RESPIRATORY DISORDERS AND ATOPY IN DANISH REFUSE WORKERS

This survey describes respiratory and mucosal symptoms of garbage-hand ling and recycling workers in Denmark. The study includes 20 paper-sor ting workers, eight compost workers, and 44 garbage-handling workers. As a control group, 119 workers from water purification plants of Cope nhagen were chosen; workers in our study had a lower mean age and shor ter mean employment time than did members of the control group. There was no significant difference in tobacco consumption between the group s. Garbage-handling workers were exposed to a significantly higher mea n 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 a nd composting areas compared with paper-sorting as well as water suppl y 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 diffe rence could not be explained as an effect of differential growth requi rements. Significantly higher amounts of gram-negative bacteria were f ound in composting and garbage-handling plants than in water-supply pl ants. In garbage-handling plants only, there were significantly higher amounts of endotoxins than in paper-sorting plants. Significantly hig her prevalence of chest tightness (14%), flu-like symptoms (14%), itch ing eyes (27%), itching nose (14), and sore or itching throat(21%) wer e 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-su pply workers to 19% and 27% among the garbage workers. Organic dust to xic syndrome (ODTS) was found to be associated with garbage handling. In a multivariate analysis, ODTS was found to be associated with a fam iliar disposition to atopy. No differences were seen in basic lung fun ction parameters or bronchial reactivity. There was an increased propo rtion of people with variation in peak flow rates of more than 20% in the garbage and compost workers, indicating an acute effect of the wor k environment upon the lungs. Skin symptoms were significantly more pr evalent 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 s ymptoms among garbage and compost workers and also has found these wor kers to have a raised prevalence of ODTS and gastrointestinal symptoms , related to working either with highly contaminated garbage or in hig hly contaminated areas.