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No link between gastrointestinal symptoms and Helicobacter pylori status in sewage workers

Posted Feb 05 2010 10:22am

The objective of this Belgian study was to assess the seroprevalence of Helicobacter pylori infection in sewage workers at municipal waste water sewage plants (WWTPs). The aim was to determine whether sewage exposure is an important risk factor for acquisition of H pylori and the possible association with gastrointestinal symptoms. A seroprevalence study of H pylori antibodies was conducted among 317 WWTP employees and compared with those of 250 employees of a pharmaceutical company.

No significant associations were found between the H pylori status and gastrointestinal symptomsoccupational exposures in different tasksnor with hygienic practices. These results do not suggest that H pylori infection is a probable cause of part of gastrointestinal symptoms among Flemish municipal sewage workers of WWTPs.

Work-related Helicobacter pylori infection among sewage workers in municipal wastewater treatment plants in Belgium
Wim Van HoosteAnne-Marie CharlierPaul RotsaertSimon BulterysGuido MoensMarc van SprundelAntoon De Schryver
Occup Environ Med 2010;67:91-97 doi:10.1136/oem.2008.040436r

Abstract:

Introduction: Most studies among sewage workers of wastewater treatment plants (WWTPs) have found a higher prevalence of gastrointestinal symptoms than among non-sewage exposed workers. Waterborne transmission of Helicobacter pylori (H pylori) has been hypothesisedas the bacteria can survive into an aqueous environment and has been detected in sewage. A health and hygiene questionnaire has demonstrated a higher prevalence of peptic ulcers among Belgian WWTP operators and maintenance workers than among non-sewage exposed colleagues.

Objectives: To assess the seroprevalence of H pylori infection in Belgian sewage workers at municipal WWTPsand to determine whether sewage exposure is an important risk factor for acquisition of H pylori and the possible association with gastrointestinal symptoms.

Methods: A seroprevalence study of H pylori antibodies was conducted among 317 WWTP employees (operatorsmaintenance workerslaboratory personnelother job). Information about demographic variablespossible H pylori risk factorsworking historyand history of current gastrointestinal symptoms during last 3 months was obtained by a questionnaire. The presence of H pylori IgG was investigated with an ELISA. The results were compared with those of 250 employees of a pharmaceutical company (operatorsmaintenance workerslaboratory personnel).

Results: The prevalence of H pylori IgG antibodies among sewage workers was 16.7% (95% CI 12.6 to 20.8%) compared to 13.6% (95% CI 9.4 to 17.8%) among the control group. In a logistic regression model with controlling for age and educational levelsOR study/control group was 1.02 (95% CI 0.58 to 1.80 with p=0.93). No significant associations were found between the H pylori status and gastrointestinal symptomsoccupational exposures in different tasksnor with hygienic practices.

Conclusions: Our results do not suggest that H pylori infection is a probable cause of part of gastrointestinal symptoms among Flemish municipal sewage workers of WWTPs.

Filed under: Biological agentsInfectious diseases Tagged: GastrointestinalInfectious diseasesSewage worker
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