibe M, Sankaranarayanan R, Thomas G, et al. Body mass index, tobacco chewing, alcohol drinking and the risk of oral submucous fibrosis in Kerala, India. Cancer Causes Control. 2002;13(1):55-64. doi:10.1023/a:1013991025848
 
18.
Hashibe M, Mathew B, Kuruvilla B, et al. Chewing tobacco, alcohol, and the risk of erythroplakia. Cancer Epidemiol Biomarkers Prev. 2000;9(7):639–645. PMID:10919731.
 
19.
Benedetti G, Campus G, Strohmenger L, Lingström P. Tobacco and dental caries: a systematic review. Acta Odontol Scand. 2013;71(3–4):363–371. doi:10.3109/00016357.2012.734409
 
20.
Millar W J, Locker D. Smoking and oral health status. J Can Dent Assoc. 2007;73(2):155. PMID:17355806.
 
21.
Maida C A, Marcus M, Spolsky V W, Wang Y, Liu H. Sociobehavioral predictors of self-reported oral health-related quality of life. Qual Life Res. 2013;22(3):559–566. doi:10.1007/s11136-012-0173-z
 
22.
Åstrøm AN, Ekback G, Ordell S, Unell L. Social inequality in oral health-related quality of life, OHRQoL, at early older age: evidence from a prospective cohort study. Acta Odontol Scand. 2011;69(6):334–342. doi:10.3109/00016357.2011.568965
 
23.
Lagos State Ministry of Science and Technology, Lagos State Government. About Lagos. 2018. https://lagosstate.gov.ng/abou.... Accessed October 8, 2019.
 
24.
Sreedevi M, Ramesh A, Dwarakanath C. Periodontal status in smokers and nonsmokers: a clinical, microbiological, and histopathological study. Int J Dent. 2012;2012:1-10. doi:10.1155/2012/571590
 
25.
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25(4):284-290. doi:10.1111/j.1600-0528.1997.tb00941.x
 
26.
Kramer IR, Pindborg JJ, Bezroukov V, Infirri JS. Guide to epidemiology and diagnosis of oral mucosal diseases and conditions. World Health Organization. Community Dent Oral Epidemiol. 1980;8(1):1–26. doi:10.1111/j.1600-0528.1980.tb01249.x
 
27.
Tse JLM, Flin R, Mearns K. Bus driver well-being review: 50 years of research. Transportation Research Part F: Traffic Psychology and Behaviour. 2006;9(2):89–114. doi:10.1016/j.trf.2005.10.002
 
28.
Benavides FG, Benach J, Mira M, Sáez M, Barceló A. Occupational categories and sickness absence certified as attributable to common diseases. Eur J Public Health. 2003;13(1):51-55. doi:10.1093/eurpub/13.1.51
 
29.
Jornet PL, Garcia FJ, Berdugo ML, Perez FP, Lopez AP. Mouth self-examination in a population at risk of oral cancer. Aust Dent J. 2015;60(1):59-64. doi:10.1111/adj.12274
 
30.
Aniebue PN, Okonkwo KOB. Prevalence of psychoactive drug use by taxi drivers in Nigeria. J College Med. 2008;13(3):48-52. doi:10.3126/jcmsn.v13i3.18403
 
31.
Lasebikan VO, Gureje O. Lifetime and 7-day alcohol consumption in the elderly, prevalence and correlates: Reports from the Ibadan Study of Aging. Afr J Med Med Sci. 2015;44(1):33-41. PMID:26548114.
 
32.
Young LA, Young LG, Klein MM, Klein DM, Beyer D. Recreational drugs. New York, NY: Macmillan Pub Co; 1985.
 
33.
Galanter M. Innovations: alcohol & drug abuse: spirituality in Alcoholics Anonymous: a valuable adjunct to psychiatric services. Psychiatr Serv. 2006;57(3):307-309. doi:10.1176/appi.ps.57.3.307
 
34.
Choi B, Schnall P, Dobson M, Yang H, Baker D, Seo Y. A socioecological framework for research on work and obesity in diverse urban transit operators based on gender, race, and ethnicity. Annals of Occupational and Environmental Medicine. 2017;29(1):15. doi:10.1186/s40557-017-0171-2
 
35.
Dietrich T, Bernimoulin J-P, Glynn R. The effect of cigarette smoking on gingival bleeding. J Periodontol. 2004;75(1):16–22. doi:10.1902/jop.2004.75.1.16
 
36.
Grossi SG, Genco RJ, Machtei EE, et al. Assessment of risk for periodontal disease: II: Risk indicators for alveolar bone loss. J Periodontol. 1995;66(1):23–29. doi:10.1902/jop.1995.66.1.23
 
37.
Benowitz NL. Pharmacology of nicotine – addiction and therapeutics. Annu Rev Pharmacol Toxicol. 1996;36(1):597–613. doi:10.1146/annurev.pa.36.040196.003121
 
38.
Warnakulasuriya S, Ariyawardana A. Malignant transformation of oral leukoplakia: a systematic review of observational studies. J Oral Pathol Med. 2016;45(3):155-166. doi:10.1111/jop.12339
 
39.
Hämäläinen J, Kaprio J, Isometsä E, Heikkinen M, Poikolainen K, Lindeman S, Aro S. Cigarette smoking, alcohol intoxication and major depressive episode in a representative population sample. J Epidemiol Community Health. 2001;55(8):573–576. doi:10.1136/jech.55.8.573
 
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