Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.
Centre of Environmental Health and Safety, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia.
Front Public Health. 2021 Mar 8;9:646790. doi: 10.3389/fpubh.2021.646790. eCollection 2021.
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. 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. 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. 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.
污水处理厂的工人面临着更高的风险，他们可能会接触到各种存在于污水厂中的潜在职业性呼吸道危害。尽管之前的研究讨论了职业性呼吸道危害物质浓度对污水处理厂工人呼吸健康的影响，但结果却很少且相互矛盾。因此，有必要确定污水厂中的潜在呼吸道危害物质，以明确其对工人短期和长期呼吸健康的影响。因此，本系统评价（SR）旨在批判性地回顾之前研究调查污水厂中存在的潜在呼吸道危害物质及其对污水处理厂工人呼吸健康影响的研究。本 SR 使用 PubMed、EBSCO Medline、Web of Science、Scopus 和 Google Scholar 数据库，检索了 1994 年 1 月至 2020 年 10 月期间发表的评估潜在接触呼吸道危害物质及其对污水处理厂工人呼吸健康影响的同行评议研究。本次 SR 选择了“污水处理厂”、“呼吸道危害”和“呼吸道健康影响”这三个主要的搜索词。纳入标准为：（1）研究污水处理厂工人潜在职业性呼吸道危害物质暴露；（2）手稿以英文撰写；（3）发表在同行评议文献中的研究。采用有效公共卫生实践项目质量评估工具评估了人类观察性研究的质量。通过初步数据库检索，我们共识别出 5660 篇文章，仅有 26 篇符合纳入标准并纳入本次综述，其中包括 15 项人类观察性研究和 11 项环境评估研究。大多数人类观察性研究被评为中等质量，两项研究被评为低质量，一项研究被评为高质量。发现了一些潜在的呼吸道危害物质，如硫化氢、生物气溶胶、细颗粒物 2.5（PM2.5）和挥发性有机化合物（VOC）。大多数风险导致了污水处理厂工人呼吸健康的不良后果，但呼吸道危害物质暴露与呼吸健康影响之间的关系存在一些不一致的发现。本综述发现，尽管这一领域非常重要，但高质量的研究仍然缺乏。需要进一步的研究来阐明呼吸道危害物质暴露对污水处理厂工人和呼吸健康的影响，特别是 PM2.5 和 VOC。
