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      Occupational health hazards in sewage and sanitary workers

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          Abstract

          An estimated 1.2 million scavengers in the country are involved in the sanitation of our surroundings. The working conditions of these sanitary workers have remained virtually unchanged for over a century. Apart from the social atrocities that these workers face, they are exposed to certain health problems by virtue of their occupation. These health hazards include exposure to harmful gases such as methane and hydrogen sulfide, cardiovascular degeneration, musculoskeletal disorders like osteoarthritic changes and intervertebral disc herniation, infections like hepatitis, leptospirosis and helicobacter, skin problems, respiratory system problems and altered pulmonary function parameters. This can be prevented through engineering, medical and legislative measures. While the engineering measures will help in protecting against exposures, the medical measures will help in early detection of the effects of these exposures. This can be partly achieved by developing an effective occupational health service for this group of workers. Also, regular awareness programs should be conducted to impart education regarding safer work procedures and use of personal protective devices.

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          Most cited references23

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          Respiratory effects of chronic hydrogen sulfide exposure.

          A cross-sectional study investigated whether the exposure of sewer workers to hydrogen sulfide (H2S) was associated with reduced lung function. Sixty-eight sewer workers and 60 water treatment workers performed spirometric tests. Job titles were used to classify the sewer workers according to presumed H2S exposure, and water treatment workers served as a comparison population presumed to have no occupational exposure to H2S. There was a statistically significant difference in mean FEV1/FVC values between sewer and water treatment workers of similar age, height, race, and smoking habits (-3.1, s.e. = 1.4). This deficit was greatest (-5.7, s.e. = 2.0) for sewer workers presumed to have high H2S exposure. Nonsmoking sewer workers presumed to have high H2S exposure achieved only 89% of their predicted FEV1/FVC value, whereas nonsmoking water treatment workers achieved nearly 98% of their predicted FEV1/FVC value. In conclusion, this study found evidence that chronic low level exposure to H2S may be associated with reduced lung function.
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            Work related symptoms among sewage workers: a nationwide survey in Sweden.

            To assess the risk for work related symptoms among sewage workers in Sweden using a postal questionnaire. All municipalities in Sweden were contacted and asked to provide addresses of sewage workers and controls. Controls were recruited among other municipal workers not exposed to sewage, such as workers in drinking water plants and gardeners. A questionnaire was sent to the subjects and after two reminders, the response rate was 74% among sewage workers and 59% among controls. Significantly increased risks for airway symptoms, chronic bronchitis, and toxic pneumonitis, as well as central nervous system symptoms such as headache, unusual tiredness, and concentration difficulties were found among the sewage workers compared with controls. Furthermore, an increased risk for non-specific work related gastrointestinal symptoms was found among the sewage workers; an increased risk for joint pains, related to pains in more than four joints but not with loading, was also found. The results of this questionnaire survey show an increased risk for airway, gastrointestinal, and general symptoms such as joint pains and central nervous system symptoms among sewage workers. Clinical investigations are needed to determine the cause of the reported symptoms among sewage workers, and further field studies are required to assess the causal agents.
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              Increased risk of hepatitis E in sewage workers from India.

              Considering feco-oral transmission of hepatitis E virus (HEV), the risk of the infection was assessed among sewage workers. On the basis of the close contact with sewage, the participants (n = 147) were divided into sewage workers (n = 92) and others (n = 55); none used personal protective equipment (eg, coveralls, boots, gloves) Age-matched individuals from lower socioeconomic status and without any exposure to sewage were used as controls. IgG-anti-HEV positivity in enzyme-linked immunosorbent assay was significantly higher (P 5 years. Multivariate regression analysis identified contact with sewage as the independent variable associated with anti-HEV positivity. Strict adherence to good working practices must take top priority for protection of these workers from sewage pathogens.
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                Author and article information

                Journal
                Indian J Occup Environ Med
                IJOEM
                Indian Journal of Occupational and Environmental Medicine
                Medknow Publications (India )
                0973-2284
                1998-3670
                December 2008
                : 12
                : 3
                : 112-115
                Affiliations
                Occupational Medicine Division, National Institute of Occupational Health, Ahmedabad, India
                Author notes
                For correspondence: Dr. Rajnarayan R. Tiwari, Occupational Medicine Division, National Institute of Occupational Health, Meghani Nagar, Ahmedabad - 380 016, India. Email: rajtiwari2810@ 123456yahoo.co.in
                Article
                IJOEM-12-112
                10.4103/0019-5278.44691
                2796749
                20040968
                ac5004db-f7b7-4d90-be3e-58a690e21b5f
                © Indian Journal of Occupational and Environmental Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Review Article

                Occupational & Environmental medicine
                sanitary workers,sewage workers
                Occupational & Environmental medicine
                sanitary workers, sewage workers

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