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Song X, Lin D, Wang D, Weng S, Qiu S, Zhou W, Xiao A, Zhang N. Association of lymphocyte count and serum albumin concentration with telomere length in Chinese sanitation workers. PLoS One 2024; 19:e0311736. [PMID: 39388510 DOI: 10.1371/journal.pone.0311736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 09/24/2024] [Indexed: 10/12/2024] Open
Abstract
OBJECTIVE This study aimed to examine the association between inflammation-related indicators (IRIs) and telomere length (TL) in Chinese sanitation workers. METHODS This study adopted a case-control design, conducted from January to December 2022 in Shenzhen, a city in eastern China. A total of 80 sanitation workers, as well as 80 matched controls, were randomly recruited from the Luohu district of Shenzhen city in China. Their blood samples were collected and analyzed for the IRIs and TL in the Medical Laboratory of Shenzhen Prevention and Treatment Center for Occupational Diseases. The relationship between IRIs and TL was analyzed using multivariate linear regression, and their dose-response relationship was explored using restricted cubic spline analysis. RESULTS The systemic inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were significantly elevated in the sanitation workers in comparison to the controls. Moreover, the lymphocyte count (LYM), serum albumin concentration (ALB), and TL were found to be lower in the sanitation workers compared to the controls (P < 0.05). After adjusting for potential confounding variables, LYM was negatively correlated with TL in the sanitation workers (β = -0.31, 95% CI: -0.57, -0.05), whereas no correlation was observed in the controls. Furthermore, ALB demonstrated a non-linear relationship with TL in sanitation workers. CONCLUSION We found higher novel inflammatory markers (SII, PLR, and NLR) in the sanitation workers, and identified a correlation between LYM and ALB with shortened TL in them, providing new evidence for the effect of elevated inflammation on accelerated aging in Chinese sanitation workers.
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Affiliation(s)
- Xingxu Song
- Public Health Department, Jilin University, Changchun, China
| | - Dafeng Lin
- Occupational Health Department, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Dianpeng Wang
- Medical Laboratory, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Shaofan Weng
- Occupational Health Department, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Shuyi Qiu
- Public Health and Preventive Medicine Department, Shantou University, Shantou, China
| | - Wei Zhou
- Occupational Health Department, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Aipin Xiao
- Public Health Department, Southern Medical University, Guangzhou, China
| | - Naixing Zhang
- Occupational Health Department, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
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Otelea MR, Oancea C, Reisz D, Vaida MA, Maftei A, Popescu FG. Club Cells-A Guardian against Occupational Hazards. Biomedicines 2023; 12:78. [PMID: 38255185 PMCID: PMC10813369 DOI: 10.3390/biomedicines12010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Club cells have a distinct role in the epithelial repair and defense mechanisms of the lung. After exposure to environmental pollutants, during chronic exposure, the secretion of club cells secretory protein (CCSP) decreases. Exposure to occupational hazards certainly has a role in a large number of interstitial lung diseases. According to the American Thoracic Society and the European Respiratory Society, around 40% of the all interstitial lung disease is attributed to occupational hazards. Some of them are very well characterized (pneumoconiosis, hypersensitivity pneumonitis), whereas others are consequences of acute exposure (e.g., paraquat) or persistent exposure (e.g., isocyanate). The category of vapors, gases, dusts, and fumes (VGDF) has been proven to produce subclinical modifications. The inflammation and altered repair process resulting from the exposure to occupational respiratory hazards create vicious loops of cooperation between epithelial cells, mesenchymal cells, innate defense mechanisms, and immune cells. The secretions of club cells modulate the communication between macrophages, epithelial cells, and fibroblasts mitigating the inflammation and/or reducing the fibrotic process. In this review, we describe the mechanisms by which club cells contribute to the development of interstitial lung diseases and the potential role for club cells as biomarkers for occupational-related fibrosis.
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Affiliation(s)
- Marina Ruxandra Otelea
- Clinical Department 5, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Corina Oancea
- Department of Physical Medicine and Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniela Reisz
- Department of Neurology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Monica Adriana Vaida
- Department of Anatomy and Embryology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Andreea Maftei
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Florina Georgeta Popescu
- Department of Occupational Health, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
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Tolera ST, Temesgen S, Mulat Endalew S, Alamirew TS, Temesgen LM. Global systematic review of occupational health and safety outcomes among sanitation and hygiene workers. Front Public Health 2023; 11:1304977. [PMID: 38174086 PMCID: PMC10763668 DOI: 10.3389/fpubh.2023.1304977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Sanitary workers are exposed to a variety of occupational hazards in a variety of working environments, which can result in occupational-related outcomes. As a result, the goal of this review was to identify occupational health and safety outcomes among sanitary workers worldwide. Methods PRISMA was used as flow diagram and PICOS was used review questions. The studies published in English were searched from databases and others methods ranging from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords used: (Occupation *OR Job *OR Work) AND (Occupational related respiratory Symptoms *OR Disease) AND [Solid waste collectors (SWCs) *OR Street sweepers (SS) *OR Sewage workers and waste treatment (STWs)] AND (Countries). Results A total of 228 studies were identified from 23 countries across the world. Studies were found via PubMed (n = 40), Medline (n = 25), Embase (n = 11) and Global Health (n = 66) and Google scholar (n = 63) and from previous (n = 23). From 8,962 of eligible sanitary workers, about 4,742 (54%), 1714 (19%) and 1,441 (16%) were sewage, sweepers and solid waste workers, respectively. A total study (n = 51) were eligible for occupational health and safety outcomes. Of these, respiratory problems accounted 27 (52%) and Gastroenteritis 14 (27%). Conclusion Despite a large number of studies to date provides sanitary employees all over the world face occupational-related risks, hence more research is needed to enhance and quantify illness burden among sanitary workers.
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Affiliation(s)
- Sina Temesgen Tolera
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Shibiru Temesgen
- Department of Statistics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Salie Mulat Endalew
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | | | - Liku Muche Temesgen
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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Batterman S, Grant-Alfieri A, Seo SH. Low level exposure to hydrogen sulfide: a review of emissions, community exposure, health effects, and exposure guidelines. Crit Rev Toxicol 2023; 53:244-295. [PMID: 37431804 PMCID: PMC10395451 DOI: 10.1080/10408444.2023.2229925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 07/12/2023]
Abstract
Hydrogen sulfide (H2S) is a toxic gas that is well-known for its acute health risks in occupational settings, but less is known about effects of chronic and low-level exposures. This critical review investigates toxicological and experimental studies, exposure sources, standards, and epidemiological studies pertaining to chronic exposure to H2S from both natural and anthropogenic sources. H2S releases, while poorly documented, appear to have increased in recent years from oil and gas and possibly other facilities. Chronic exposures below 10 ppm have long been associated with odor aversion, ocular, nasal, respiratory and neurological effects. However, exposure to much lower levels, below 0.03 ppm (30 ppb), has been associated with increased prevalence of neurological effects, and increments below 0.001 ppm (1 ppb) in H2S concentrations have been associated with ocular, nasal, and respiratory effects. Many of the studies in the epidemiological literature are limited by exposure measurement error, co-pollutant exposures and potential confounding, small sample size, and concerns of representativeness, and studies have yet to consider vulnerable populations. Long-term community-based studies are needed to confirm the low concentration findings and to refine exposure guidelines. Revised guidelines that incorporate both short- and long-term limits are needed to protect communities, especially sensitive populations living near H2S sources.
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Affiliation(s)
- Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Amelia Grant-Alfieri
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Sung-Hee Seo
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, United States
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Stobnicka-Kupiec A, Gołofit-Szymczak M, Cyprowski M, Górny RL. Detection and identification of potentially infectious gastrointestinal and respiratory viruses at workplaces of wastewater treatment plants with viability qPCR/RT-qPCR. Sci Rep 2022; 12:4517. [PMID: 35296727 PMCID: PMC8924946 DOI: 10.1038/s41598-022-08452-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/07/2022] [Indexed: 12/11/2022] Open
Abstract
This study aimed to qualitatively and quantitatively assess the prevalence of the most common respiratory and gastrointestinal viruses in the air, surface swab, and influent/effluent samples collected in wastewater treatment plants (WWTPs). Application of qPCR/RT-qPCR (quantitative polymerase chain reaction/reverse-transcription quantitative polymerase chain reaction) assays combined with PMA (propidium monoazide) dye pretreatment allowed detecting the potentially infectious and disintegrated viral particles in collected samples. In the air at workplaces in WWTPs, the most frequent isolation with the highest concentrations (reaching up to 103 gc/m3 of potentially infectious intact viral particles) were observed in case of adenoviruses (AdVs) and rotaviruses (RoVs), followed by noroviruses (NoVs). Viruses were significantly more often detected in the air samples collected with Coriolis μ impinger, than with MAS-100NT impactor. The temperature negatively (Spearman correlation: –1 < R < 0; p < 0.05), while RH (relative humidity) positively (0 < R < 1; p < 0.05) affected airborne concentrations of potentially infectious viral particles. In turn, the predominant viruses on studied surfaces were RoVs and noroviruses GII (NoV GII) with concentrations of potentially infectious virions up to 104 gc/100 cm2. In the cases of SARS-CoV-2 and presumptive SARS-CoV-2 or other coronaviruses, their concentrations reached up to 103 gc/100 cm2. The contamination level of steel surfaces in WWTPs was similar to this on plastic ones. This study revealed that the qualitative and quantitative characteristics of respiratory and gastrointestinal viruses at workplaces in WWTPs is important for proper exposure assessment and needs to be included in risk management in occupational environment with high abundance of microbial pollutants derived from wastewater.
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Affiliation(s)
- Agata Stobnicka-Kupiec
- Central Institute for Labour Protection - National Research Institute, Czerniakowska 16 Street, Warsaw, Poland.
| | - Małgorzata Gołofit-Szymczak
- Central Institute for Labour Protection - National Research Institute, Czerniakowska 16 Street, Warsaw, Poland
| | - Marcin Cyprowski
- Central Institute for Labour Protection - National Research Institute, Czerniakowska 16 Street, Warsaw, Poland
| | - Rafał L Górny
- Central Institute for Labour Protection - National Research Institute, Czerniakowska 16 Street, Warsaw, Poland
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Characteristics and Determinants of the Presence of Respiratory Symptoms among Sewage Workers in Malaysia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:8567594. [PMID: 35321247 PMCID: PMC8938149 DOI: 10.1155/2022/8567594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/25/2021] [Accepted: 02/19/2022] [Indexed: 11/17/2022]
Abstract
Background The purpose of this study was to determine the relationships of PM 2.5 and H2S exposure with the presence of work-related respiratory symptoms among sewage workers. Methods A cross-sectional study was conducted in eleven sewage plants located in the central region of Peninsular Malaysia. One hundred ninety-one sewage workers were assessed using the British Medical Research Council (BMRC) questionnaire. Area air sampling was performed in three different sewage plants to measure the following parameters: physical air quality and concentration of PM 2.5 and H2S. Result Chronic cough (34.0%) was reported as the most common symptom, followed by chronic phlegm (26.2%), shortness of breath (7.9%), and chest tightness (3.7%). There were five significant determinants of the presence of respiratory symptoms among the sewage workers: shift work (AOR 23.50, 95% CI: 1.90–616.52), working at a sludge treatment facility (STF) (AOR 25.46, 95% CI: 2.06–314.29), a longer duration of working years (AOR 1,21, 95% CI: 1.01–1.44), individual cumulative exposure to PM 2.5 (AOR 9.01, 95% CI: 1.98–83.33), and individual cumulative exposure to H2S (AOR 1.04, 95% CI: 1.01–1.07). The majority of STF and non-STF workers had higher exposure to PM 2.5 and H2S concentrations in the air than office workers. Conclusion Sewage workers working at non-STFs or STFs reported a significantly higher prevalence of work-related respiratory symptoms and exposure to PM 2.5 and H2S compared with office workers. Exposure-response relationships were also found in sewage workers' cumulative exposure to PM 2.5 and H2S and the presence of respiratory symptoms.
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Oza HH, Lee MG, Boisson S, Pega F, Medlicott K, Clasen T. Occupational health outcomes among sanitation workers: A systematic review and meta-analysis. Int J Hyg Environ Health 2022; 240:113907. [PMID: 34942466 PMCID: PMC8837624 DOI: 10.1016/j.ijheh.2021.113907] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/16/2021] [Accepted: 12/14/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sanitation workers are essential to global public health and societal wellbeing. However, the health risks and outcomes associated with exposure to occupational risk factors among sanitation workers are neither well understood nor well quantified. We undertook a systematic review to (1) identify occupational risk factors among sanitation workers and (2) assess the effect of occupational exposure to human fecal sludge and wastewater on selected health outcomes among these workers. METHODS We searched four databases (i.e., PubMED, MEDLINE, EMBASE, and LILACS) for eligible studies from inception through to January 01, 2020. The included population was workers ≥15 years engaged, formally or informally, in installing, operating, servicing, cleaning or emptying a sanitation technology at any step of the sanitation chain. The included comparator was workers in other occupations or the general population. Eligible outcomes were: mortality (any or all causes), gastroenteritis, occupational injuries, respiratory diseases, musculoskeletal disorders, and mental and social health conditions. Risk of bias was assessed separately on exposure assessment and health outcome using a modified Liverpool Quality Assessment Tool (LQAT). We pooled sufficiently homogenous studies using inverse variance meta-analysis with random effects. RESULTS A total of 65 studies (9 cohort studies, 56 cross-sectional studies) met the inclusion criteria. One quarter of studies (n = 15) were from middle-income countries. Few studies assessed occupational risk factor exposures directly; most assigned exposure via proxy of occupation of sanitation worker. We judged nearly all studies to have "high risk of bias" in exposure and outcome assessment. Despite these limitations, the consistency of the overall evidence suggests that sanitation workers are at increased risk of gastroenteritis and respiratory conditions, and may be at increased risk of musculoskeletal disorders and mental/social health conditions. The pooled odds ratio for hepatitis A--the only outcome deemed suitable for meta-analysis--was 2.09 (95% Predicted Interval: 1.39-3.00, 12 studies). There was conflicting evidence from studies of increased risk of mortality; only one study reported on injuries. CONCLUSION Despite a large number of studies, there is limited evidence to date of the health risks faced by sanitation workers, particularly among groups that may be at particular risk-- women, informal workers and those living in low-income countries. Nevertheless, the research to date provides suggestive evidence of elevated occupational risk among sanitation workers across a range of health condition. More research is needed to improve the current bodies of evidence for all included health outcomes to be able to quantify disease burden among this occupational group.
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Affiliation(s)
- Hemali Harish Oza
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Madison Gabriella Lee
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sophie Boisson
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Kate Medlicott
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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8
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Compendium of analytical methods for sampling, characterization and quantification of bioaerosols. ADV ECOL RES 2022. [DOI: 10.1016/bs.aecr.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ahmad J, Ahmad M, Usman ARA, Al-Wabel MI. Prevalence of human pathogenic viruses in wastewater: A potential transmission risk as well as an effective tool for early outbreak detection for COVID-19. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 298:113486. [PMID: 34391102 PMCID: PMC8352675 DOI: 10.1016/j.jenvman.2021.113486] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 05/09/2023]
Abstract
Millions of human pathogenic viral particles are shed from infected individuals and introduce into wastewater, subsequently causing waterborne diseases worldwide. These viruses can be transmitted from wastewater to human beings via direct contact and/or ingestion/inhalation of aerosols. Even the advanced wastewater treatment technologies are unable to remove pathogenic viruses from wastewater completely, posing a serious health risk. Recently, coronavirus disease 2019 (COVID-19) has been urged globally due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has resulted in >4.1 million deaths until July 2021. A rapid human-to-human transmission, uncertainties in effective vaccines, non-specific medical treatments, and unclear symptoms compelled the world into complete lockdown, social distancing, air-travel suspension, and closure of educational institutions, subsequently damaging the global economy and trade. Although, few medical treatments, rapid detection tools, and vaccines have been developed so far to curb the spread of COVID-19; however, several uncertainties exist in their applicability. Further, the acceptance of vaccines among communities is lower owing to the fear of side effects such as blood-clotting and heart inflammation. SARS-CoV-2, an etiologic agent of COVID-19, has frequently been detected in wastewater, depicting a potential transmission risk to healthy individuals. Contrarily, the occurrence of SARS-CoV-2 in wastewater can be used as an early outbreak detection tool via water-based epidemiology. Therefore, the spread of SARS-CoV-2 through fecal-oral pathway can be reduced and any possible outbreak can be evaded by proper wastewater surveillance. In this review, wastewater recycling complications, potential health risks of COVID-19 emergence, and current epidemiological measures to control COVID-19 spread have been discussed. Moreover, the viability of SARS-CoV-2 in various environments and survival in wastewater has been reviewed. Additionally, the necessary actions (vaccination, face mask, social distancing, and hand sanitization) to limit the transmission of SARS-CoV-2 have been recommended. Therefore, wastewater surveillance can serve as a feasible, efficient, and reliable epidemiological measure to lessen the spread of COVID-19.
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Affiliation(s)
- Jahangir Ahmad
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia
| | - Munir Ahmad
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia
| | - Adel R A Usman
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia; Department of Soils and Water, Faculty of Agriculture, Assiut University, Assiut, 71526, Egypt
| | - Mohammad I Al-Wabel
- Soil Sciences Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh, 11451, Saudi Arabia; Department of Science and Environmental Studies, The Education University of Hong Kong, Hong Kong.
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Yan C, Leng YL, Wu JT. Quantitative microbial risk assessment for occupational health of temporary entrants and staffs equipped with various grade PPE and exposed to microbial bioaerosols in two WWTPs. Int Arch Occup Environ Health 2021; 94:1327-1343. [PMID: 33721095 PMCID: PMC7957280 DOI: 10.1007/s00420-021-01663-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/17/2021] [Indexed: 12/07/2022]
Abstract
PURPOSE This study was to evaluate the occupational health risks of infection from Gram-negative bacteria and Staphylococcus aureus bioaerosols to temporary entrants and staffs equipped with various grade personal protection equipment (PPE) related to wastewater treatment plants (WWTPs). METHODS This study determined the emission concentrations of Gram-negative bacteria and Staphylococcus aureus bioaerosols from two WWTPs under various aeration modes. Then, a strict quantitative microbial risk assessment (QMRA) was performed on several exposure scenarios associated with occupational health risks of temporary entrants (researchers, visitors, and inspectors) and staffs (field engineer and laboratory technician). RESULTS Although the bioaerosol concentrations were generally regarded as safe according to existing standards, these bioaerosols' health risks were still unacceptable. The microbial bioaerosols posed considerable infection health risks in WWTPs. These risks were generally above the WHO and US EPA benchmarks. The health risks of females were always smaller than those of male of grown-up age group. Staffs that had been exposed to bioaerosols for a long time were found to have higher health risks compared with temporary entrants. In addition, field engineers equipped with PPE rendered low health risks, thus revealing that wearing PPE could effectively reduce the occupational health risks. CONCLUSION This study provided novel data and enriched the knowledge of microbial bioaerosol emission's health risks from various aeration modes in WWTPs. Management decisions could be executed by authorities on the basis of the results of QMRA for field engineers equipped with PPE to reduce the related occupational health risks.
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Affiliation(s)
- Cheng Yan
- School of Environmental Studies, China University of Geosciences, 388 Lumo Road, Wuhan, 430074, People's Republic of China.
| | - Ya-Li Leng
- School of Environmental Studies, China University of Geosciences, 388 Lumo Road, Wuhan, 430074, People's Republic of China
| | - Jun-Ting Wu
- School of Environmental Studies, China University of Geosciences, 388 Lumo Road, Wuhan, 430074, People's Republic of China
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Muzaini K, Yasin SM, Ismail Z, Ishak AR. Systematic Review of Potential Occupational Respiratory Hazards Exposure Among Sewage Workers. Front Public Health 2021; 9:646790. [PMID: 33763402 PMCID: PMC7982603 DOI: 10.3389/fpubh.2021.646790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Sewage workers have a higher risk of exposure to various potential occupational respiratory hazards found in sewage plants. Although previous studies discuss occupational respiratory hazard concentration impacting sewage workers' respiratory health, the results are scarce and mixed. Hence, there is a need to identify the potential respiratory hazards in sewage plants so as to clarify the short- and long-term respiratory health effects. Therefore, this systematic review (SR) aims to critically review previous studies investigating potential respiratory hazards found at sewage plants and their effects on sewage workers' respiratory health. Methods: An SR was conducted using PubMed, EBSCO Medline, Web of Science, Scopus, and Google Scholar on peer-reviewed studies published between January 1994 and October 2020 evaluating the impact of potential exposure to respiratory hazards and its effects on respiratory health among sewage workers. "Sewage treatment plant," "respiratory hazards," and "respiratory health effects" were the three main search terms chosen in this SR. The inclusion criteria were (1) studies on potential occupational respiratory hazard exposure among sewage workers, (2) manuscripts written in English, and (3) studies published in the peer-reviewed literature. The human observational studies' quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Results: We identified 5,660 articles through an initial database search. Only 26 items met the inclusion criteria and were included in this review; 15 human observational studies and 11 environmental assessment studies were conducted in the sewage industries. Most of the human observational studies were rated as moderate quality, two studies were rated as weak quality, and one study with strong quality was identified. Hydrogen sulfide, bioaerosols, particulate matter 2.5 (PM 2.5), and volatile organic compounds (VOC) were found to be potential respiratory hazards. Most of the risks contributed to adverse outcomes on the sewage workers' respiratory health with some inconsistent findings on the relationship between respiratory hazard exposure and respiratory health effects. Conclusion: Our review finds that, although this area is of great importance, quality studies are still lacking. There is a need for additional studies to clarify the effects of respiratory hazard exposure on sewage workers and respiratory health, especially PM 2.5 and VOC.
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Affiliation(s)
- Kamarulzaman Muzaini
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Siti Munira Yasin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Ahmad Razali Ishak
- Centre of Environmental Health and Safety, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
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Han Y, Yang T, Xu G, Li L, Liu J. Characteristics and interactions of bioaerosol microorganisms from wastewater treatment plants. JOURNAL OF HAZARDOUS MATERIALS 2020; 391:122256. [PMID: 32062341 DOI: 10.1016/j.jhazmat.2020.122256] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/14/2020] [Accepted: 02/07/2020] [Indexed: 05/13/2023]
Abstract
Bacteria and fungi are abundant and ubiquitous in bioaerosols from wastewater treatment plants (WWTPs). However, the specificity and interactions of bioaerosol microorganism, particularly of potential pathogens, from WWTPs are still poorly understood. In this study, we investigated 9 full-scale WWTPs in different areas of China for 3 years, and found microbial variations in bioaerosols to be associated with regions, seasons, and processes. Relative humidity, total suspended particulates, wind speed, temperature, total organic carbon, NH4+, Cl- and Ca2+ were the major factors influencing this variation, and meteorological factors were more strongly associated with the variation than chemical composition. In total, 95 and 22 potential bacterial and fungal pathogens were detected in bioaerosols, respectively. The linear discriminant analysis effect size method suggested that Serratia, Yersinia, Klebsiella, and Bacillus were discriminative genera in bioaerosols on the whole, and were also hub niches in the interactions within potential bacterial pathogens, based on network analysis. Strong co-occurrences such as Serratia-Bacillus and Staphylococcus-Candida, and co-exclusions such as Rhodotorula-Cladosporium and Pseudomonas-Candida, were found within and between potential bacterial and fungal pathogens in bioaerosols from WWTPs. This study furthers understanding of the biology and ecology of bioaerosols from WWTPs, and offers a theoretical basis for determining bioaerosol control.
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Affiliation(s)
- Yunping Han
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; National Engineering Laboratory for VOCs Pollution Control Material & Technology, University of Chinese Academy of Sciences, Beijing 101408, PR China.
| | - Tang Yang
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; National Engineering Laboratory for VOCs Pollution Control Material & Technology, University of Chinese Academy of Sciences, Beijing 101408, PR China.
| | - Guangsu Xu
- School of Resources and Environmental Engineering, Ludong University, Yantai 264025, PR China.
| | - Lin Li
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; National Engineering Laboratory for VOCs Pollution Control Material & Technology, University of Chinese Academy of Sciences, Beijing 101408, PR China.
| | - Junxin Liu
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; National Engineering Laboratory for VOCs Pollution Control Material & Technology, University of Chinese Academy of Sciences, Beijing 101408, PR China.
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Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112009. [PMID: 31195677 PMCID: PMC6603999 DOI: 10.3390/ijerph16112009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/23/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022]
Abstract
Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal protective equipment (PPE) is a significant factor that can reduce or decrease the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to examine wastewater worker’s beliefs and practices on wearing PPE through the integration of the Health Belief Model (HBM), identify the impact that management has on wastewater workers wearing PPE, and determine the predictors of PPE compliance among workers in the wastewater industry. Data was collected from 272 wastewater workers located at 33 wastewater facilities across the southeast region of the United States. Descriptive statistical analysis was conducted to present frequency distributions of participants’ knowledge and compliance with wearing PPE. Univariate and multiple linear regression models were applied to determine the association of predictors of interest with PPE compliance. Wastewater workers were knowledgeable of occupational exposures and PPE requirements at their facility. Positive predictors of PPE compliance were perceived susceptibility and perceived severity of contracting an occupational illness (p < 0.05). A negative association was identified between managers setting the example of wearing PPE sometimes and PPE compliance (p < 0.05). Utilizing perceived susceptibility and severity for safety programs and interventions may improve PPE compliance among wastewater workers.
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Maal-Bared R. Efficacy of laundering and tumble-drying in reducing microbial contamination of wastewater treatment plant worker coveralls. Am J Infect Control 2019; 47:527-533. [PMID: 30578140 DOI: 10.1016/j.ajic.2018.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Evidence implicates textiles in health care as potential reservoirs of pathogens. No similar data exist for the wastewater treatment plant (WWTP) industry. We investigated if coveralls worn by WWTP workers could present occupational infection risk. METHODS We enumerated heterotrophic plate counts (HPCs), total coliforms, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Clostridium difficile, and Acinetobacter spp on coverall swatches experimentally contaminated with raw, primary, secondary, and final effluent. Contaminated swatches were examined by culture-based methods after laundering, tumble-drying, and storing. RESULTS Concentrations of microorganisms and efficacy of decontamination differed depending on the contaminating wastewater matrix and the organism. Laundering was an effective decontamination method for coveralls contaminated with all microorganisms, except HPCs. Tumble-drying resulted in statistically significant decreases for HPCs, P aeruginosa, and Acinetobacter. Increases in contamination after laundering were seen in Acinetobacter spp, in P aeruginosa when coverall swatches were contaminated with raw and final effluent, and in HPCs when contaminated with secondary effluent. DISCUSSION Results suggest that solely laundering at 60°C for 25 minutes as per ASTM Standard F1449 may not always be an efficient means of controlling microorganisms on coveralls. CONCLUSIONS Clearer guidelines are needed to better protect WWTP workers.
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Heldal KK, Austigard ÅD, Svendsen KH, Einarsdottir E, Goffeng LO, Sikkeland LI, Nordby KC. Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System. Ann Work Expo Health 2019; 63:437-447. [DOI: 10.1093/annweh/wxz020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/04/2019] [Accepted: 02/20/2019] [Indexed: 01/27/2023] Open
Affiliation(s)
- Kari K Heldal
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - Åse D Austigard
- Municipality of Trondheim, Working Environment Office, Trondheim, Norway
| | - Kristin H Svendsen
- Department of Industrial Economics and Technology Management, NTNU, Trondheim, Norway
| | - Elin Einarsdottir
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - Lars Ole Goffeng
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - Liv Ingun Sikkeland
- Department of Respiratory Medicine, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Karl-Christian Nordby
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
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Tustin JL, Hau JP, Hon CY. Occupational health and safety hazards encountered by Ontario Public Health Inspectors. ACTA ACUST UNITED AC 2019. [DOI: 10.5864/d2019-004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Public health inspectors (PHIs) are exposed to many occupational health and safety issues during their daily tasks. However, to our knowledge, no study has investigated the job-specific health and safety hazards among working PHIs. Our objective was to determine the type and extent of health and safety hazards faced by PHIs working for Ontario health units as well as their perception of risk with respect to these hazards. In early 2018, an invitation to a web-based survey was sent to all members of the Canadian Institute of Public Health Inspectors Ontario Branch. One-hundred and thirty-four respondents met the inclusion criteria and were included in the study. Results showed PHIs reported safety hazards (e.g., slips or falls), working alone, and chemical hazards as the top three types of hazards. Inspections of food and (or) nonfood premises were the duties most associated with encountering all types of hazards. In addition, a majority of respondents reported being somewhat concerned about their exposure to all types of hazards. This study provides novel information on the occupational health and safety risks as reported by Ontario PHIs. Further in-depth research is needed to investigate the specific hazards and concerns among PHIs as well as the level of prevention and monitoring within health units.
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Affiliation(s)
- Jordan Lee Tustin
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
| | - Jeffrey P. Hau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chun-Yip Hon
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
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17
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Chandra K, Arora VK. Tuberculosis and other chronic morbidity profile of sewage workers of Delhi. Indian J Tuberc 2018; 66:144-149. [PMID: 30797273 DOI: 10.1016/j.ijtb.2018.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/14/2018] [Accepted: 09/24/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sewage management is hazardous due to chronic exposure to chemical gases, bioaerosols and micro-organisms through inhalation; accidental oral intake and penetration through skin or mucous membranes through injuries or breech in personal protective equipment. While there has been some research on isolated infections and multisystem symptom profiling of sewage workers, there is little research on the burden of chronic illnesses like Tuberculosis and Non Communicable Diseases (NCDs). METHODS A cross sectional observational study was conducted on chronic comorbidity profile of sewage workers with more than five years of occupational experience and employed in three contiguous districts of NCT of Delhi. RESULTS The study sample consisted of 104 sewage workers with mean age of 50.71 (±8.43) years, an average of 7.35 (±3.75) years of formal education and an average occupational exposure to sewage work of 21.28 (±10.54) years. 21.15% sewage workers had Tuberculosis and 92.31% had at least one of the chronic respiratory diseases (COPD, Asthma or ACOS). 85.6% of participants were smokers. The most common NCD was Hypertension (67.3%) followed by Dyslipidaemia (50%) and Diabetes Mellitus (43.3%). There was clustering of NCDs with 53.85% subjects having three or more chronic disorders. Less than 5% of study participants were free from all the investigated chronic diseases. CONCLUSION The sewage workers have an adverse chronic morbidity profile for both Tuberculosis and NCDs. There is an urgent need for epidemiological research and targeted screening and public health intervention for Tuberculosis and other NCDs in sewage workers as an occupational group.
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Affiliation(s)
| | - Vijay Kumar Arora
- Formerly Vice Chancellor, Professor and Head Od Department of TB and Chest Diseases, Santosh University, Ghaziabad, Delhi NCR, India.
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Brokamp C, Beck AF, Muglia L, Ryan P. Combined sewer overflow events and childhood emergency department visits: A case-crossover study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 607-608:1180-1187. [PMID: 28732397 PMCID: PMC5818157 DOI: 10.1016/j.scitotenv.2017.07.104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 05/05/2023]
Abstract
In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records. The location and timing of CSO events were obtained from the Metropolitan Sewer District (MSD) of Greater Cincinnati. ED visits with a residential address within 500m of a CSO site were used in a case-control crossover study with two bi-directional control periods. Conditional logistic regression models were used to estimate the risk of an ED visit associated with a CSO event at lag periods of 0 to 7days. Statistically significant elevated risks for GI-related ED visits was observed two (OR: 1.16 [95% CI 1.04,1.30]) days after CSO events. CSO events were not significantly associated with asthma- or SSTI-related ED visits, but show similar trends. Our findings suggest an increased risk for GI-related ED visits following CSO events among children who reside near CSO sites.
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Affiliation(s)
- Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Andrew F Beck
- Divisions of General and Community Pediatrics and Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Louis Muglia
- Division of Human Genetics and Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patrick Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Jäckel U, Martin E, Schäfer J. Heterogeneity in Cultivation-Based Monitoring of Airborne Bacterial Biodiversity in Animal Farms. Ann Work Expo Health 2017. [DOI: 10.1093/annweh/wxx039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Schäfer J, Weiß S, Jäckel U. Preliminary Validation of a Method Combining Cultivation and Cloning-Based Approaches to Monitor Airborne Bacteria. Ann Work Expo Health 2017. [DOI: 10.1093/annweh/wxx038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Uhrbrand K, Schultz AC, Koivisto AJ, Nielsen U, Madsen AM. Assessment of airborne bacteria and noroviruses in air emission from a new highly-advanced hospital wastewater treatment plant. WATER RESEARCH 2017; 112:110-119. [PMID: 28153697 DOI: 10.1016/j.watres.2017.01.046] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/20/2016] [Accepted: 01/22/2017] [Indexed: 05/21/2023]
Abstract
Exposure to bioaerosols can pose a health risk to workers at wastewater treatment plants (WWTPs) and to habitants of their surroundings. The main objective of this study was to examine the presence of harmful microorganisms in the air emission from a new type of hospital WWTP employing advanced wastewater treatment technologies. Air particle measurements and sampling of inhalable bacteria, endotoxin and noroviruses (NoVs) were performed indoor at the WWTP and outside at the WWTP ventilation air exhaust, downwind of the air exhaust, and upwind of the WWTP. No significant differences were seen in particle and endotoxin concentrations between locations. Bacterial concentrations were comparable or significantly lower in the exhaust air than inside the WWTP and in the upwind reference. Bacterial isolates were identified using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry. In total, 35 different bacterial genera and 64 bacterial species were identified in the air samples. Significantly higher genus and species richness was found with an Andersen Cascade Impactor compared with filter-based sampling. No pathogenic bacteria were found in the exhaust air. Streptomyces was the only bacterium found in the air both inside the WWTP and at the air emission, but not in the upwind reference. NoV genomes were detected in the air inside the WWTP and at the air exhaust, albeit in low concentrations. As only traces of NoV genomes could be detected in the exhaust air they are unlikely to pose a health risk to surroundings. Hence, we assess the risk of airborne exposure to pathogenic bacteria and NoVs from the WWTP air emission to surroundings to be negligible. However, as a slightly higher NoV concentration was detected inside the WWTP, we cannot exclude the possibility that exposure to airborne NoVs can pose a health risk to susceptible to workers inside the WWTP, although the risk may be low.
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Affiliation(s)
- K Uhrbrand
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, 2860 Søborg, Denmark.
| | - A C Schultz
- National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, 2860 Søborg, Denmark
| | - A J Koivisto
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - U Nielsen
- DHI, Agern Allé 5, 2970 Hørsholm, Denmark
| | - A M Madsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
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Abstract
This review deals with endotoxin in the environment and its relation to disease among exposed persons. Data are presented on levels of endotoxin in different environments with maximum values of several μg/m3. The cellular reactions of importance for inhalation exposure effects are attachment to lipopolysaccharide binding protein, CD14 cell surface protein and TLR-4 receptors. The internalisation of endotoxin in macrophages and endothelial cells results in local production of inflammatory cytokines with subsequent migration of inflammatory cells into the lung and the penetration of cytokines into the blood. These events orchestrate clinical effects in terms of toxic pneumonitis, airways' inflammation and systemic symptoms. Inhalation challenges with pure endotoxin and field studies confirm the relation between these effects and exposure to dusts containing endotoxin. It is possible that polymorphism in genes determining endotoxin reactivity, particularly TLR-4, influences the risk for disease after environmental exposures. Some data suggest that the inflammation caused by inhaled endotoxin may decrease the risk for atopic sensitisation among children and lung cancer among workers exposed to organic dust. Additional research is needed to clarify the role of other environmental agents that are present in connection with endotoxin, particularly (1→3)-β-D-glucan from mold cell walls.
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Affiliation(s)
- Ragnar Rylander
- Department of Environmental Medicine, University of Gothenburg, Sweden,
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Haig CW, Mackay WG, Walker JT, Williams C. Bioaerosol sampling: sampling mechanisms, bioefficiency and field studies. J Hosp Infect 2016; 93:242-55. [PMID: 27112048 PMCID: PMC7124364 DOI: 10.1016/j.jhin.2016.03.017] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/15/2016] [Indexed: 11/21/2022]
Abstract
Investigations into the suspected airborne transmission of pathogens in healthcare environments have posed a challenge to researchers for more than a century. With each pathogen demonstrating a unique response to environmental conditions and the mechanical stresses it experiences, the choice of sampling device is not obvious. Our aim was to review bioaerosol sampling, sampling equipment, and methodology. A comprehensive literature search was performed, using electronic databases to retrieve English language papers on bioaerosol sampling. The review describes the mechanisms of popular bioaerosol sampling devices such as impingers, cyclones, impactors, and filters, explaining both their strengths and weaknesses, and the consequences for microbial bioefficiency. Numerous successful studies are described that point to best practice in bioaerosol sampling, from the use of small personal samplers to monitor workers' pathogen exposure through to large static samplers collecting airborne microbes in various healthcare settings. Of primary importance is the requirement that studies should commence by determining the bioefficiency of the chosen sampler and the pathogen under investigation within laboratory conditions. From such foundations, sampling for bioaerosol material in the complexity of the field holds greater certainty of successful capture of low-concentration airborne pathogens. From the laboratory to use in the field, this review enables the investigator to make informed decisions about the choice of bioaerosol sampler and its application.
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Affiliation(s)
- C W Haig
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK.
| | - W G Mackay
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK
| | - J T Walker
- Public Health England, National Infection Service, Biosafety Unit, Porton Down, UK
| | - C Williams
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK
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Impact on the Quality of Life When Living Close to a Municipal Wastewater Treatment Plant. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:8467023. [PMID: 27375747 PMCID: PMC4914737 DOI: 10.1155/2016/8467023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/15/2016] [Indexed: 11/17/2022]
Abstract
The objective of the study was to investigate the impact on the quality of life of people living close to a municipal wastewater treatment plant. A case control study, including 235 inhabitants living within a 500 m radius by a municipal wastewater treatment plant (cases) and 97 inhabitants living in a different area (controls), was conducted. A standardized questionnaire was self-completed by the participants which examined the general health perception and the overall life satisfaction. Also, the concentration of airborne pathogenic microorganisms in aerosol samples collected around the wastewater treatment plant was investigated. Significant risk for symptoms such as headache, unusual tiredness, and concentration difficulties was recorded and an increased possibility for respiratory and skin diseases was reported. A high rate of the cases being irritable and moody was noticed. Significantly higher gastrointestinal symptoms were also reported among the cases in relation to the controls. The prevalence of pathogenic airborne microorganisms originating from the wastewater treatment plant was reported in high numbers in sampling points close to the wastewater treatment plant. More analytical epidemiological investigations are needed to determine the cause as well as the burden of the diseases to inhabitants living surrounding the wastewater treatment plant.
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Biomarkers of inflammation in workers exposed to compost and sewage dust. Int Arch Occup Environ Health 2015; 89:711-8. [DOI: 10.1007/s00420-015-1109-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 12/15/2015] [Indexed: 11/27/2022]
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Yan Y, Wang X, Wu J, Xu L. Occupational skin diseases and prevention among sanitation workers in China. Afr Health Sci 2015; 15:768-75. [PMID: 26957964 DOI: 10.4314/ahs.v15i3.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Little research has been focused on the health status or the occupational protection awareness of sanitation workers. The policy recommendations on the occupational safety and health of sanitation workers based on the scientific research are also insufficient in developing countries like China. OBJECTIVE To study the incidence of dermatoses and the relevance with occupational exposure, protection awareness and protective measures among sanitation workers for better management and protection of the sanitation workers. METHODS 273 sanitation workers and 113 administrative staff from 11 streets of Wuhan were recruited. Dermatological problems were evaluated and recorded by physical examination. Occupational exposure, protection awareness, the use of protective equipments and personal history of skin disease were assessed by questionnaires. RESULTS Compared with administrative staff, sanitation workers had much more occupational dermatological problems and had a much higher rate of harmful ultraviolet ray exposure. Young sanitation workers were more aware of occupational self-protection and a relatively higher rate of them using protective equipments compared with old ones. CONCLUSION Exposure to multiple health hazards and the poor use of protective equipments are related to skin diseases in sanitation workers. Prejob training of self-protection and the use of protective equipments are recommended.
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Basu R, Ram SS, Biswas A, Ray SS, Mukhopadhyay A, Chakraborty A, Mathummal S, Chakrabarti S. Investigation on the Trace Elemental Profile of Sewage Workers in Kolkata, an Indian Megacity. J Public Health Res 2015; 4:473. [PMID: 26425493 PMCID: PMC4568422 DOI: 10.4081/jphr.2015.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/18/2015] [Accepted: 03/24/2015] [Indexed: 11/23/2022] Open
Abstract
Background Environmental pollution has become a global health risk. Exposure to pollutants at the work place, i.e. occupational exposure, is one of the areas that need immediate attention. The civic drainage workers are exposed to pollutants present in the wastewater they handle and most of them are toxic heavy metals. Exposure to such pollutants may be a health hazard, since it can lead to the imbalance in nutrient elements status. Design and Methods In the present study, profiling of trace elements in the blood of drainage worker population from an Indian megacity, Kolkata, was carried out by energy dispersive x-ray fluorescence (EDXRF) and compared with the control group population of the same area. Results The elements detected by EDXRF spectrometry include P, S, Cl, K, Fe, Cu, Zn, Se, Br, and Rb. By using ANOVA with 5% significance level, we observed significant alterations in the trace elements status, iron over loading, selenium deficiency, and in Cu-Zn ratio. Gender specific variations within the same population were also observed. Conclusions The results indicate that the drainage workers have altered elemental profile in comparison to that of control population. Significance for public health Environmental pollution is a global health risk and awareness among sewage workers is growing very slowly in many developing countries. Due to this fact, workers are often exposed to different pollutants which are responsible for several health complications. Imbalances in the presence of trace elements in blood are a symptom of different health status and could also indicate new health perspectives for the future. In the present scenario, this paper is essential since this kind of analysis has not been done yet, especially regarding the health status of sewage workers. We hope this initial study will be a starting point for future investigations.
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Affiliation(s)
- Rajlaxmi Basu
- Institute of Haematology and Transfusion, Medicine Medical College , Kolkata, India
| | | | | | | | | | | | | | - Sila Chakrabarti
- Institute of Haematology and Transfusion, Medicine Medical College , Kolkata, India
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Masclaux FG, Hotz P, Gashi D, Savova-Bianchi D, Oppliger A. Assessment of airborne virus contamination in wastewater treatment plants. ENVIRONMENTAL RESEARCH 2014; 133:260-5. [PMID: 24981824 DOI: 10.1016/j.envres.2014.06.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/20/2014] [Accepted: 06/04/2014] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Occupational exposure to bioaerosols in wastewater treatment plants (WWTP) and its consequence on workers' health are well documented. Most studies were devoted to enumerating and identifying cultivable bacteria and fungi, as well as measuring concentrations of airborne endotoxins, as these are the main health-related factors found in WWTP. Surprisingly, very few studies have investigated the presence and concentrations of airborne virus in WWTP. However, many enteric viruses are present in wastewater and, due to their small size, they should become aerosolized. Two in particular, the norovirus and the adenovirus, are extremely widespread and are the major causes of infectious gastrointestinal diseases reported around the world. The third one, hepatitis E virus, has an emerging status. GOAL AND METHODS This study׳s objectives were to detect and quantify the presence and concentrations of 3 different viruses (adenovirus, norovirus and the hepatitis E virus) in air samples from 31 WWTPs by using quantitative polymerase chain reaction (qPCR) during two different seasons and two consecutive years. RESULTS Adenovirus was present in 100% of summer WWTP samples and 97% of winter samples. The highest airborne concentration measured was 2.27 × 10(6) genome equivalent/m(3) and, on average, these were higher in summer than in winter. Norovirus was detected in only 3 of the 123 air samples, and the hepatitis E virus was not detected. CONCLUSIONS Concentrations of potentially pathogenic viral particles in WWTP air are non-negligible and could partly explain the work-related gastrointestinal symptoms often reported in employees in this sector.
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Affiliation(s)
- Frédéric G Masclaux
- Institute for Work and Health (IST), University of Lausanne and University of Geneva, Route de la Corniche 2, 1066 Epalinges-Lausanne, Switzerland.
| | - Philipp Hotz
- Occupational and Environmental Medicine Unit, Med. Poliklinik USZ, Rämistrasse 100, 8091 Zürich, Switzerland.
| | - Drita Gashi
- Occupational and Environmental Medicine Unit, Med. Poliklinik USZ, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Dessislava Savova-Bianchi
- Institute for Work and Health (IST), University of Lausanne and University of Geneva, Route de la Corniche 2, 1066 Epalinges-Lausanne, Switzerland
| | - Anne Oppliger
- Institute for Work and Health (IST), University of Lausanne and University of Geneva, Route de la Corniche 2, 1066 Epalinges-Lausanne, Switzerland.
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Lange JH, Mastrangelo G, Cegolon L. Infectious disease risk in asbestos abatement workers. BMC Public Health 2012; 12:665. [PMID: 22897975 PMCID: PMC3472281 DOI: 10.1186/1471-2458-12-665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 08/01/2012] [Indexed: 11/17/2022] Open
Abstract
Background The current literature reports increased infectious disease occurrence in various construction occupations, as an important contributor to morbidity and mortality arising from employment. These observations should be expanded to asbestos abatement workers, as the abatement can create an environment favorable for bacterial, viral and fungal infections. Discussion Asbestos abatement work employs activities resulting in cuts, blisters and abrasions to the skin, work in a dirty environment and exposure to dust, mists and fumes. Furthermore, this population exhibits a high smoking rate which increases the risk of chronic obstructive pulmonary disease and respiratory infections. In addition, these workers also commonly employ respirators, which can accumulate dirt and debris magnifying exposure to microbes. Use of respirators and related types of personal protective equipment, especially if shared and in the close environment experienced by workers, may enhance communicability of these agents, including viruses. Summary Abatement workers need to be provided with information on hazards and targeted by appropriate health education to reduce the infection risk. Epidemiological studies to investigate this risk in asbestos removers are recommended.
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Affiliation(s)
- John H Lange
- Envirosafe Training and Consultants, Pittsburgh, PA, USA
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Heldal KK, Barregard L, Larsson P, Ellingsen DG. Pneumoproteins in sewage workers exposed to sewage dust. Int Arch Occup Environ Health 2012; 86:65-70. [PMID: 22350277 PMCID: PMC3535374 DOI: 10.1007/s00420-012-0747-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/01/2012] [Indexed: 11/30/2022]
Abstract
Purpose The association between exposure to bacteria and endotoxins in sewage dust and the serum concentrations of pneumoproteins in sewage treatment plant workers were studied. Methods Forty-four workers from eight sewage treatment plants and 38 reference workers participated in the study. Microbial aerosol was collected by personal inhalable samplers. The concentrations of bacteria and endotoxins were determined by fluorescence microscopy and the Limulus assay, respectively. Pneumoproteins (Clara cell protein: CC16, and Surfactant proteins A and D: SP-A, SP-D) were determined by ELISA in blood samples collected post-shift. Results The exposure to dust ranged from 0.02 to 9.3 (geometric mean (GM) 0.3 mg/m3, of bacteria from 0.3 to 4,900 × 103 (GM 27 × 103) cells/m3 and endotoxins from 1 to 3,160 (GM 28) EU/m3. The exposed workers had lower CC16 [arithmetic mean (AM) 4.9 ng/ml] compared to the referents (AM 6.4 ng/ml, p < 0.01). No significant difference was observed for SP-D and SP-A. Exposure to bacteria was positively associated with CC16 (p < 0.05) and SP-D (p < 0.05), adjusting for possible confounders. Conclusions This study showed that exposed workers had lower serum concentration of CC16 as compared to the referents, which may reflect a long-term effect on secretion of these pneumoproteins. The positive association between exposure to bacteria and the serum concentrations of CC16 and SP-D may be explained by a transient increased permeability of the lung–blood barrier.
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Affiliation(s)
- Kari Kulvik Heldal
- National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway.
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Barbosa-Branco A, Souza WR, Steenstra IA. Incidence of work and non-work related disability claims in Brazil. Am J Ind Med 2011; 54:858-71. [PMID: 21630300 DOI: 10.1002/ajim.20974] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sickness benefit claims are an important economic burden to society. This study aims to determine the incidence of sickness benefit claims in Brazil in 2008, exploring the role of economic activity. METHODS Population-based study on sickness claims lasting longer than 15 days of sickness absence granted to private sector employees. Data on gender, age, economic activity, diagnosis, and work-relatedness were collected. RESULTS The annual incidence of sickness benefits was 421.8/10,000 jobs, 435.4 for males and 452.0 for females. There were 3.5 times more non-work-related than work-related claims. The main diagnoses were injuries, musculoskeletal disorders, and mental disorders. Rates increased with age up to 59 years. Economic activity 37-Sewage had the highest incidence of non-work-related and work-related claims. CONCLUSION The incidence of sickness benefits is higher among female and older workers. Economic activities show great variability of sickness benefit rates, work-relatedness, diagnostic categories, and gender.
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Affiliation(s)
- Anadergh Barbosa-Branco
- University of Brasilia, Faculty of Health Sciences/Institute for Work & Health, Brasília, Brazil.
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Abstract
An estimated 1.2 million scavengers in the country are involved in the sanitation of our surroundings. The working conditions of these sanitary workers have remained virtually unchanged for over a century. Apart from the social atrocities that these workers face, they are exposed to certain health problems by virtue of their occupation. These health hazards include exposure to harmful gases such as methane and hydrogen sulfide, cardiovascular degeneration, musculoskeletal disorders like osteoarthritic changes and intervertebral disc herniation, infections like hepatitis, leptospirosis and helicobacter, skin problems, respiratory system problems and altered pulmonary function parameters. This can be prevented through engineering, medical and legislative measures. While the engineering measures will help in protecting against exposures, the medical measures will help in early detection of the effects of these exposures. This can be partly achieved by developing an effective occupational health service for this group of workers. Also, regular awareness programs should be conducted to impart education regarding safer work procedures and use of personal protective devices.
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Affiliation(s)
- Rajnarayan R Tiwari
- Occupational Medicine Division, National Institute of Occupational Health, Ahmedabad, India
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Gangamma S, Patil RS, Mukherji S. Characterization and proinflammatory response of airborne biological particles from wastewater treatment plants. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2011; 45:3282-3287. [PMID: 21425829 DOI: 10.1021/es103652z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Wastewater contains a variety of microorganisms, and unit operations in the plants could release these biological components into the air environment. These airborne biological particles could have adverse health effects on plant workers and the downwind population. This study provides a first report on the concentration and characterization of the airborne biological particles in six wastewater treatment plants in Mumbai, India. The study indicates that 49% and 27% of the samples exceed, respectively, the exposure limit for airborne endotoxin and bacteria in occupational settings. Endotoxin was identified as the single most important component of the particulate matter responsible for induction of proinflammatory indicator (tumor necrosis factor-α) in in vitro assay. Identification of several clinically important bacterial species in the samples suggests that the workers at the treatment plant are exposed to opportunistic and infectious bacteria. Principal component analysis was used to identify the groups among the bacterial species which serves as the signature for transport study. Analysis also shows that the component related to spore-forming bacteria is present in all samples.
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Affiliation(s)
- S Gangamma
- Centre for Environmental Science and Engineering, Indian Institute of Technology , Bombay, Mumbai, India
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Sahar Ali Farahat, Nirmeen Adel Kishk. Cognitive functions changes among Egyptian sewage network workers. Toxicol Ind Health 2010; 26:229-38. [PMID: 20237195 DOI: 10.1177/0748233710364966] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current work aimed at investigating the cognitive functions impairment among workers of sewer networks due to exposure to hydrogen sulfide (H(2)S) and the relation of this impairment, if any, to the level of H(2)S exposure biomarker 'urinary thiosulfate.' Besides, the validity of using Mini Mental State Examination (MMSE) as screening test for cognitive impairment among the exposed workers was tested. The work was conducted among 33 sewage network maintenance male workers and a matched unexposed control group (n = 30). The participants were subjected to clinical neurological history, estimation of urinary thiosulfate, and assessment of cognitive dysfunction by using neurophysiological (simple reaction time, P300 test) and neuropsychological tests (Wechsler Memory Scale) and frontal executive functions tests. Clinical neurological history revealed significantly higher neurological symptoms (headache, memory defects, lack of concentration) among exposed workers compared to their controls (p < 0.05). Exposed workers had significantly prolonged simple reaction time and delayed P300 latency and showed poor performance of most of neuropsychological tests. Marked elevation of urinary thiosulfate was observed among the exposed workers (p < 0.001) but this elevation was not correlated with the duration of exposure or any of the other measured parameters. Exposed workers had significantly lower mean value of MMSE scoring than that of the controls (p < 0.001). In conclusion, exposure to H( 2)S among sewer network workers is associated with cognitive impairment, which can be screened by applying MMSE as a simple rapid test for H( 2)S occupationally exposed workers.
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Affiliation(s)
- Sahar Ali Farahat
- Department of Industrial Medicine and Occupational Diseases, Faculty of Medicine, Cairo University, Egypt.
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Rinsoz T, Hilfiker S, Oppliger A. Quantification of thermotolerant Campylobacter in Swiss water treatment plants, by real-time quantitative polymerase chain reaction. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2009; 81:929-933. [PMID: 19860149 DOI: 10.2175/106143009x407429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A total of 49 wastewater samples from 23 different wastewater treatment plants (WWTPs) were analyzed using real-time quantitative polymerase chain reaction for the presence and quantity of thermotolerant campylobacters. Thermotolerant campylobacters were detected in 87.5% (21/24) and 64% (16/25) of untreated and treated wastewater samples, respectively. Their concentration was sufficiently high to be quantified in 20.4% (10/49) of the samples. In these samples, the concentration ranged from 68,000 to 2,292,000 cells/L in untreated wastewater and from 10,800 to 28,000 cells/L in treated water. We conclude that thermotolerant campylobacters present a health hazard for workers at WWTPs in Switzerland.
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Affiliation(s)
- Thomas Rinsoz
- Institute for Work and Health, University of Lausanne and Geneva, Lausanne, Switzerland
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Monitoring risks in association with exposure levels among wastewater treatment plant workers. J Occup Environ Med 2007; 49:1235-48. [PMID: 17993928 DOI: 10.1097/jom.0b013e3181568b40] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the relationship between exposure to hydrogen sulfide and endotoxin during specific job tasks and health symptoms among wastewater treatment plant (WWTP) workers. METHODS The exposure levels for specific tasks were measured by personal monitoring. The health symptoms of WWTP workers were compared with those of water treatment plant workers through a questionnaire survey. RESULTS Exposure levels for all monitored tasks were less than 1 ppm for hydrogen sulfide and 91 EU/m (endotoxin units/m) for endotoxin. Statistically higher odds ratios of respiratory, ocular and skin irritation, neurology, and gastrointestine symptoms were shown among WWTP workers compared with water treatment plant workers. Tasks related to sludge handling and plant inspection showed statistically significant associations with memory/concentration difficulties, throat irritation, and stomach pain. CONCLUSIONS These results suggest that exposure control programs for specific job tasks and work locations are needed.
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Widmeier S, Bernard A, Tschopp A, Jeggli S, Dumont X, Hilfiker S, Oppliger A, Hotz P. Surfactant protein A, exposure to endotoxin, and asthma in garbage collectors and in wastewater workers. Inhal Toxicol 2007; 19:351-60. [PMID: 17365040 DOI: 10.1080/08958370601144456] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Endotoxin causes an inflammation at the bronchial and alveolar level. The inflammation-induced increase in permeability of the bronchoalveolar epithelial barrier is supposed to cause a leakage of pneumoproteins. Therefore, their concentrations are expected to increase in the bloodstream. This study aimed at examining the association between occupational exposure to endotoxin and a serum pneumoprotein, surfactant protein A, to look for nonoccupational factors capable of confounding this association, and examine the relation between surfactant protein A and spirometry. There were 369 control subjects, 325 wastewater workers, and 84 garbage collectors in the study. Exposure to endotoxin was assessed through personal sampling and the Limulus amebocytes lysate assay. Surfactant protein A was determined by an in house sandwich enzyme-linked immunosorbent assay (ELISA) in 697 subjects. Clinical and smoking history were ascertained and spirometry carried out according to American Thoracic Society criteria. Multiple linear regression was used for statistical analysis. Exposure was fairly high during some tasks in wastewater workers but did not influence surfactant protein A. Surfactant protein A was lower in asthmatics. Interindividual variability was large. No correlation with spirometry was found. Endotoxin has no effect on surfactant protein A at these endotoxin levels and serum surfactant protein A does not correlate with spirometry. The decreased surfactant protein A secretion in asthmatics requires further study.
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Affiliation(s)
- Susanne Widmeier
- Occupational and Environmental Medicine Unit, University of Zurich, Zurich, Switzerland
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Aamodt AH, Stovner LJ, Langhammer A, Hagen K, Zwart JA. Is headache related to asthma, hay fever, and chronic bronchitis? The Head-HUNT Study. Headache 2007; 47:204-12. [PMID: 17300360 DOI: 10.1111/j.1526-4610.2006.00597.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To examine the relationship between migraine and nonmigrainous headache and asthma, hay fever, and chronic bronchitis in a large cross-sectional population-based study. BACKGROUND Associations between prevalence of migraine and asthma or allergy have been demonstrated in clinic-based and epidemiologic studies whereas studies on chronic bronchitis are scarce. METHODS A total of 51,383 subjects completed a headache questionnaire and constituted the "Head-HUNT" Study. Of these 50,401 (98.1%) answered the questions about asthma and chronic bronchitis, and 47,029 (91.5%) answered the question about hay fever. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). RESULTS Both migraine and nonmigrainous headache were approximately 1.5 times more likely among those with current asthma, asthma related symptoms, hay fever, and chronic bronchitis than those without. The association increased with increasing headache frequency. CONCLUSIONS This large questionnaire-based study confirms that migraine and other headaches are associated with respiratory and allergic disorders. The magnitude of the association between headache and asthma, hay fever, and chronic bronchitis tended to be in the same order. Headache frequency seems to have a greater impact on the association with respiratory or allergic conditions than headache diagnoses. Whether it is a causal relationship is uncertain, but the results underline the importance of considering comorbid disorders among patients with frequent headache.
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Affiliation(s)
- Anne H Aamodt
- Norwegian National Headache Centre, Trondheim University Hospital, Norway
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Robinson C, Robinson K, Tatgenhorst C, Campbell D, Webb C. Assessment of wastewater treatment plant workers exposed to biosolids: Pilot test of a newly developed health survey. ACTA ACUST UNITED AC 2006; 54:301-6. [PMID: 16862877 DOI: 10.1177/216507990605400702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to develop and pilot test a health survey for wastewater treatment workers exposed to biosolids, using an upstream framework for environmental health. The questionnaire included items about health status, symptoms, frequency of contact with biosolids, use of personal protective equipment, and demographic data. A majority of workers regularly exposed to biosolids reported at least one health-related symptom, although some attributed their symptoms to contact with materials other than biosolids. All 11 participants took unnecessary health risks such as periodically neglecting to wear masks, respirators, gloves, or goggles to protect themselves from potential exposure to biosolids. However, those who reported symptoms were the least compliant with personal protective equipment use. Survey results highlighted that occupational health nurses must effectively communicate to their clients the need for proper use of personal protective equipment when working with potentially hazardous material.
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40
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Visser MJ, Spaan S, Arts HJJM, Smit LAM, Heederik DJJ. Influence of Different Cleaning Practices on Endotoxin Exposure at Sewage Treatment Plants. ACTA ACUST UNITED AC 2006; 50:731-6. [PMID: 16782738 DOI: 10.1093/annhyg/mel026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Exposure to endotoxin at sewage treatment plants is associated with an increased prevalence of work-related symptoms in sewage workers. Since cleaning activities are regarded as an important determinant of endotoxin exposure, workers' endotoxin exposure levels during different cleaning activities were compared in an experimental setting. Variables considered were water used (tap water, surface water or effluent), water pressure (low or high pressure, and a fire hose with the mouth open or obstructed), presence of mechanical ventilation and the distance between the worker and the object to be cleaned (concentration gradient). Experimental cleaning scenarios were defined, during which endotoxin exposure was measured with personal and stationary air sampling. Data were statistically analyzed with mixed effects models. The water used for cleaning appeared to have a large influence on endotoxin exposure, especially the use of effluent, which caused a factor 2.4 increase in exposure. Use of high pressure did not significantly add to the exposure. Use of a fire hose with fully opened mouth (spout opening) led to a 3-fold decrease in exposure when compared with a partially obstructed mouth. The presence of mechanical ventilation decreased endotoxin concentration in a room, provided that the capacity of the ventilation system was sufficient. The worker's distance to the object that was cleaned did not significantly influence exposure.
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Affiliation(s)
- M J Visser
- Environmental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Müller T, Jörres RA, Scharrer EM, Hessel H, Nowak D, Radon K. Acute blood neutrophilia induced by short-term compost dust exposure in previously unexposed healthy individuals. Int Arch Occup Environ Health 2006; 79:477-82. [PMID: 16435151 DOI: 10.1007/s00420-006-0083-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 01/03/2006] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Systemic effects of organic dust inhalation have been described in farming environments. The purpose of this study was to examine whether a single exposure at a biowaste composting facility could also exert systemic effects in healthy volunteers not previously exposed to organic dust from such facilities. METHODS Seventeen subjects (age 20-35 years) were exposed to organic dust for 2 h (exposure day) during moderate exercise; 12 of these subjects also took part in a control experiment (control day). Spirometry was performed before and immediately after the exposure. White blood cell counts and levels of tumor-necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) in peripheral blood were determined before and 3 h after exposure. RESULTS Exposures did not result in significant changes in lung function or blood cytokine levels. In contrast, the number and percentage of neutrophils increased during the exposure day [median (range) percent change of percentages 14 (-2; 67) %; P=0.002], but not during the control day [5 (-22; 35) %; P=0.66). Furthermore, there was a decrease in the number and percentage of eosinophils during the exposure day [-47 (-57; 0.0) %; P=0.002], whereas the change during the control day was smaller [-8 (-56; 71) %; P=0.68]. CONCLUSION Short-term exposure of healthy, young subjects to organic dust from composting facilities had opposite effects on the numbers of blood neutrophils and blood eosinophils. These effects, though mild, suggest that even during a limited period of moderate work a sufficient amount of bioactive material can be deposited in the lung to elicit acute systemic alterations.
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Affiliation(s)
- Tim Müller
- Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Lee JA, Johnson JC, Reynolds SJ, Thorne PS, O'Shaughnessy PT. Indoor and outdoor air quality assessment of four wastewater treatment plants. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2006; 3:36-43. [PMID: 16482976 DOI: 10.1080/15459620500455380] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The study assessed the air quality of four wastewater treatment plants (WWTPs) by monitoring levels of hydrogen sulfide (H2S) and endotoxin. Samples were taken over a 1-year period (2001-2002). The unit operations at each WWTP were categorized as: (a) grit removal, (b) primary clarification, (c) biological treatment, (d) secondary clarification, (e) sludge dewatering, and (f) digestion. Temperature and humidity were monitored simultaneously, whereas airborne H2S and endotoxin were monitored at each of the six unit operations in each plant. Carbonaceous biochemical oxygen demand (CBOD) and total incoming flow of the day of visit were also recorded. The geometric means of H2S concentration were less than 1 ppm and endotoxin ranged from 6-1247 EU/m3. A mixed model analysis of covariance (ANCOVA) was used for the statistical analysis. While temperature was not associated with the levels of both contaminants, humidity was influential on the level of H2S (p < 0.01) but not of endotoxin. CBOD did not affect the levels of either contaminant; however, incoming flows showed an association with the levels of H2S (p < 0.05). The concentrations of H2S in the six unit operations were statistically different, whereas endotoxin did not show any differences in concentrations between units. Individual comparisons proved that concentrations of H2S in the grit removal and sludge dewatering unit operations were statistically higher than the other operations. Overall, the concentrations of H2S varied depending on total incoming flow, humidity, and different unit operations. This trend was not observed for endotoxin. The results showed that the factors analyzed affected concentrations of H2S and endotoxin differently. Therefore, different control methods for endotoxin and H2S need to be considered to effectively reduce their concentrations at WWTPs.
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Affiliation(s)
- Joung Ae Lee
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City 52242, USA
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Steiner D, Jeggli S, Tschopp A, Bernard A, Oppliger A, Hilfiker S, Hotz P. Clara cell protein and surfactant protein�B in garbage collectors and in wastewater workers exposed to bioaerosols. Int Arch Occup Environ Health 2005; 78:189-97. [PMID: 15772810 DOI: 10.1007/s00420-004-0586-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Accepted: 10/02/2004] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Inhalation of bioaerosols has been hypothesised to cause "toxic pneumonitis" that should increase lung epithelial permeability at the bronchioloalveolar level. Serum Clara cell protein (CC16) and serum surfactant protein B (SPB) have been proposed as sensitive markers of lung epithelial injury. This study was aimed at looking for increased lung epithelial permeability by determining CC16 and SPB in workers exposed to bioaerosols from wastewater or garbage. METHODS Subjects (778 wastewater, garbage and control workers; participation 61%) underwent a medical examination, lung function tests [American Thoracic Society (ATS) criteria], and determination of CC16 and SPB. Symptoms of endotoxin exposure and several potential confounders (age, gender, smoking, kidney function, obesity) were looked for. Results were examined with multiple linear or logistic regression. RESULTS Exposure to bioaerosols increased CC16 concentration in the wastewater workers. No effect of exposure on SPB was found. No clue to work-related respiratory diseases was found. CONCLUSIONS The increase in CC16 in serum supports the hypothesis that bioaerosols cause subclinical "toxic pneumonitis", even at low exposure.
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Affiliation(s)
- D Steiner
- Occupational and Environmental Medicine Unit, Sumatrastrasse 30, 8006, Zurich, Switzerland
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Tooher R, Griffin T, Shute E, Maddern G. Vaccinations for waste-handling workers. A review of the literature. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2005; 23:79-86. [PMID: 15751399 DOI: 10.1177/0734242x05048037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A review of the literature relating to the need for vaccination against infectious disease in the solid waste industry was conducted, focusing on hepatitis A, hepatitis B and tetanus. Databases (Medline, PreMedline, EMBASE, CINAHL, Current Contents, Cochrane Database, HTA Database, DARE, OSHROM) were searched up to and including August 2003. Articles were included in the review if they reported the prevalence of immunity to hepatitis A, hepatitis B or tetanus in solid waste workers or the incidence of clinical infection with any of these diseases. Papers about hazardous or medical waste, incineration or other infectious diseases were excluded. Forty-four papers constituted the evidence database. Only one paper studied the prevalence of antibodies to hepatitis A and hepatitis B in solid waste workers compared with sewage plant workers and office workers, and no difference was found between these groups of workers. There was some evidence to support a theoretical risk of infection with hepatitis A, B and tetanus; however, no studies could be found of the risk of these diseases in solid waste workers. No single cases of these diseases being acquired occupationally in solid waste management were identified in the literature. Workers in the solid waste industry may theoretically be at increased risk of acquiring infectious diseases occupationally. However, at present no studies could be found which have documented this risk.
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Affiliation(s)
- Rebecca Tooher
- ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, South Australia
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Reply to letter by Lange. Clin Rheumatol 2004. [DOI: 10.1007/s10067-004-0948-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thorn J, Beijer L. Work-related symptoms and inflammation among sewage plant operatives. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2004; 10:84-9. [PMID: 15070030 DOI: 10.1179/oeh.2004.10.1.84] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Sewage operatives at five sewage treatment plants (n = 59) and controls not exposed to sewage (n = 55) were examined to determine work-related symptoms and inflammatory responses. Symptoms were elicited using a questionnaire, and spirometry was performed. Inflammatory markers were determined in blood and nasal lavage. Workplace endotoxin and hydrogen sulfide were measured and adeno- and enterovirus antibodies were evaluated in blood. Gastrointestinal and airway symptoms, joint pains, unusual tiredness, and toxic pneumonitis were more common among operatives, and the proportion of blood neutrophils was higher among operatives as compared with controls. A relationship was found between several reported symptoms and the inflammatory markers. Hydrogen sulfide levels were very low. Endotoxin levels were generally low, but high at some work sites.
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Affiliation(s)
- Jörgen Thorn
- Department of Environmental Medicine, Göteborg University, Göteborg, Sweden.
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Jeggli S, Steiner D, Joller H, Tschopp A, Steffen R, Hotz P. Hepatitis E, Helicobacter pylori, and gastrointestinal symptoms in workers exposed to waste water. Occup Environ Med 2004; 61:622-7. [PMID: 15208379 PMCID: PMC1740808 DOI: 10.1136/oem.2003.011411] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Workers exposed to sewage may have an increased risk of infection by Helicobacter pylori and hepatitis E virus (HEV). AIMS To assess the prevalence of clinical hepatitis E (HE) and peptic ulcer disease as well as the seroprevalence of antibodies to H pylori and HEV in workers with and without sewage exposure and to look for symptoms due to exposure to endotoxin. METHODS In the first year of a prospective cohort study 349 sewage exposed workers and 429 municipal manual workers (participation: 61%) underwent a complete medical examination. Travelling to endemic areas, socioeconomic level, age, country in which childhood was spent, and number of siblings were considered as the main confounding factors. RESULTS Peptic ulcer disease and clinical HE did not occur more often in workers exposed to sewage. Prevalence of antibodies to HEV was 3.3% and overall prevalence of IgG antibodies to H pylori was 42% with large differences between subgroups. Logistic regression did not show an increased risk of seropositivity or antibodies to parietal cells in sewage exposed workers, but disentangling the effect of exposure from that of confounders was extremely difficult. No increase of symptoms due to exposure to endotoxin was found in sewage workers, with the exception of diarrhoea. CONCLUSIONS No clear increased risk of infection by H pylori or by HEV in workers exposed to sewage was found in this cross-sectional study, but these results need to be confirmed by follow up.
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Affiliation(s)
- S Jeggli
- Occupational and Environmental Medicine Unit, Zurich, Switzerland
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Rhône M, Testud F, Lambert-chhum R. ARCH MAL PROF ENVIRO 2004; 65:56. [DOI: 10.1016/s1775-8785(04)93021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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