Indicadores infecciosos e inflamatórios entre trabalhadores da limpeza urbana em São Paulo

Abstract

Resumo O objetivo deste trabalho foi comparar agravos à saúde entre grupos funcionais de trabalhadores da limpeza urbana (TLU) decorrentes de exposição biológica do contato com os Resíduos Sólidos (RS) em São Paulo, 2007. Para tal, amostras dos grupos de TLU e um grupo Controle de servidores ferroviários realizaram entrevistas, contagens sanguíneas, provas de atividade inflamatória, marcadores sorológicos de infecção e exame protoparasitológico de fezes. Ao término, foram avaliados 217 indivíduos. O grupo Controle relatou menor cobertura vacinal para o tétano, enquanto os Varredores tiveram a menor proporção de cobertura para a hepatite B. Os Motoristas usaram mais antibióticos e apresentaram o número de leucócitos mais elevado quando comparados aos Controles. Os Motoristas apresentaram também maiores médias de neutrófilos e monócitos quando comparados aos Varredores. A presença de parasitas nas fezes foi mais frequente entre os Varredores e os Coletores quando comparados aos Controles. Os grupos de Coleta, Transbordo e Aterro apresentaram indicadores de infecções respiratórias e de atividade inflamatória sistêmica similares aos Controles. Não foram observadas diferenças entre episódios de sinusites, pneumonias, marcadores séricos de atividade inflamatória, contato com o vírus da hepatite B ou com a estreptolisina O entre os grupos estudados. Palavras-chave: resíduos sólidos, saúde do trabalhador, exposição a agentes biológicos. AbstractThe purpose of this work was to evaluate the health effects due to biological exposure within different activities performed by groups of urban cleaning workers (UCW) compared to each other and to a control group of railway workers in Sao Paulo, 2007. Functional groups of UCW were submitted to interviews, blood counts, tests of inflammatory activity, serologic markers of infection, and stool parasitological testing. The final evaluation included 217 participants. The Control group reported lower vaccine protection against tetanus, whereas the Sweepers reported the lowest vaccine protection against hepatitis B. Drivers reported more antibiotic use and showed higher total leukocyte counts when compared to Controls. Drivers also demonstrated higher neutrophils and monocytes counts when compared to Sweepers. There was a higher presence of stool parasites among Sweepers and Collectors when compared to Controls. There were also no differences in indicators of respiratory infections or increased measurable inflammatory activity between Collectors, Landfills, and Intermediate Stations workers when compared to Controls. There were no differences in the number of sinusitis or pneumonias episodes, as well as serologic markers for inflammatory activity, contact with hepatitis B virus or anti-streptolysin O among studied groups.

Hepatitis B and C in household and health services solid waste workers

“…These studies show the vulnerability of the workers who are exposed to infection without the appropriate immunization 5,21,22,26,29 .…”

“…Six of the studies concluded that workers collecting urban solid waste are exposed to greater risk when compared with those who have no exposure 19,21,22,23,24,25 , although one study found no such additional risk 5 . With regard to health care waste, three studies indicate higher risk among those collecting than those working with urban solid waste 26,27,28 , and a fourth study found none 29 .…”

“…This limits the representativeness of the study population. Considering prevalence for exposed and non-exposed subjects, seven studies 5,19,21,22,24,25,29 did not have a sufficient sample size to ensure statistical significance, according to Kelsey et al 30 .…”

“…Five studies 5,19,21,22,25 included workers in activities not associated with waste collection as the control group. Other studies 26,27,28,29 included household waste collectors as the control group.…”

“…Workers involved in management of these wastes are exposed to biological, chemical and physical risks to their health 2,5,6,7,8 .…”