Occupational implications of fishing on oral health: A systematic review and meta-analysis

BACKGROUND: Fishermen face unique occupational hazards that may adversely affect oral health, yet this remains an understudied area. This systematic review and meta-analysis evaluated oral health outcomes among fishermen and identified occupation-specific risk factors. MATERIAL AND METHODS: A comprehensive search was conducted across five databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library) and Google Scholar from inception to April 2025. Studies assessing oral health conditions in fishermen aged > 18 years were included. Data extraction followed a standardized protocol, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Meta-analysis was performed using a random-effects model. RESULTS: Nineteen studies from seven countries were included, comprising 15 cross-sectional, one case-control, and three cohort studies. Six studies (n = 6) were suitable for meta-analysis of dental caries prevalence. The pooled dental caries prevalence was 71% (95% CI: 0.55-0.83) with substantial heterogeneity (I2 = 97.9%, p < 0.001). Fishermen consistently exhibited poorer periodontal health and oral hygiene compared to non-fishermen populations across six studies. Eight studies documented elevated prevalence of oral potentially malignant disorders (OPMDs), particularly actinic cheilitis and leukoplakia, associated with chronic sun exposure and tobacco/alcohol use. Five studies identified extensive unmet restorative and periodontal treatment needs. CONCLUSIONS: Fishermen demonstrate significantly compromised oral health characterized by high dental caries prevalence, poor periodontal status, and increased OPMD risk. Targeted interventions including mobile dental services, preventive education programs, and occupational protective measures are urgently needed to address these health disparities in this vulnerable population.