Systematic Review of Potential Occupational Respiratory Hazards Exposure Among Sewage Workers

Characterization of bioaerosol exposures in wastewater treatment plant workers and serum levels of lung and inflammatory markers

Wastewater treatment plant (WWTP) workers are exposed to bioaerosols containing bacteria, fungi, and endotoxin, potentially posing health risks to workers. This study quantified personal exposure levels to airborne bacteria and fungi, endotoxin, and dust among 44 workers during two seasons at four WWTPs. Associations between the exposure measurements and serum levels of biomarkers CRP, SAA, and CC16 were also assessed. The potential deposition of viable microorganisms in workers' airways were explored using stationary fractionating samplers. Microbial communities were characterized using long-read nanopore amplicon sequencing and MALDI-TOF mass spectrometry to identify species, including pathogenic or allergenic microorganisms. We found that bacterial and fungal exposure levels were significantly associated with work task (p < 0.001 and p = 0.00041, respectively), with high exposure variability within and between tasks. Workshop, sewer system inspection, and sewer cleaning were associated with the highest exposure levels. A significant positive correlation was found between CRP and bacterial exposure (p = 0.013), while significant negative correlations were found between CRP and endotoxin and dust exposures (p = 0.012 and p = 0.018, respectively). No significant associations were found between SAA or CC16 and the exposure measures. Microbial community composition in bioaerosols differed significantly between some work tasks while others showed similar compositions. Viable hazardous microorganisms such as Clostridium perfringens and Aspergillus fumigatus were found in workers' exposures and in respiratory fractions of stationary air samples, indicating potential lung deposition. Further research is needed to assess possible long-term health risks from bioaerosol exposure at WWTPs.

Health Outcomes Related to Multiple Exposures in Occupational Settings: A Review

Individuals are constantly exposed to hazardous factors that can affect their health, the hazards encountered in the workplace can lead to the development of occupational diseases. Risk mitigation measures help to reduce the risks, but they are often designed without consideration of interactions between occupational exposures. Therefore, there is a need for research and it resulted in international research plans and programmes. The aim of this scoping review is to provide an overview of the scientific results related to the link between multiple occupational exposures and human health outcomes. Sixty-three articles were reviewed. Research articles were included only if they mentioned: several combined exposures, the direct characterisation of each exposure, and exposure/health outcome associations. Seven activity sectors were identified: 'extraction and energy production and distribution', 'health care', 'banks, public administration and defence', 'chemical production', 'manufacturing industry', 'agriculture and food industry' and 'transport and logistics'. Six multiple exposures scenarios were identified: chemical (n = 35), chemical/physical-biomechanical (n = 22), chemical/psychosocial-organisational (n = 6), physical-biomechanical (n = 9), physical-biomechanical/psychosocial-organisational (n = 13), and psychosocial-organisational (n = 12). The health problems identified concern nervous, mental, respiratory, musculoskeletal, auditory and other systems. Eighty-eight of 97 (91%) multiple exposure/health problem associations were reported to be statistically significant. Twenty studies (32%) provided specific risk prevention advice for multiple exposures. Prevention aimed at reducing risks to workers' health is still underdeveloped, further research is needed to improve prevention methods. No study was related to biological risk, and some other multiple exposures known to have health effects were not identified as well. This highlights the need for more multiple exposures research.

High Performance H2S Sensor Based on Ordered Fe2O3/Ti3C2 Nanostructure at Room Temperature

The utilization of a heterogeneous nanojunction design has shown significant enhancements in the gas sensing capabilities of traditional metal oxide gas sensors. In this study, a novel room temperature H2S gas sensor employing Fe2O3 functionalized Ti3C2 MXene as the sensing material has been developed. This sensor exhibits a broad detection range (0.01-500 ppm), low detection limit (10 ppb), and rapid response/recovery times (10 s/15 s), making it ideal for ppb-level H2S detection. The exceptional gas sensitivity of Fe2O3/Ti3C2 composite to H2S can be attributed to several key factors. First, the unique layered frame structure of Fe2O3/Ti3C2 significantly amplifies the surface area of the hybrid material, enhancing the absorption and diffusion capabilities of H2S molecules. Second, the abundance of functional groups (-O, -OH, and -F) on the surface of Ti3C2 MXene nanosheets provides additional active sites for H2S adsorption, The density functional theory calculation confirms that the adsorption energy of the Fe2O3/Ti3C2 composite for H2S (-2.93 eV) is significantly lower than that of pure Fe2O3 (-2.37 eV) and Ti3C2 (-0.2 eV). Lastly, the remarkable metal conductivity of Ti3C2 MXene ensures efficient electron transfer, thereby enhancing overall sensing performance.

Microbiological aspects of sewage odor problems in the urban environment - a review

Growing human population and increasing urbanization call for the need for proper wastewater treatment to reduce environmental pollution and reduce the excess use of natural resources. During the collection of municipal wastewater, the rapid aerobic respiration often causes oxygen depletion and anaerobic conditions in the sewer system resulting in the production of malodorous compounds. The odor problems may lead to public complaints, or in the case of the sewage workers the released volatile compounds even cause serious health hazards. Therefore, microbes have a dual contribution in the urban water cycle, since they have a decisive role in wastewater treatment and the removal of pollutants, but they can also cause problems in the artificial environment. In this review, I would like to summarize the processes underlying the generation of the bad smell associated with sewage and wastewater or with the collection and treatment infrastructure, tracking the way from the households to the plants, including the discussion of processes and possible mitigation related to the released hydrogen sulfide, volatile organics and other compounds.

Monitoring of enteropathogenic Gram-negative bacteria in wastewater treatment plants: a multimethod approach

The wastewater treatment processes are associated with the emission of microbial aerosols, including enteropathogenic bacteria. Their presence in this work environment poses a real threat to the health of employees, both through the possibility of direct inhalation of the contaminated air and indirectly through the pollution of all types of surfaces with such bioaerosol particles. This study aimed to investigate the prevalence of enteropathogenic bacteria in the air, on surfaces, and in wastewater samples collected in four wastewater treatment plants (WWTPs). The effectiveness of conventional culture-biochemical, as well as spectrometric and molecular methods for the rapid detection of enteropathogenic bacteria at workstations related to particular stages of wastewater processing, was also evaluated. Bioaerosol, surface swab, and influent and effluent samples were collected from wastewater plants employing mechanical-biological treatment technologies. The air samples were collected using MAS-100 NT impactor placed at a height of 1.5 m above the floor or ground, simulating aspiration from the human breathing zone. Surface samples were collected with sterile swabs from different surfaces (valves, handles, handrails, and coveyor belts) at workplaces. The raw influent and treated effluent wastewater samples were aseptically collected using sterile bottles. The identification of bacterial entheropathogens was simultaneously conducted using a culture-based method supplemented with biochemical (API) tests, mass-spectrometry (MALDI TOF MS), and molecular (multiplex real-time PCR) methods. This study confirmed the common presence of bacterial pathogens (including enteropathogenic and enterotoxigenic Escherichia coli, Salmonella spp., Campylobacter spp., and Yersinia enterocolitica) in all air, surface, and wastewater samples at studied workplaces. Higher concentrations of enteropathogenic bacteria were observed in the air and on surfaces at workplaces where treatment processes were not hermetized. The results of this study underline that identification of enteropathogenic bacteria in WWTPs is of great importance for the correct risk assessment at workplaces. From the analytical point of view, the control of enteropathogenic bacterial air and surface pollution using rapid multiplex-PCR method should be routinely performed as a part of hygienic quality assessment in WWTPs.

Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond

Wastewater-based surveillance (WBS) has undergone dramatic advancement in the context of the coronavirus disease 2019 (COVID-19) pandemic. The power and potential of this platform technology were rapidly realized when it became evident that not only did WBS-measured SARS-CoV-2 RNA correlate strongly with COVID-19 clinical disease within monitored populations but also, in fact, it functioned as a leading indicator. Teams from across the globe rapidly innovated novel approaches by which wastewater could be collected from diverse sewersheds ranging from wastewater treatment plants (enabling community-level surveillance) to more granular locations including individual neighborhoods and high-risk buildings such as long-term care facilities (LTCF). Efficient processes enabled SARS-CoV-2 RNA extraction and concentration from the highly dilute wastewater matrix. Molecular and genomic tools to identify, quantify, and characterize SARS-CoV-2 and its various variants were adapted from clinical programs and applied to these mixed environmental systems. Novel data-sharing tools allowed this information to be mobilized and made immediately available to public health and government decision-makers and even the public, enabling evidence-informed decision-making based on local disease dynamics. WBS has since been recognized as a tool of transformative potential, providing near-real-time cost-effective, objective, comprehensive, and inclusive data on the changing prevalence of measured analytes across space and time in populations. However, as a consequence of rapid innovation from hundreds of teams simultaneously, tremendous heterogeneity currently exists in the SARS-CoV-2 WBS literature. This manuscript provides a state-of-the-art review of WBS as established with SARS-CoV-2 and details the current work underway expanding its scope to other infectious disease targets.

A Systematized Overview of Published Reviews on Biological Hazards, Occupational Health, and Safety

Introduction

The COVID-19 pandemic turned biological hazards in the working environment into a global concern. This systematized review of published reviews aimed to provide a comprehensive overview of the specific jobs and categories of workers exposed to biological hazards with the related prevention.

Methods

We extracted reviews published in English and French in PubMed, Embase, and Web of Science. Two authors, working independently, subsequently screened the potentially relevant titles and abstracts recovered (step 1) and then examined relevant full texts (step 2). Disagreements were resolved by consensus. We built tables summarizing populations of exposed workers, types of hazards, types of outcomes (types of health issues, means of prevention), and routes of transmission.

Results

Of 1426 studies initially identified, 79 studies by authors from every continent were selected, mostly published after 2010 (n = 63, 79.7%). About half of the reviews dealt with infectious hazards alone (n = 38, 48.1%). The industrial sectors identified involved healthcare alone (n = 16), laboratories (n = 10), agriculture (including the animal, vegetable, and grain sectors, n = 32), waste (n = 10), in addition of 11 studies without specific sectors. The results also highlighted a range of hazards (infectious and non-infectious agents, endotoxins, bioaerosols, organic dust, and emerging agents).

Conclusion

This systematized overview allowed to list the populations of workers exposed to biological hazards and underlined how prevention measures in the healthcare and laboratory sectors were usually well defined and controlled, although this was not the case in the agriculture and waste sectors. Further studies are necessary to quantify these risks and implement prevention measures that can be applied in every country.

Evaluating the threshold limit value of acceptable exposure concentration for exposure to bioaerosols in a wastewater treatment plant: Reverse-quantitative microbial risk assessment and sensitivity analysis

Agitation operations produce numerous pathogenic bioaerosols in WWTPs¹. QMRA² can determine risks of persons exposed to these bioaerosols. However, QMRA framework cannot help stakeholders in immediately deciding whether a risk is intolerable. Thus, evaluating threshold of acceptable exposure concentration is an urgent issue but is still rarely addressed in WWTPs. This study analyzed TLV³ benchmarks of E. coli and S. aureus bioaerosols emitted from a WWTP by reverse-QMRA. Furthermore, variance of input parameters was clarified by sensitivity analysis. Results showed that, under conservative and optimistic estimates, TLV of technicians was 1.52-2.06 and 1.26-1.68 times as large as those of workers, respectively; wearing mask drive TLV up to 1-2 orders of magnitude; TLV of M⁴ was at most 1.33 and 1.31 times as large as that of RD⁵, respectively. For sensitivity analysis, removal fraction by equipping PPE enlarge TLV for effortlessly obtaining an acceptable assessment result; exposure time was dominant when without PPE excepting the scenario of technicians exposed to E. coli bioaerosol. This study helps establish threshold guidelines for bioaerosols in WWTPs and contribute innovative perspectives for stakeholders.

Scientometric evaluation of trends and global characteristics of published research on occupational public health

The objective of this scientometric study was to assess the global trends and characteristics of published occupational health research from 2016 to 2020. The SciVal tool (Elsevier) was used to perform the corresponding bibliometric analyses such as the Field-Weighted Citation Impact (FWCI), Source Normalized Impact per Paper (SNIP), CiteScore, and SCImago Journal Rank (SJR). Most of the manuscripts (46.5%) had national collaboration, with an average of 6.1 citations per paper. However, only 71 manuscripts (5.4%) presented single authorship (without collaboration). It was found that 486 manuscripts related to occupational health were published in Q2 journals (top 26-50%). Scientific publications on occupational health have increased remarkably worldwide, especially in Europe, and have mainly been published in Q1 and Q2 journals with a total of 292 and 289 scientific manuscripts in 2019 and 2020, respectively.

Research progress on distribution and exposure risk of microbial aerosols in animal houses

Environmental aerosols in animal houses are closely related to the productive performance and health level of animals living in the houses. Preferable housing environments can improve animal welfare and production efficiency, so it is necessary to monitor and study these environments. In recent years, there have been many large-scale outbreaks of respiratory diseases related to biological aerosols, especially the novel coronavirus that has been sweeping the world. This has attracted much attention to the mode of aerosol transmission. With the rapid development of large-scale and intensive breeding, microbial aerosols have gradually become the main factor of environmental pollution in animal houses. They not only lead to a large-scale outbreak of infectious diseases, but they also have a certain impact on the health of animals and employees in the houses and increase the difficulty of prevention and control of animal-borne diseases. This paper reviews the distribution, harm, and control measures of microbial aerosols in animal house environments in order to improve people's understanding of them.

Impact of mannose-binding lectin gene polymorphism on lung functions among workers exposed to airborne Aspergillus in a wastewater treatment plant in Egypt

In this study, the risk of Aspergillus (Asp.) positivity and its respiratory health impacts on wastewater treatment plant (WWTP) workers were studied. In addition, it identified the geno-susceptibility role of mannose-binding lectin 2 (MBL2) gene polymorphisms and the mannose-binding lectin (MBL) serum levels on the pulmonary functions of the Asp.-positive workers. Pulmonary function tests (PFTs) were performed for 89 workers from a selected WWTP, after exclusion of the smokers. Molecular identification of Asp. blood positivity was done by 18S rRNA sequencing. Determination of MBL2 gene polymorphism and estimation of MBL serum levels were done. PFTs revealed abnormalities in 49.2% of the workers. Asp. was positive in 42.5% of the workers with different species. Among the Asp.-positive workers, 6.5% of the workers were with obstructive PFTs, 12.9% with restriction, and 22.6% with combined PFT abnormalities. MBL2 genotyping showed that wild genotype AA was common (68.5%) among Asp.-positive workers compared to the other genotypes. This allele, whether homozygous or heterozygous, was significantly associated with decline in PFTs of the exposed workers. MBL serum levels were significantly lower in workers with obstructive, restrictive, and combined PFT abnormalities compared to those with normal PFTs, and in the workers with Asp.-positive species than the Asp.-negative workers. Moreover, it was significantly lower in workers with Asp. fumigatus compared to that in the workers with other Asp. species, and in the Asp.-positive workers with homozygous or heterozygous A allele compared to that in the Asp.-positive workers with homozygous B allele. Working in a WWTP can be associated with impaired PFTs due to exposure to airborne fungi. MBL2 genotyping showed that Asp.-positive workers with homozygous or heterozygous A allele were at risk to develop decline in their PFTs.