title: Health and safety in waste collection: Towards evidence-based worker health surveillance.
abstract: BACKGROUND
  Waste collectors around the world are at risk for work-related disorders and injuries. The aim of this study was to assess work demands, acute physiologic responses, illnesses, and injuries as a starting point for worker health surveillance (WHS).
  
  
  METHODS
  A systematic search was performed in PubMed and Embase on work demands, acute bodily responses, health, and injuries. A quality assessment and evidence synthesis was performed.
  
  
  RESULTS
  From a total of 379 retrieved studies, 50 studies fulfilled the inclusion criteria. Waste collecting varied from informal manual gathering to semi-automated systems. Most studies ("number of studies") on work demands and/or acute bodily responses addressed bioaerosols (14). Studies of health effects addressed respiratory complaints (8), and those on injuries addressed acute musculoskeletal disorders (3). Strong evidence is available that exposure to bioaerosols exceeds recommendations. Moderate evidence is available for an increased risk of respiratory complaints and musculoskeletal injuries, with significant odds ratios reported varying between 1.9-4.1 and 1.5-3.3, respectively. Limited evidence exists for gastrointestinal disorders and hearing loss.
  
  
  CONCLUSIONS
  WHS in waste collection is warranted for early detection of respiratory, gastrointestinal, and musculoskeletal disorders, and hearing loss.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands. p.p.kuijer@amc.uva.nl
authors.forename: P Paul F M
authors.initials: PP
authors.lastname: Kuijer
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data; D000336:Aerosols; D005735:Garbage; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D009790:Occupations / Q000639:trends*; D011159:Population Surveillance; D012037:Refuse Disposal / Q000379:methods; D012196:Review Literature as Topic; D012449:Safety; D018505:Waste Management
chemical_list: D000336:Aerosols