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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 14  |  Issue : 2  |  Page : 126-130

Knowledge, attitude, and practice/awareness on the impact of mobile phone radiations on the oral cavity among mobile phone users: A cross-sectional study


Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission21-Nov-2021
Date of Decision31-Jan-2022
Date of Acceptance12-Feb-2022
Date of Web Publication01-Jul-2022

Correspondence Address:
M P Revanth
Department of Public Health Dentistry, Ragas Dental College and Hospital, 2/102, East Coast Road, Uthandi, Chennai - 600 119, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jorr.jorr_77_21

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  Abstract 


Background: The usage of mobile phones has increased drastically in recent years. Their use without any knowledge of their adverse effects is quite unsafe. Studies on cancers due to electromagnetic radiation from mobile phones are available but there is a need to research on the harmful effects of mobile phones on general and oral health among the rampant mobile phone users.
Aim: The aim of the study is to evaluate the knowledge, attitude, and practice or awareness regarding mobile phone radiation and its impact on the oral cavity among the individuals using mobile phones.
Materials and Methods: The present study was a self-administered structured questionnaire study which was filled by 259 participants between the age group of 18–33 years through online forms.
Results: The study resulted that 50% of the participants did not have knowledge on deleterious effects of mobile phone radiation on the oral cavity and have experienced oral problems such as dry mouth (39.4%) and hypersalivation (41.7%) after prolonged talk time and 54.1% of the participants were aware on the impact of mobile phone radiation on health status.
Conclusion: The results showed that most of the participants were aware of the potential risks arising from the use of mobile phones on general health but lacking the knowledge on oral health.

Keywords: Adverse effect, knowledge, mobile phone, oral cavity


How to cite this article:
Revanth M P, Aparna S, Madankumar PD. Knowledge, attitude, and practice/awareness on the impact of mobile phone radiations on the oral cavity among mobile phone users: A cross-sectional study. J Oral Res Rev 2022;14:126-30

How to cite this URL:
Revanth M P, Aparna S, Madankumar PD. Knowledge, attitude, and practice/awareness on the impact of mobile phone radiations on the oral cavity among mobile phone users: A cross-sectional study. J Oral Res Rev [serial online] 2022 [cited 2022 Aug 16];14:126-30. Available from: https://www.jorr.org/text.asp?2022/14/2/126/349717




  Introduction Top


The evolution of smartphone technologies and continuous availability of Internet access all over the day led to huge rise in the number of mobile users and intensity of their usage.[1] The exposure of the general population to radiofrequency fields from mobile phones and other communication tools has become universal and continuous in recent years.[2] Particularly, the age group of 18–34 years is found to have the highest mobile phone usage rate of 62%.[3] The dependence on the mobile phone is increasingly high and they are being used by each and every one in today's scenario. Their use without any knowledge of their harmful effects is unsafe. Although there are few studies of mobile phone use and its harmful effects in literature review suggest that excessive mobile phone use may be associated with health-compromising behaviors such as smoking or alcohol drinking.[4]

Studies on mobile phone use have suggested that excessive use may be associated with subjective distress, loneliness, and social isolation.[5] There is a concern that radiation emitted from mobile phones might induce or promote cancer, and the symptoms associated with their use include sleep disturbance, memory problems, headaches, nausea, and dizziness.[6]

The possible oral cell changes related to excessive mobile use include the DNA damage such as micronuclei or nuclear buds, cytokinetic defects such as binucleated cells, proliferative potential, and/or cell death that can be related to a high risk of carcinogenic process and other salivary changes.[7] Being in close proximity to the ears, similar cellular changes have also been observed in the parotid gland. Since the parotid gland is an organ which is in close contact with the mobile phone during usage. Studies suggested the incidence of salivary gland dysfunction distinctly increases in the population who majorly use mobile phones for longer period of time. Contrary to this, various other studies stated no significant association exist between salivary gland disorder and mobile phone radiation exposure.[8],[9]

In a systematic review by Revanth et al., mobile phone-emitted radiations had adverse effects on buccal mucosal cells such as the formation of micronuclei and broken egg which were considered biomarkers of genotoxicity.[10]

In spite of some knowledge on unfavorable health effects, the usage of mobile phones has increased dramatically, especially since the time they have become more affordable and available worldwide.[7] The awareness about the hazards of excessive use of mobile phones was assessed in a previous study by Kumar et al., who showed that the overall perception of mobile phone hazard was 62%. Most participants agreed that mobile phone usage can cause headache, loss of mental attention, and sleeping disturbances and a study by Nasser et al. in 2018 about the knowledge, attitude, and practice regarding mobile phone usage, the studied group had deficient knowledge about how the mobile phone could affect them.[1],[4] Various health organizations have confirmed that mobile phone use indeed represents a health menace and classified mobile phone radiation as a carcinogenic hazard, i.e., possible carcinogenic to humans.[7]

The previous studies and literature have assessed the knowledge, attitude, and perception of mobile phone hazards only on general health but not on oral health.

Hence, the present study was aimed to evaluate the knowledge, attitude, and practice or awareness regarding mobile phone usage and its impact on the oral cavity among the individuals using mobile phones.


  Materials and Methods Top


This cross-sectional questionnaire study was approved by the Institutional Ethical Committee of Ragas Dental College and Hospital, Chennai. The samples were collected as per the ethical guidelines and with prior consent obtained from mobile phone users. The participants included in the study were those who were owning smartphones with the age group between 18 and 33 years and who gave consent to participate in the study. The participants owning mobile phones other than smartphones were excluded from the study.

Questionnaire development and data collection

The questionnaire was sent to participant experts to check for the content validity, and the 21item questionnaire was found to be internally reliable (Cronbach's alpha 0.77). The data were collected from the pretested selfdesigned structured questionnaire provided to the participants through Google Forms. The questionnaire consisted of a total of 21 items of three parts, namely six questions on knowledge, 11 questions on attitude, and four questions on practice/awareness. In addition, demographic data such as age, gender, and qualification were also ascertained from the questionnaire. The study was conducted over 1 month (December 2020).

Sample size calculation

A convenient sampling method was used to select the participants and sample size calculation was performed according to the study conducted by Nasser et al.[1] Considering a study with an 80% power and α = 0.05, the minimum sample size was arrived as 154 individuals using G-Power software version 3.1.

Statistical analysis

The collected 21-item questionnaire was revised for completeness and logical consistency. The data were analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). for statistical analysis. Descriptive statistics were used to measure the frequency distribution.


  Results Top


A total of 259 participants participated in the study with a mean age of 24.45 ± 3.29 years. There was almost equal distribution of male (52.5%) and female (47.5%) seen. A majority of the participants were using the mobile phone for more than 5 years (78%). Based on the hours used per week, nearly 50.2% of the participants reported a talk time of more than 6 h with an overall usage (texting, browsing, and various other purposes) found to be more than 2 h/day among 71% of them [Table 1].
Table 1: Distribution of the study sample by gender, age, occupation, years of mobile phone usage, duration of talk-time per day, and overall usage of mobile phone per day

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Knowledge on the effects of mobile phone radiation on the oral cavity and its adverse effects on general and oral health

[Table 2] shows 50% of the participants stated that the prolonged talk time will not have any deleterious effects on the oral cavity. The participants also affirmed that they do not know mobile phone radiation increase/decreases the salivary flow and cause cellular mutation. However, 30% of them had the knowledge that keeping mobile phones away from the body/oral cavity might reduce the hazardous effect.
Table 2: Knowledge on the effects of mobile phone radiation on oral cavity and its adverse effects on general and oral health

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Attitude and awareness/practice toward the usage of mobile phone and decreasing the hazardous effects

[Table 3] presents the attitude and awareness/practices toward the usage of mobile phones and decreasing the hazardous effects. In this, 46.7% of the participants preferred to decrease the duration of their talk time and 49.8% of them preferred to decrease the overall use of mobile phones such as texting and browsing. The majority of the participants (>60%) felt mild-to-moderate headache, itchy/burning eyes, pain in the ear, and distraction in their concentration while using the mobile phone for long time.
Table 3: Attitude and awareness/practice toward the usage of mobile phone and decreasing the hazardous effects

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On assessing the awareness about the hazardous effect of mobile phone emitted radiation and its practicing, sixty-four percent (64.5%) of the participants were aware that buying mobile phones with lesser Specific Absorption Rate (SAR) value will avoid the hazardous effect, and nearly 50% of the population was unaware about the potential health hazard of the mobile emitted radiation.


  Discussion Top


The mobile phone is a modern-day invention, which has reached many parts of the world enabling telecommunications across areas where it was not possible in the previous decades. In spite of the ill effects on general and oral health, the use of mobile phones among young children and adolescents is increasing dramatically.

This study was aimed to assess the knowledge, attitude, and practice/awareness regarding the usage of mobile phones and its impact on the oral cavity among the individuals using mobile phones.

In our study, 32.4% of the participants had knowledge on the impact of mobile phones on oral cavity and 46.7% of the participants preferred to decrease the duration of their talk time. In accordance with our research, a study by Nasser et al. revealed that 60% had knowledge on cancer hazardous effects of mobile phones, and also major group of individuals (81.3%) showed interest to reduce call duration.[1] The study population in both the studies desired to reduce the usage of mobile phones.

In this study, more than 60% of the participants (>60%) felt mild-to-moderate headache, itchy/burning eyes, pain in the ear, and distraction in their concentration while using the mobile phone for long time. A study by Acharya et al. in 2013 examined the health effects of cell phones usage among students pursuing professional courses in colleges and showed that in students of age group between 17 and 23 years in both rural and urban areas, headache was the most common symptom followed by irritability/anger.[9] Among physical symptoms – body aches, eye strain, and digital thumb were found to be frequent in both sexes.[10]

Apart from the general health issues, the participants of our study have also experienced oral problems such as dry mouth (39.4%) and hypersalivation (41.7%) after prolonged talk time. Hardell et al., 2004, in his study reported that the hypersalivation may be due to extensive exposure to heat because of mobile phones which increases the capillary blood flow adjacent to the parotid glands and result in an increased perfusion due to which there is an increased salivary flow rate.[11] These results were in contrast to the study done by Singh et al. in 2016, where the results showed that there were significantly lesser stimulated salivary secretions in the majority of the study participants. The reason may be due to the effect of radiation emitted from mobile phone base station on parotid glands. The salivary gland dysfunction is caused due to the damage of plasma membrane of the acinar cells or might be due to the lack of proper cell renewal because of damage to DNA of progenitor cells and stem cells.[12]

The effects of radiation on the parotid gland and its components gain a particular interest, as the altered salivary composition cause irreversible complications, namely increased risk to oral infections, oral discomfort, and increased susceptibility to dental caries due to oral dryness and distress.[13] Sialorrhea negatively impacts the quality of life both physically (e.g., irritation of perioral skin and worsening dysarthria) and psychosocially (e.g., embarrassment and isolation).[14]

A study by Muhayawi et al. in 2012 showed that the students' awareness regarding the adverse effects of mobile phone radiation was 88%, which were acquired mostly through electronic sources, printed media sources, and through social communication in the community.[15] In our study, only 54.1% of the participants were aware on the impact of mobile phone radiation on health status.

The usage of mobile phones is mainly for social communication, followed by study purposes and other reasons. Education and raising awareness are the key factors for improving the behavior of people regarding the extensive use of mobile phones.[13] Mobile phone use and its radiation emission at the initial stage may have a temporary and reversible ill effect on both general and oral health, but when it was not controlled initially, it may lead to serious effects.

However, this study might have had certain limitations. Firstly, small sample size. Secondly, the information was collected by a questionnaire, and the participants might have overestimated positive practices and underestimated negative behaviors.


  Conclusion Top


The results showed that most of the participants were aware of the potential risks arising from the use of mobile phones on general health but lacking knowledge on oral health. By considering all major findings in this study, it is clear that some interventional steps have to be taken on individual as well as community levels to increase the awareness regarding hazards of mobile phone use. This study highlighted the truth that the individuals are very knowledgeable regarding the new advancement and technology but they are not aware about its consequences. Technology always helps human beings for their progress but its overuse without knowing about its hazards is always dangerous. The present study highlighted this truth. Hence, it is necessary to recognize this truth and some action has to be taken.

Ethical clearance

The study was approved by the institutional Ethics Committee of Ragas Dental college and Hospital, chennai. (Approval no:20200137).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nasser S, Amer NM, Ghobashi MM, Morcos G, Hafez SF, Shaheen W, et al. Knowledge, Attitude, and Practices (KAP) study and antioxidant status among mobile phone users. Biosci Res 2018;15:3658-64.  Back to cited text no. 1
    
2.
Keykhosravi A, Neamatshahi M, Mahmoodi R, Navipour E. Radiation effects of mobile phones and tablets on the skin: A systematic review. Adv Med 2018;2018:9242718.  Back to cited text no. 2
    
3.
Davey S, Davey A. Assessment of smartphone addiction in Indian adolescents: A mixed method study by systematic-review and meta-analysis Approach. Int J Prev Med 2014;5:1500-11.  Back to cited text no. 3
    
4.
Kumar LR, Chii KD, Way LC, Jetly Y, Rajendaran V. Awareness of mobile phone hazards among university students in a Malaysian medical school. Health 2011;3:406-15.  Back to cited text no. 4
    
5.
Kraut R, Patterson M, Lundmark V, Kiesler S, Mu-kopadhyay T, Scherlis W. Internet-paradox: A social technology that reduces social involvement and psychological well being? Am Psychol 1998;53:1017-31.  Back to cited text no. 5
    
6.
Maier M, Blakemore C, Koivisto M. The health hazards of mobile phones. BMJ 2000;320:1288-9.  Back to cited text no. 6
    
7.
Ros-Llor I, Sanchez-Siles M, Camacho-Alonso F, Lopez-Jornet P. Effect of mobile phones on micronucleus frequency in human exfoliated oral mucosal cells. Oral Dis 2012;18:786-92.  Back to cited text no. 7
    
8.
Duan Y, Zhang HZ, Bu RF. Correlation between cellular phone use and epithelial parotid gland malignancies. Int J Oral Maxillofac Surg 2011;40:966-72.  Back to cited text no. 8
    
9.
Acharya JP, Acharya I, Waghrey D. A Study on Some of the Common Health Effects of Cell-Phones amongst College Students. J Community Med Health Educ 2013;3:214.  Back to cited text no. 9
    
10.
Revanth MP, Aparna S, Madankumar PD. Effects of mobile phone radiation on buccal mucosal cells: A systematic review. Electromagn Biol Med 2020;39:273-81.  Back to cited text no. 10
    
11.
Hardell L, Hallquist A, Hansson Mild K, Carlberg M, Gertzén H, Schildt EB, et al. No association between the use of cellular or cordless telephones and salivary gland tumours. Occup Environ Med 2004;61:675 -9.  Back to cited text no. 11
    
12.
Singh K, Nagaraj A, Yousuf A, Ganta S, Pareek S, Vishnani P. Effect of electromagnetic radiations from mobile phone base stations on general health and salivary function. J Int Soc Prev Community Dent 2016;6:54-9.  Back to cited text no. 12
    
13.
Chitra S, Shyamala Devi CS. Effects of radiation and alpha-tocopherol on saliva flow rate, amylase activity, total protein and electrolyte levels in oral cavity cancer. Indian J Dent Res 2008;19:213-8.  Back to cited text no. 13
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14.
Stone CA, O'Leary N. Systematic review of the effectiveness of botulinum toxin or radiotherapy for sialorrhea in patients with amyotrophic lateral sclerosis. J Pain Symptom Manage 2009;37:246-58.  Back to cited text no. 14
    
15.
Muhayawi SA, Eldeek B, Abubakr H, Kuddah RB, Zahid A, Abukhashabah H. The impact of medical education on Saudi medical students' awareness of cell phone use and its health hazards. Life Sci J 2012;9:1143-8.  Back to cited text no. 15
    



 
 
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  [Table 1], [Table 2], [Table 3]



 

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