[Accumulation of respiratory diseases among employees at a recently established refuse sorting plant]

An increasing number of plants for re-use of refuse have been constructed in Denmark in recent years. The Kaastrup Plant near Skive was opened in spring 1986. The plant accepts household rubbish and industrial refuse separately. The refuse is sorted by machine (industrial refuse is sorted partially manually) and in a large partially open machine plant, refuse is converted into fuel pellets. During a period of eight months, eight out of 15 employees developed respiratory symptoms. In seven, bronchial asthma was diagnosed and chronic bronchitis in one person. Four had initial symptoms of the organic dust toxic syndrome. After further six months, another case of occupationally-conditioned asthma occurred in the plant. Only two out of nine had previously had asthma or atopic disease. The investigation did not reveal any evidence of type-I allergy. Six out of nine had specific precipitating antibodies to refuse while all had negative RAST tests to this. In spring 1989, from six to eighteen months after the onset of the symptoms, six had still dyspnoea on exertion and three had positive histamine-provocation tests and seven out of nine had left the plant. Occupational medical measurements revealed dust concentrations of 8.1 mg/cubic millimeter in September 1986 and total germs of up to 3 x 10(9) cfu/cubic meter. Construction of the plant involved considerable contact with the refuse on account of the cleansing processes and open systems and it was reconstructed in the course of 1987/1988 so that the hygienic conditions are now acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)