RESPIRATORY DISORDERS AND ATOPY IN DANISH REFUSE WORKERS

This survey describes respiratory and mucosal symptoms of garbage-handling and recycling workers in Denmark. The study includes 20 paper-sorting workers, eight compost workers, and 44 garbage-handling workers. As a control group, 119 workers from water purification plants of Copenhagen were chosen; workers in our study had a lower mean age and shorter mean employment time than did members of the control group. There was no significant difference in tobacco consumption between the groups. Garbage-handling workers were exposed to a significantly higher mean concentration (SD) of total dust than were water supply workers - 0.74 (0.77) mg/m(3) compared with 0.42 (0.25) mg/m(3) (p < 0.05). Total count of microorganisms was significantly higher in garbage-handling and composting areas compared with paper-sorting as well as water supply areas 0.46 (0.125) x 10(5), 0.54 (0.77) x 10(5), 4.7 (5.89) x 10(3), and 0.08 (0.04) x 10(3) cfu/m(3), respectively (p < 0.05). This difference could not be explained as an effect of differential growth requirements. Significantly higher amounts of gram-negative bacteria were found in composting and garbage-handling plants than in water-supply plants. In garbage-handling plants only, there were significantly higher amounts of endotoxins than in paper-sorting plants. Significantly higher prevalence of chest tightness (14%), flu-like symptoms (14%), itching eyes (27%), itching nose (14), and sore or itching throat(21%) were found among garbage-handling workers, compared with, respectively, 1, 1, 11 and 0% among water-supply workers. Furthermore, prevalence of nausea and vomiting or diarrhea rose from 2% and 7% among the water-supply workers to 19% and 27% among the garbage workers. Organic dust toxic syndrome (ODTS) was found to be associated with garbage handling. In a multivariate analysis, ODTS was found to be associated with a familiar disposition to atopy. No differences were seen in basic lung function parameters or bronchial reactivity. There was an increased proportion of people with variation in peak flow rates of more than 20% in the garbage and compost workers, indicating an acute effect of the work environment upon the lungs. Skin symptoms were significantly more prevalent among garbage-handling workers, with 23% experiencing itching of the skin more than once per year and 14% more than once per month. This study has confirmed an increased prevalence of mucosal and skin symptoms among garbage and compost workers and also has found these workers to have a raised prevalence of ODTS and gastrointestinal symptoms, related to working either with highly contaminated garbage or in highly contaminated areas.