Ivens U I, Breum N O, Ebbehøj N, Nielsen B H, Poulsen O M, Würtz H
Department of Occupational Medicine, National Institute of Occupational Health, Copenhagen, Denmark.
Scand J Work Environ Health. 1999 Jun;25(3):238-45. doi: 10.5271/sjweh.430.
A high frequency of gastrointestinal problems has previously been reported for waste collectors. The present study relates the gastrointestinal problems to measurements of the bioaerosols that waste collectors are exposed to during work.
A job-exposure matrix was constructed from a combination of questionnaire data and field measurements. The questionnaire data were collected from 1747 male waste collectors and a comparison group of 1111 male municipal workers. Moreover a total of 189 full-shift personal samples was collected. The samples were used for characterizing the bioaerosol exposure described by viable fungi, total count of fungal spores, microorganisms, and endotoxins.
In a multivariate analysis, high exposure to endotoxins was associated with nausea [prevalence proportion ratio (PPR) 1.60], and the risk of reporting nausea decreased with decreasing exposure so that workers with low exposure had the fewest reports (PPR 1.39) in the comparison with the unexposed group. High exposure to endotoxins was also associated with reports of diarrhea (PPR 5.60), and the risk of reporting diarrhea decreased with decreasing exposure so that the workers with low exposure had the fewest reports (PPR 3.02). The same pattern existed for exposure to fungi, for which high exposure resulted in the most reports (PPR = 4.59), and for diarrhea, for which low exposure resulted in the fewest reports (PPR = 3.15).
An exposure-response relationship was found between nausea and endotoxin exposure and between diarrhea and exposure to both endotoxins and viable fungi.
此前有报道称垃圾收集者胃肠道问题的发生率较高。本研究将胃肠道问题与垃圾收集者在工作期间接触的生物气溶胶测量结果相关联。
通过问卷调查数据和现场测量相结合构建了工作暴露矩阵。问卷调查数据收集自1747名男性垃圾收集者和1111名男性市政工人组成的对照组。此外，共收集了189份全时段个人样本。这些样本用于表征由活菌真菌、真菌孢子总数、微生物和内毒素描述的生物气溶胶暴露情况。
在多变量分析中，高内毒素暴露与恶心相关（患病率比例比[PPR]为1.60），报告恶心的风险随着暴露程度降低而降低，因此与未暴露组相比，低暴露的工人报告最少（PPR为1.39）。高内毒素暴露还与腹泻报告相关（PPR为5.60），报告腹泻的风险随着暴露程度降低而降低，因此低暴露的工人报告最少（PPR为3.02）。真菌暴露也存在相同模式，高暴露导致报告最多（PPR = 4.59），腹泻方面，低暴露导致报告最少（PPR = 3.15）。
发现恶心与内毒素暴露之间以及腹泻与内毒素和活菌真菌暴露之间存在暴露-反应关系。
