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.
Highlights
Various studies widely demonstrate that sewage treatment plants (STP) produce bundles of occupational hazards through different sewage plant processes to remove contaminants from wastewater or as by-products [1, 2]
We developed several eligibility criteria to address these critical question: What evidence of potential occupational respiratory hazards could arise from the sewage treatment plant and possibly cause adverse respiratory health effects among sewage workers? To widen our findings, we selected (i) observational studies involving human subjects and (ii) environmental assessment studies conducted in sewage plants
The inclusion criteria were (i) studies on potential occupational respiratory hazard exposure among sewage workers, (ii) manuscripts written in English, and (iii) studies published in the peer-reviewed literature from January
Summary
Various studies widely demonstrate that sewage treatment plants (STP) produce bundles of occupational hazards through different sewage plant processes to remove contaminants from wastewater or as by-products [1, 2]. There are several occupational hazards that potentially exist in the sewage plant, such as chemical, biological, and physical hazards [4] Exposure to these potential occupational hazards can lead to work-related diseases and adverse health effects. Much previous literature shows that workers at sewage treatment plants are at high risk of experiencing a broad range of adverse health impacts, including respiratory disorders (asthma or chronic obstructive pulmonary disease), infections (such as tuberculosis, leptospirosis, hepatitis A, or tetanus), gastrointestinal problems (for example, gastroenteritis), skin illnesses (for instance, contact dermatitis or eczema), cancers (such as lung, stomach, and renal cancers), and general symptoms (such as unusual tiredness and headache) [4,5,6]. 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
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