埃及城市固体废物工人的健康障碍及对其危险暴露的知识、态度和实践的评估。

Public Health and Community Medicine Department (Public Health and Community Medicine Specialty), Faculty of Medicine, Menoufia University, Gamal Abdel Nasser st, 5th floor, Shibin El Kom, Menoufia, Egypt.

Department of Occupational and Environmental Health, University of Iowa, Iowa City, USA.

Environ Sci Pollut Res Int. 2021 Jun;28(24):30993-31002. doi: 10.1007/s11356-021-12856-3. Epub 2021 Feb 16.

Solid waste workers are exposed to variety of injuries and diseases at work. To study health disorders among workers in the waste management field and to assess their knowledge attitude and practice (KAP) towards hazardous exposure and safety measures. A cross-sectional study was carried out on 275 waste workers and an equal number as a group of controls from workers' relatives or workers not involved in waste management. Workers completed a self-administered or interviewer-based questionnaire containing data about (i) knowledge, e.g., management of wastes, types of hazards associated with solid waste management, and safety measures; (ii) attitude, e.g., opinions about mode of transmission of infection and safety measures; and (iii) practice, e.g., available safety measures to prevent exposure to hazards. Health education sessions were carried out with pre- and post-assessment of KAP. Both groups were assessed regarding the health status through history, general, and local examination (respiratory system and skin) in addition to spirometric measurements and complete blood count. A total of 275 exposed solid waste workers and 275 controls were included. A significantly higher prevalence of symptoms regarding respiratory, gastrointestinal, renal, musculoskeletal, and dermatological systems were detected among the exposed group than the controls (P<0.05). Significantly lower levels of RBCs, Hb, HCT, and MCH were reported among the exposed group than the controls (P<0.05). Among the exposed group vs. controls, FEV1 reported 99.75±13.35 vs. 104.83±10.47 (P<0.001), FEV/FVC% reported 98.88±15.32 vs. 102.72±14.36 (P=0.003), FEF% reported 99.64±17.06 vs. 103.07±19.38 (P=0.029), and PEF% reported 58.73±16.31 vs. 62.12±12.91 (P=0.007). Unsatisfactory knowledge was reported among 64% of solid waste workers, 69.1% had negative attitude, and 73.8% had unsafe practice. KAP was significantly higher post than pre-health education (P<0.001). Respiratory, gastrointestinal, and skin infections were common among solid waste workers. Assessment of KAP towards management of wastes, transmission of infection, exposure to sharps, and safety measures showed poor levels that got improved after health education. To maintain good health among solid waste workers, direct supervision with periodic medical examination and focused continuous health education are required.

固体废物处理工人在工作中会接触到各种伤害和疾病。为了研究固体废物管理领域工人的健康障碍，并评估他们对危险暴露和安全措施的知识、态度和实践（KAP）。对 275 名固体废物处理工人和相同数量的作为对照组的工人的亲属或不从事固体废物管理的工人进行了横断面研究。工人完成了一份自我管理或访谈员为基础的问卷，其中包含关于以下方面的数据：（i）知识，例如废物管理、与固体废物管理相关的危险类型以及安全措施；（ii）态度，例如关于感染传播途径和安全措施的看法；（iii）实践，例如防止接触危险的可用安全措施。在进行 KAP 预评估和后评估的同时，开展了健康教育课程。两组人员均通过病史、一般检查和局部检查（呼吸系统和皮肤）以及肺功能测量和全血细胞计数来评估健康状况。共纳入 275 名暴露于固体废物的工人和 275 名对照者。与对照组相比，暴露组的呼吸系统、胃肠道、肾脏、肌肉骨骼和皮肤系统的症状发生率显著更高（P<0.05）。与对照组相比，暴露组的 RBC、Hb、HCT 和 MCH 水平显著较低（P<0.05）。与对照组相比，暴露组的 FEV1 报告为 99.75±13.35 vs. 104.83±10.47（P<0.001），FEV/FVC%报告为 98.88±15.32 vs. 102.72±14.36（P=0.003），FEF%报告为 99.64±17.06 vs. 103.07±19.38（P=0.029），PEF%报告为 58.73±16.31 vs. 62.12±12.91（P=0.007）。64%的固体废物处理工人报告知识水平不足，69.1%的人态度消极，73.8%的人实践不安全。KAP 在健康教育后明显高于健康教育前（P<0.001）。呼吸道、胃肠道和皮肤感染在固体废物处理工人中很常见。对废物管理、感染传播、接触锐器和安全措施的 KAP 评估显示，水平较低，经健康教育后有所提高。为了保持固体废物处理工人的良好健康，需要进行直接监督，定期进行体检，并开展重点持续的健康教育。