Health complaints from workplace exposure to bioaerosols: a questionnaire study in sewage workers

A questionnaire study was performed in 99 workers at a large sewage treatment plant to investigate self-reported health complaints from workplace exposure to bioaerosols. The study population was divided into subgroups according to different work stations: mechanical treatment (MT), biological treatment (BT), sewage sludge treatment (SST) and operation control (OC). The questionnaire included personal data, workpost and job characteristics, exposure to chemicals, history of employment and exposure, workplace hygiene and protective measures, smoking and drinking habits. There was also a series of 25 questions on subjective health complaints grouped into the following clusters: 'flu-like symptoms', 'respiratory symptoms', 'nose, eye, throat and skin irritation', 'neurological symptoms' and 'gastrointestinal symptoms'. Each subject was asked whether the complaints had occurred 'frequently', 'rarely', or 'never' within the previous 12 months. Air concentrations of endotoxins and (1 --> 3)- beta-D-glucans in the worker's breathing zone were also determined. The measurements of concentrations were made in the summertime during a morning shift. To determine endotoxins concentration, the Chromogenic Limulus Amebocyte Lysate (LAL) Test was applied. The questionnaire data and determination results were subject to a statistical analysis. No statistically significant relationship was found between the reported health complaints and such variables as job title, exposure to endotoxins and glucans, tobacco smoking, age and period of employment as sewage worker. The findings revealed that among the complaints, muscle and joint ache was reported most frequently, while among the symptom clusters, the flu-like symptoms prevailed. These symptom clusters occurred most frequently in OC workers, and were least often found in SST workers. In the worker's breathing zone, the geometric mean concentration of endotoxins amounted to 20.3 ng/m3 and of glucans to 7.76 ng/m3, and was not related to job title or job characteristics. A high correlation was found between endotoxins and (1 --> 3)- beta -D-glucans concentrations (Pearson correlation coefficient 0.86, p < 0.0005).