Many different cleaning agents were used. The average exposure to solvents was low, but some working tasks included relatively high short-term exposure. To prevent adverse health effects, it is important to inform workers about the health risks and to restrict the use of the most toxic chemicals. Furthermore, it is important to develop good working procedures and to encourage the use of personal protection equipment.
Though their average exposure to organic solvents was low, the graffiti removers reported significantly higher prevalence of unspecific symptoms such as fatigue and headache as well as irritative symptoms from the eyes and respiratory tract, compared with the controls. To prevent adverse health effects it is important to inform the workers about the health risks, and to restrict use of the most hazardous chemicals. Furthermore, it is important to develop good working practices and to encourage the use of personal protective equipment.
Objectives An increased risk for gastric cancer among sewage workers has been described in several studies. During the last decade the bacterium Helicobncter pylori has emerged as one important risk factor for gastric cancer and is now considered a class I carcinogen by the International Agency for Research on Cancer. The route of transmission for this bacterium remains unclear, but fecal-oral transmission has been proposed. If true, this might entail a yet undescribed risk for sewage workers. Method The prevalence of immunoglobulin G (IgG) antibodies against H ~l o r i was studied with a crosssectional study design in a group of 289 municipal workers. Samples of serum from 151 sewage workers at 11 sewage plants in Sweden and of serum from 138 referents were analyzed. The referents were group matched for age and socioeconomic status. Results The prevalence of IgG antibodies against Hpylori arnong sewage workers did not differ from that of the referents. The adjusted odds ratio (adjOR) was calculated from a logistic model with age and residence as confounding variables (adjOR 0.90, 95% confidence interval 0.53-1.5). The previously described increase in the prevalence of IgG antibodies against H pylori with increasing age was observed. Geographic differences were also observed in the prevalence of Hpylori in Sweden. C O~C~U S~O~S The exposures in sewage work in Sweden do not cause an increased risk of infection withHpylori.
Objectives-To study the cancer incidence in a cohort of Swedish sewage workers. An increased incidence of cancer of the stomach, the kidney and the nervous system in this cohort was previously reported. This new analysis reports on 9 more years of follow up. Methods-The study is an analysis of a cohort of all 711 employees at 17 Swedish sewage plants employed for at least for 1 year during the years 1965-86. Assessment of exposures was performed by classification of work tasks. Standardised incidence ratios (SIRs), and 95% confidence intervals (95% CIs) were calculated. Results-The total cancer incidence was not significantly increased (SIR=1.2, 95% CI 0.92 to 1.5) but the incidence of prostate cancer was (SIR=1.6, 95% CI 1.0 to 2.5), and based on two cases only, there seemed to be a significant increase of cancer of the nose and the nasal sinuses (SIR=12, 95% CI 1.5 to 44). The incidence of stomach cancer was also increased (SIR=2.3, 95% CI 0.99 to 4.5). There was no relation between cancer incidence and level of sewage exposure. Conclusions-Sewage workers did not have an increased risk of cancer, and the increased risk estimates for some specific cancer sites were not conclusive. (Occup Environ Med 1999;56:672-673) Keywords: cancer; epidemiology; sewage workers Sewage workers are exposed to a wide variety of materials including mutagenic and carcinogenic substances. [1][2][3] There are several reports on workers exposed to sewage that indicate an increased risk of cancer at various sites: larynx ; and lymphopoietic system. 5 In 1993 we reported the results from a retrospective analysis of a cohort of Swedish sewage workers. 10 The incidence of all cancers did not diVer from that of the general population, but there were numerical increases in cancer of the stomach, the kidney, and the nervous system. This present report accounts for an additional 9 years of follow up and a roughly doubled number of tumours in the cohort. Subjects and methodsThe cohort was formed of all sewage workers who had worked for >1 year during the period 1965-86 at the municipal sewage plants in 17 small and medium sized cities in central and southern Sweden. Seven hundred and twelve workers (657 men and 55 women) were identified from employment records. The median age at the start of observation was 36 years (range 16-64), and the median duration of employment at the start of observation was 11 years (range 1-49). Vital status was determined on 31 December 1995. One person with a missing national identification number was excluded, one person had emigrated, 130 had died, and 580 were still alive.For each worker the duration of employment and main work tasks were noted. Also employment before 1965 was noted and accounted for in the analyses with an induction latency period. On the basis of a qualitative exposure classification of the work tasks, four exposure classes were identified in order of increasing exposure: laboratory work, work in the sewage processing plant, sludge pipe flushing or exhaustion, and work at sewage pum...
Self-Reported Asthma and Respiratory Symptoms in Sewage Workers: Lennart FRIIs, et a!.
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