Hepatitis E,Helicobacter pylori, and gastrointestinal symptoms in workers exposed to waste water

Abstract

Background: Workers exposed to sewage may have an increased risk of infection by Helicobacter pylori and hepatitis E virus (HEV). Aims: To assess the prevalence of clinical hepatitis E (HE) and peptic ulcer disease as well as the seroprevalence of antibodies to H pylori and HEV in workers with and without sewage exposure and to look for symptoms due to exposure to endotoxin. Methods: In the first year of a prospective cohort study 349 sewage exposed workers and 429 municipal manual workers (participation: 61%) underwent a complete medical examination. Travelling to endemic areas, socioeconomic level, age, country in which childhood was spent, and number of siblings were considered as the main confounding factors. Results: Peptic ulcer disease and clinical HE did not occur more often in workers exposed to sewage. Prevalence of antibodies to HEV was 3.3% and overall prevalence of IgG antibodies to H pylori was 42% with large differences between subgroups. Logistic regression did not show an increased risk of seropositivity or antibodies to parietal cells in sewage exposed workers, but disentangling the effect of exposure from that of confounders was extremely difficult. No increase of symptoms due to exposure to endotoxin was found in sewage workers, with the exception of diarrhoea. Conclusions: No clear increased risk of infection by H pylori or by HEV in workers exposed to sewage was found in this cross-sectional study, but these results need to be confirmed by follow up.

Phylogenetic and Case‐Control Study on Hepatitis E Virus Infection in Germany

“…The results of this study are in accordance with several other recently published findings from seroprevalence studies and case series. Studies involving several hundred Swedish pig farmers and Swiss sewage workers did not show significantly different prevalences of anti-HEV IgG antibodies, compared with population-based, nonexposed control groups [21,22]. In Japan, HEV has been linked to consumption of uncooked deer and [18] and the Genbank accession number.…”

Clara cell protein and surfactant protein�B in garbage collectors and in wastewater workers exposed to bioaerosols

“…Results presented here relate to the baseline examination some preliminary results of which have already been presented (Steiner et al 2003). For reasons described elsewhere (Jeggli et al 2004), it was attempted to have a population of 150 garbage collectors, 300 wastewater workers and 150 control workers. From the results reported by Bernard et al (1994), a mean CC16 serum concentration of 16 lg/l, a standard deviation (SD) of 5 lg/l, and a clinically relevant difference of 4 lg/l were assumed.…”

“…Carcasses, glass, and paper are collected by garbage workers in one of both towns only. The work of the wastewater workers has already been described (Jeggli et al (2004). Gardeners maintain the green areas of the city of Zurich (parks, graveyards, flower production, etc.).…”

“…Procedures for collecting clinical data (check list, coding, quality control) have been described elsewhere (Jeggli et al 2004). Current symptoms are defined as having occurred during the 4 weeks prior to the clinical examination if not stated otherwise.…”

“…In accordance with Ivens et al (1997) and Nielsen et al (1995), drivers were considered as not exposed if they did not load garbage. Exposure to wastewater was assessed as described by Jeggli et al (2004). Work as a farmer was defined according to the Swiss census (codes 111.…”