Association between urban garbage exposure and allergic diseases among sanitation practitioners: A cross-sectional study

BACKGROUND: The prevalence of allergic diseases has increased significantly in China over the last few decades, and there have been very few reports of allergic diseases in certain occupational specialties, with almost no reports among sanitation workers.

OBJECTIVE: Our objective was to investigate the prevalence of allergic diseases and the prevalence of common allergen sensitization in the population engaged in sanitation, and to try to answer the connection between urban garbage waste exposure and the development of allergic diseases.

METHODS: We conducted a cross-sectional survey of people working in sanitation-related jobs in Liwan District, Guangzhou, China.

A total of 893 people completed the questionnaire for this study, and 500 of them were further screened and tested for allergens specific IgE and IgG4.

Combining the questionnaire and test results, we investigated the incidence of allergy disorders and patterns of sensitization to allergens in this community, and evaluated the presence of occupational-related risk factors in this particular population.

RESULTS: Of the 893 sanitation workers, 166 (18.59%) self-reported allergic diseases, predominantly suffering from allergic rhinitis (AR) (n = 98, 10.97%), followed by drug allergy (n = 31, 3.47%), atopic dermatitis (n = 27, 3.02%), food allergy (n = 21, 2.35%), and asthma (n = 9, 1.00%), in that order.

In addition to dust mites (32.20%), which had the highest sensitization rate, the subject population had relatively high sensitization rates to ragweed (7.00%) and moulds mixture (8.20%) when compared with the rates of sensitization to moulds and ragweed in the general population; the top 3 sIgG4 positivity rates were egg (50.00%), milk (10.20%), and soybean (9.40%).

The prevalence of self-reported AR was higher in office managers (the control group) than in cleaning staff (the exposed group), but there was no difference in sIgE positivity for serum allergens between the 2 groups.

The chance of having AR may increase with management positions (crude OR 2.20, 95% CI 1.38–3.50), P = 0.001).

CONCLUSION: This is the first study to investigate the prevalence of allergy illnesses in the sanitation workforce in mainland China.

We identified a community of real sanitation workers with high ragweed and mycobacterial sensitization rates.

Urban cleaning may be protective factor against AR at the symptom level, but the serological results did not show this to be the case.