Chandra Kalpana, Arora Vijay Kumar
Santosh University, Ghaziabad, Delhi NCR, India.
Formerly Vice Chancellor, Professor and Head Od Department of TB and Chest Diseases, Santosh University, Ghaziabad, Delhi NCR, India.
Indian J Tuberc. 2019 Jan;66(1):144-149. doi: 10.1016/j.ijtb.2018.09.003. Epub 2018 Oct 9.
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).
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.
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.
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.
污水管理工作具有危险性，因为长期通过吸入接触化学气体、生物气溶胶和微生物；意外经口摄入，以及因受伤或个人防护装备破损导致通过皮肤或粘膜渗透。虽然已有一些关于污水工人的孤立感染和多系统症状分析的研究，但对于结核病和非传染性疾病（NCDs）等慢性病负担的研究却很少。
对在德里国家首都辖区三个相邻地区工作、有五年以上职业经验的污水工人的慢性合并症情况进行了横断面观察研究。
研究样本包括104名污水工人，平均年龄为50.71（±8.43）岁，平均接受正规教育7.35（±3.75）年，平均从事污水工作21.28（±10.54）年。21.15%的污水工人患有结核病，92.31%的人至少患有一种慢性呼吸道疾病（慢性阻塞性肺疾病、哮喘或哮喘-慢性阻塞性肺疾病重叠综合征）。85.6%的参与者吸烟。最常见的非传染性疾病是高血压（67.3%），其次是血脂异常（50%）和糖尿病（43.3%）。非传染性疾病呈聚集性，53.85%的受试者患有三种或更多慢性疾病。不到5%的研究参与者没有所有被调查的慢性疾病。
污水工人患结核病和非传染性疾病的慢性发病情况不佳。迫切需要对污水工人这一职业群体进行结核病和其他非传染性疾病的流行病学研究、针对性筛查和公共卫生干预。
