Biological treatment in wastewater treatment plants (WWTPs) releases high amounts of bioaerosols carrying a variety of pathogens. Quantitative microbial risk assessment (QMRA) is a framework prevalently intended for the quantitative estimation of health risks for occupational exposure scenarios (e.g. in WWTPs). However, the quantitative contributions of health-risk-estimate inputted variable parameters remain ambiguous. Therefore, this research aimed to study the disease burden of workers exposed to Staphylococcus aureus bioaerosol during warm and cold periods and to strictly quantify the contributions of the inputted parameters of disease burden by sensitivity analysis based on Monte Carlo simulation. The results showed that the disease health risk burden in the warm period was higher than in the cold period, disease health risk burden in the rotating-disc aeration mode was regularly higher than in the microporous aeration mode. The disease health risk burden of the workers with personal protective equipment (PPE) almost all satisfied the WHO benchmark (≤10E-6 DALYs pppy), and was consistently lower by one or two orders of magnitude than the workers without PPE in both warm and cold periods. Referring to the sensitivity analysis, exposure concentration and aerosol ingestion rate were the most and second predominant factor for the estimated risk in all exposure scenarios, respectively. The sensitivity of the removal fraction by employing PPE ranked third in the contribution to disease health risk burden. In addition, no remarkable differences were revealed in the sensitivity percentage ratio between warm and cold periods. This research can deepen the understanding of the QMRA framework and promote the development of sensitivity analysis, especially under various meteorological conditions (warm and cold periods).
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