title: Work related symptoms among sewage workers: a nationwide survey in Sweden.
abstract: OBJECTIVE
  To assess the risk for work related symptoms among sewage workers in Sweden using a postal questionnaire.
  
  
  METHODS
  All municipalities in Sweden were contacted and asked to provide addresses of sewage workers and controls. Controls were recruited among other municipal workers not exposed to sewage, such as workers in drinking water plants and gardeners. A questionnaire was sent to the subjects and after two reminders, the response rate was 74% among sewage workers and 59% among controls.
  
  
  RESULTS
  Significantly increased risks for airway symptoms, chronic bronchitis, and toxic pneumonitis, as well as central nervous system symptoms such as headache, unusual tiredness, and concentration difficulties were found among the sewage workers compared with controls. Furthermore, an increased risk for non-specific work related gastrointestinal symptoms was found among the sewage workers; an increased risk for joint pains, related to pains in more than four joints but not with loading, was also found.
  
  
  CONCLUSIONS
  The results of this questionnaire survey show an increased risk for airway, gastrointestinal, and general symptoms such as joint pains and central nervous system symptoms among sewage workers. Clinical investigations are needed to determine the cause of the reported symptoms among sewage workers, and further field studies are required to assess the causal agents.
authors.affiliation: Department of Environmental Medicine, Göteborg University, Sweden. jorgen.thorn@envmed.gu.se
authors.forename: J
authors.initials: J
authors.lastname: Thorn
authors.forename: L
authors.initials: L
authors.lastname: Beijer
authors.forename: R
authors.initials: R
authors.lastname: Rylander
mesh_terms: D002493:Central Nervous System Diseases / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D012044:Regression Analysis; D012120:Respiration Disorders / Q000453:epidemiology; D012307:Risk Factors; D012722:Sewage / Q000009:adverse effects*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
chemical_list: D012722:Sewage