Sewage Workers Research Articles

Investigation on the Trace Elemental Profile of Sewage Workers in Kolkata, an Indian Megacity.

BackgroundEnvironmental 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 MethodsIn 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.ResultsThe 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.ConclusionsThe results indicate that the drainage workers have altered elemental profile in comparison to that of control population.Significance for public healthEnvironmental 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.

Endotoxin exposure and changes in short-term pulmonary function among sewage workers.

The inhaled endotoxin is considered as a causative factor in the process of acute bronchial obstruction, which can be measured by a decrease in forced expiratory volume in 1 s (FEV1). The aim of this study was to assess endotoxin exposure among sewage treatment plant workers (STPW) and its effect on across-shift changes in respiratory airflow. A group of 78 STPW from a large sewage treatment plant was studied. Inhalable dust for endotoxin assessment was collected using personal aerosol samplers. Endotoxin was assayed with the kinetic, chromogenic Limulus amebocyte lysate test. Across-shift spirometric measurements were performed on Mondays, after 2-days absence from work, with the use of portable spirometer. The forced vital capacity (FVC), and FEV1 parameters were analyzed. Multifactor regression modeling was performed to determine parameters significantly associated with endotoxin exposure. The concentration of inhalable dust and endotoxin ranged from 0.01-1.38 mg/m3 and 0.68-214 endotoxin units per cubic meter of air (EU/m3), respectively. Endotoxins were characterized with the skewed distribution (arithmetic mean (AM) = 38.8 EU/m3, geometric mean (GM) = 15.4 EU/m3, geometric standard deviation (GSD) = 4.21). Through the use of multifactor analysis, which excluded the main confounders (inhalable dust and smoking habit) it was found that, despite low levels of endotoxin, it had significant impact on the observed across-shift decline in FEV1 (p = 0.044). For this parameter, the regression slope was additionally calculated (r = -0.017, p = 0.071). Relatively low levels of endotoxin among sewage treatment plant workers may cause small, but significant across-shift declines in FEV1. The observed relationship was independent of organic dust concentrations and smoking habit. The respiratory protection should be provided for STPW.

Sewage workers with low antibody responses may be colonized successively by several Tropheryma whipplei strains

Asymptomatic faecal carriage of Tropheryma whipplei, the agent of Whipple's disease, is reported among sewage workers. However, the potential development of such carriage is unknown. A 7-year follow-up of T. whipplei-carrying sewage workers is reported. Nineteen sewage workers previously detected as faecal carriers of T. whipplei were followed to ascertain the chronicity of their carriage. Faeces were tested by molecular assays using quantitative real-time PCR specifically targeting T. whipplei. Serological anti-T. whipplei Western blotting was also performed. Seventy-nine percent (15/19) of workers exhibited a strong immune response against T. whipplei. Among these, five were followed for more than 1 year. Four maintained a strong response, with three carrying the same strain and one becoming negative. The fifth exhibited a decreased immune response, a negative faeces result, and subsequent carriage of another strain. Three individuals with low immune responses were also followed. Two never developed a response, with one carrying the same strain and one becoming negative and then positive with another strain; the third developed a strong response and became negative. Chronic T. whipplei carriers appear to be protected against reinfection, but those with low or decreasing antibody levels may be re-colonized by another strain.

Genotoxicity Study with Special Reference to Comet Test in the Blood Cells of Workers Exposed to Sewage Water

Awareness among sewage workers to occupational exposure is growing slowly in many developing countries. Lead (Pb) and cadmium (Cd) are present in sewage water and workers are exposed to these metals as a result of unprotected handling. These heavy metals exposures are responsible for DNA damage and lowering blood total iron (Fe) concentration. Zinc (Zn) is an element for promoting metallothionine expression and binds the free Cd. The total suspended solids (TSS), total dissolved solids (TDS), Pb, and Cd were estimated in sewage water. The whole blood Zn and Fe concentration and Pd and Cd were also estimated. Genotoxicity as indicated by DNA damage was studied by comet assay. It was observed that there were significant differences (P<0.001) of Pb and Cd concentration in blood for the sewage workers when compared with control population. DNA damage was also observed to be significantly (P<0.001) higher in the exposed groups but their blood Fe concentration was significantly lower, which may be the reason for their tendency for retention of blood Cd and make them more susceptible. This study also indicated that aged workers had higher blood Zn concentrations as compared to the younger (working < 20 years) workers. This may indicate a possible adaptive response. The present study proposes that younger (working < 20 years) group is more susceptible as compared to aged group (working > 20 years).

An Unusual Skin Lesion in Cement Irritant Contact Dermatitis: A Case Report

Introduction: Cement has a wide industrial usage and it is the leading cause of occupational skin diseases among construction workers, which are present as contact urticarial and contact dermatitis. Case Presentation: A 79-year-old water sewage worker man referred to our department with numerous symmetric hyper-keratotic papules with an erythematous base on both hands and feet for about 20 years. Discussions: In this case, a large number of hyperkeratotic papules on common sites of cement contact are significant which is not reported among literature to the author’s knowledge. These lesions are painful and pruritic; however, symptoms releived after stopping cement exposure. In our case, occupational injury occurred because the patient’s lacks of knowledge about safe working with cement and its importance.

The Rat-Catcher's Prank: Interspecies Cunningness and Scavenging in Henry Mayhew's London

Drawing upon Mayhew's interviews with rat-catchers, sewer workers and the dog-men of the rat pit, the article explores the varied relationships these aforementioned groups had with rats across three distinct spaces: the country, sewers and rat-pits. In addition to developing a framework for historicizing the practices of rat-catching, the article illuminates Mayhew's highly ambiguous relationship with two key rationalizing projects: the emerging discourses of sanitary progress and ‘animal welfare’, which had consequences for how he conceptualized the diverse cultures of London's working poor.

0111 Mortality study among Paris sewage workers

ObjectivesTo describe the mortality of sewage workers from Paris (France).MethodThe cohort of 1594 Paris sewage workers since 1970 was set up in 2010 and followed-up on mortality from 1970 to...

Assessment of Biomarker with Special Reference to Antioxidant Level in Blood as Occupational Exposure of Sewage and Garage Workers<sup> </sup>

The present study deals with the estimation of antioxidant levels in blood of sewage and garage workers exposed to sewage water, washing water and vehicular air pollution compared with control group of population. The study areas were selected on the basis of drainage clearance and wards where workers are active as sewage workers. For garage workers, the garage selected was a large and busy one where continuous vehicles washing, repairing etc are carried out. These two exposed groups were compared to non-exposed group of population as control. The blood samples were collected from two groups of exposed population as well as control population and the antioxidant levels were estimated in blood. The present results clearly indicate that there was decreasing trend of the antioxidant level in blood for sewage and garage workers. In the control groups of population the antioxidant levels were found to be within normal range, but for sewage workers (0.14-0.36 mM) and garage workers (0.12-0.36 mM) the antioxidant levels were significantly lower. The range of antioxidant level in human blood is 0.5 to 2.0 mM. It was found to be significantly lower (P < 0.001 or 0.05) in addicted sewage and garage workers when compared with non-addicted groups. All the exposed groups were showed to be having significantly lower antioxidant level when compared to control groups. This study is a preliminary assessment to know the potent biomarkers for oxidative stress and estimation of antioxidant level in blood due to occupational exposure. This study shows a way for easy screening of biomarker assessment but further work is needed in relation to biochemical, enzymological and genetic damage study.

Assessment of Biomarker with Special Reference to Antioxidant Level in Blood as Occupational Exposure of Sewage and Garage Workers<sup> </sup>

The present study deals with the estimation of antioxidant levels in blood of sewage and garage workers exposed to sewage water, washing water and vehicular air pollution compared with control group of population. The study areas were selected on the basis of drainage clearance and wards where workers are active as sewage workers. For garage workers, the garage selected was a large and busy one where continuous vehicles washing, repairing etc are carried out. These two exposed groups were compared to non-exposed group of population as control. The blood samples were collected from two groups of exposed population as well as control population and the antioxidant levels were estimated in blood. The present results clearly indicate that there was decreasing trend of the antioxidant level in blood for sewage and garage workers. In the control groups of population the antioxidant levels were found to be within normal range, but for sewage workers (0.14-0.36 mM) and garage workers (0.12-0.36 mM) the antioxidant levels were significantly lower. The range of antioxidant level in human blood is 0.5 to 2.0 mM. It was found to be significantly lower (P < 0.001 or 0.05) in addicted sewage and garage workers when compared with non-addicted groups. All the exposed groups were showed to be having significantly lower antioxidant level when compared to control groups. This study is a preliminary assessment to know the potent biomarkers for oxidative stress and estimation of antioxidant level in blood due to occupational exposure. This study shows a way for easy screening of biomarker assessment but further work is needed in relation to biochemical, enzymological and genetic damage study.

Exposure to Airborne Endotoxins among Sewer Workers: An Exploratory Study

Exploratory bioaerosol sampling was performed in order to assess exposure to airborne endotoxins during sewer work. Personal samples were collected in underground sewer pipes using 37-mm closed-face cassettes containing fibreglass filters (CFC-FG method) or polycarbonate filters (CFC-PC method). Endotoxins were quantified using the limulus amoebocyte lysate assay. Concentrations of airborne endotoxins at sewer workplaces (16-420 EU m(-3)) were higher than those measured outside the sewer network (0.6-122 EU m(-3)). Sewer worker exposure to airborne endotoxins depended on the workplace and on the tasks. Exposure levels were the highest for tasks involving agitation of water and matter, especially for 'chamber cleanup' and 'pipes cleanup' with a high-pressure water jet. Airborne endotoxin levels at the workplace tended to be higher when CFC-FG was used as the sampling method rather than CFC-PC. The adjusted mean of the measured concentrations for CFC-PC represents 57% of the mean observed with CFC-FG. The number of samples collected in the descriptive study was too low for drawing definitive conclusions and further exposure investigations are needed. Therefore, our exploratory study provides new exposure data for the insufficiently documented sewer working environment and it would be useful for designing larger exposures studies.

Occupational Health Hazards among Sewage Workers: Oxidative Stress and Deranged Lung Functions.

Sewage workers, because of their occupation, are exposed to different types of dusts, bio-aerosols, fumes and gases like methane, hydrogen sulfide, sulphur dioxide, etc, which contribute towards oxidative stress and detrimental effects on various body functions, especially lung functions. This study was carried out on sewage workers (who had been working for more than five years). We wanted to study the role of oxidative stress in development of impaired lung functions among sewage workers. This cross sectional study was done in a tertiary care hospital (J.N. Medical College) in Aligarh, U.P. Study was done from March 2008 to December 2009. The study group comprised of 62 sewage workers who had been working for more than five years (32 non-smokers and 30 smokers) and 60 control subjects (30 smokers and 30 non-smokers). The pulmonary functions of these workers were assessed by using a MIR (Medical International Lab) Spiro Lab II Spirometer, with subjects in sitting position. Valid written consents were obtained from all the subjects. Malondialdehyde (MDA) is produced as a result of the action of reactive oxygen species (ROS) on the lipids present in the membranes of the cells, especially, contracting muscle cells. Serum MDA levels were assessed as an indirect measure of oxidative stress in these sewage workers and they were compared with serum MDA levels of control subjects. Appropriate statistical tests were applied for analysis of the data which was generated. There were statistically significant decreases in Peak Expiratory Flow Rate (PEFR), Forced Expiratory Volume in first second (FEV1) and FEV1/FVC percent ratio (<80%) and Forced Expiratory Flow at 25%-75% of volume as percentage of Vital Capacity (FEF 25%-75%). Also, we found statistically significant increased levels of serum MDA in these sewage workers as compared to those in control subjects (with a p-value of <0.05 with a confidence interval of 95%). Our study found that the occupational exposure of the sewage workers to harmful dust, fumes, gases and bio-aerosols contributed to oxidative stress among them. This oxidative stress was one of the mechanisms which led to the development of obstructive impairment of lung functions in these sewage workers.

302 下水浄化センターの環境効率(大気・水環境評価・改善技術(1))

The eco-efficiency of municipal wastewater treatment plant and pumping station in Japan was studied within the confine of the maintenance and management phase. We evaluate greenhouse gas emission or maintenance and management cost by eco-efficiencies defined as the ratios of the GHG emission or the cost to the population served in sewage work. It was suggested that the GHG emission did not have an advantage of scale.

Chironomid midge sensitization in sewage workers: case study

Non-biting chironomid midges (Diptera: Chironomidae) may cause sensitization and allergic reactions in humans and have recently been identified as a potential health problem in Swedish municipal sewage treatment plants. To investigate, on a pilot scale, the allergenic potential of chironomids in sewage workers, all workers (n = 8) at a sewage treatment plant and local controls (n = 16) completed a symptom questionnaire, underwent measurement of the fraction of nitric oxide in exhaled air, spirometry, and provided serum samples for the determination of atopy status and the prevalence of specific immunoglobulin E (IgE) antibodies against Chironomus thummi (Chi t) using a commercial fluorescence enzyme immunoassay (FEIA). Three sewage workers (38%) but no controls (0%) were FEIA positive for C. thummi-specific IgE antibodies (P < 0.05). No other health-related findings were significantly different between the groups. The study suggested that occupational exposure to Chironomids may cause sensitization with circulating IgE-antibodies in sewage workers.

Helicobacter pyloricagA Gene in Egyptian Sewage Workers

A comparative cross-sectional study was conducted on 60 sewage workers and 30 matched unexposed referents from Mansoura city, Egypt, to estimate the prevalence and risk factors of Helicobacter pylori (H. pylori). Stool culture and detection of H. pylori antigen were done. In addition, the polymerase chain reaction (PCR) amplification of cytotoxin-associated gene A (cagA) gene in H. pylori in stool samples was carried out. The prevalence of H. pylori in sewage workers was 56.7% compared to 16.7% in the comparison group with a highly statistically significant difference between both groups. H. pylori cagA gene was present in 64.7% of H. pylori-infected sewage workers compared with 40% of controls. cagA gene was associated with more dyspeptic symptoms (77.3%) in infected workers compared to those of noninfected ones (33.3%) (P = .041). The risk of H. pylori was significantly higher among workers with poor compliance with personal protective equipment (PPE) (OR = 3.00), with duration of work &gt; 20 years (OR = 4.71), older than 45 years (OR = 4.27), and of low education level (OR = 11.2). We concluded that H. pylori infection and heartburn with or without epigastric pain are significant health problems in the studied sewage workers. Low education and poor compliance with PPE were the only predictors of H. pylori infection in sewage workers.

Using Bayesian belief networks to support health risk assessment for sewer workers

The sanitary sewerage connection rate is an important indicator of advanced cities. Following the construction of sanitary sewerages, the maintenance and management systems are required for keeping pipelines and facilities functioning well. These maintenance tasks often require sewer workers to enter the manholes and the pipelines, which are confined spaces short of natural ventilation and have the potential for hazardous substances to be present. Working in sewers could be easily exposed to a risk of adverse health effects. This paper proposes the use of Bayesian belief networks as a higher level of noncarcinogenic health risk assessment of sewer workers. On the basis of the epidemiological studies, the actual hospital attendance records and expert experiences, the Bayesian belief networks is capable of capturing the probabilistic relationships between the hazardous substances in sewers and their adverse health effects, and accordingly inferring the morbidity and mortality of the adverse health effects. The provision of the morbidity and mortality rates of the related diseases is more informative and can alleviate the drawbacks of conventional methods.

Acute histoplasmosis in three Mexican sewer workers

We report the detection of high-titre anti-Histoplasma capsulatum IgM in the serum of three young adult males occupationally exposed to bat guano. Multidrug treatment with trimethoprim- sulfamethoxazole was started, followed by ciprofloxacin, clarithromycin, metamizole sodium, rifampicin/isoniazid/pyrazinamide, moxifloxacin and lastly amphotericin B and ceftriaxone. Despite treatment the condition of one patient deteriorated, and he died 23 days after exposure. The other two patients recovered after receiving similar therapy with the addition of voriconazole. They are currently being treated with itraconazole for a 1-year period.

Leptospirosis: a re-emerging infection

Leptospirosis, long thought to be a disease of sewage workers and found post-flooding is re-emerging as a potentially life threatening infectious disease in urban India during monsoon and immediately after due to poor sanitation and drainage. However, it is often ignored and under diagnosed due to a low index of suspicion. We present a fatal case of leptospirosis with acute liver failure, respiratory failure and jaundice and encephalopathy.

Assessing genetic structure, diversity of bacterial aerosol from aeration system in an oxidation ditch wastewater treatment plant by culture methods and bio-molecular tools

Airborne bacteria emissions from oxidation ditch with rotating aeration brushes were investigated in a municipal wastewater treatment plant in Beijing, China. Microbial samples were collected at different distances from the rotating brushes, different heights above the water surface, and different operation state over a 3-month period (April, May, and June) in order to estimate the seasonal variation and site-related distribution characteristics of the microorganisms present. The concentration of bacterial aerosol was analyzed by culture methods, while their dominant species, genetic structure and diversity were assayed using bio-molecular tools. Results showed that total microbial concentrations were highest in June and lowest in April. The mechanical rotation caused remarkable variation in concentration and diversity of culturable airborne bacteria before and after the rotating brushes. The highest concentration was observed near the rotating brushes (931 ± 129-3,952 ± 730 CFU/m(3)), with concentration decreasing as distance and height increased. Bacterial community polymerase chain reaction and denaturing gradient gel electrophoresis indicated that diversity decreased gradually with increasing height above the water surface but remained relatively constant at the same height. All dominant bacteria identified by DNA sequence analysis belonged to Firmicutes. Pathogenic species such as Moraxella nonliquefaciens and Flavobacterium odoratum were isolated from the bioaerosols. Due to the serious health risks involved, exposure of sewage workers to airborne microorganisms caused by brush aerators should be monitored and controlled.

Pneumoproteins in sewage workers exposed to sewage dust

PurposeThe association between exposure to bacteria and endotoxins in sewage dust and the serum concentrations of pneumoproteins in sewage treatment plant workers were studied.MethodsForty-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.ResultsThe 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.ConclusionsThis 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.

Ethics for the Pediatrician: A Brave New Pediatrics? Managing the Desire for Better Children Through Biotechnological Enhancement

1. Ryan M. Antiel, MA* 2. Robert M. Jacobson, MD† 3. Philip R. Fischer, MD‡ 1. *Mayo Medical School, Mayo Clinic, Rochester, MN. 2. †Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. 3. ‡Editorial board member. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. In his article published in May 2010, Dr Yates discussed the ethical principles involved in various forms of enhancement (Yates FD. Ethics for the pediatrician: the persuasion of enhancements in pediatrics. Pediatr Rev. 2010;31:216–218). In this commentary, Drs Antiel, Jacobson, and Fischer address the same concept of enhancement, providing their personal views as well as those of others, reminding the reader that pediatricians face ethical decisions in situations much more commonly encountered than the classic clinical dilemmas that involve serious illness and matters of life and death. LFN Brave New World, Aldous Huxley's masterpiece of dystopian literature, begins with a tour of the fertilizing room at the Central London Hatchery and Conditioning Center. The hatchery director, Mr Foster, describes the work in progress to the new employees: “We also predestine and condition. We decant our babies as socialized human beings, as Alphas or Epsilons, as future sewage workers or future Directors of Hatcheries.” (1) In Huxley's world with the scientific wherewithal, the state determined the destiny of each child. The state predetermined everyone to a particular class, that is, limited the potential ability of everyone to fulfill specific functions in society. Thankfully, there are no hatchery directors in the modern pediatric clinic. However, children's parents, sometimes with the spoken or unspoken support of their pediatricians, attempt to use biotechnology in a similar manner: to condition and so predestine their children. Perhaps what we now view as well-meaning attempts to increase the odds of success for our children will prove a prelude to a fearsome brave new world. Although the majority of parents may not be willing to pay exorbitant …