Building-related symptoms and inflammatory potency of dust from office buildings.

UNLABELLED: The aim was to investigate the association between building-related symptoms (BRS) in office buildings and the inflammatory potency of dust (PD). Furthermore, the association between dust potency and various building characteristics was investigated. Occupants of 22 office buildings received a retrospective questionnaire about BRS (2301 respondents). Dust was collected from groups of offices and building characteristics were recorded. The potency of a dust sample to induce interleukin-8 (IL-8) secretion from the lung epithelial cell line A549 was measured as the slope of the initial linear part of the concentration-response curve. Symptoms of the central nervous system (CNS) were associated with the potency of surface dust (OR = 1.4). This association may be due to an association between an index of CNS symptoms and dust potency in offices of 1-6 occupants (OR = 1.5). No single symptoms correlated with the potency of surface dust. The PD was not related to single building factors. The inflammatory PD may be used as an integrated proxy measure of biologically active compounds in dust, reflecting health relevant properties of the dust. PRACTICAL IMPLICATIONS: The potency of surface dust may be used as a crude measurement of the chemical and biological exposures present in the building, and being associated with the development of central nervous system symptoms. However, additional research is needed to establish the predictive value of the potency of surface dust.

Indoor climate, psychosocial work environment and symptoms in open-plan offices.

To study the indoor climate, the psychosocial work environment and occupants' symptoms in offices a cross-sectional questionnaire survey was made in 11 naturally and 11 mechanically ventilated office buildings. Nine of the buildings had mainly cellular offices; five of the buildings had mainly open-plan offices, whereas eight buildings had a mixture of cellular, multi-person and open-plan offices. A total of 2301 occupants, corresponding to a response rate of 72%, completed a retrospective questionnaire. The questionnaire comprised questions concerning environmental perceptions, mucous membrane irritation, skin irritation, central nervous system (CNS) symptoms and psychosocial factors. Occupants in open-plan offices are more likely to perceive thermal discomfort, poor air quality and noise and they more frequently complain about CNS and mucous membrane symptoms than occupants in multi-person and cellular offices. The association between psychosocial factors and office size was weak. Open-plan offices may not be suited for all job types. PRACTICAL IMPLICATION: Open-plan offices may be a risk factor for adverse environmental perceptions and symptoms.

Inflammatory potential of dust from schools and building related symptoms.

AIMS: To test whether the inflammatory potential of dust samples might be used to differentiate schools with high and low prevalence of building related symptoms (BRS) among the occupants. METHODS: Ten schools with high prevalence of BRS and 10 schools with low prevalence were selected. Dust collected from floors, horizontal surfaces, and exhaust outlets was tested at five concentrations on the lung epithelial cell line A549. The potency of the dust (PF) to stimulate IL-8 secretion was calculated from the initial linear part of the dose-response curves. The organic fraction of the dust samples was determined by incineration. RESULTS: The schools with low prevalence of symptoms had a BRS% of 4.4-11.0 and the schools with high prevalence a BRS% of 19.6-31.9. The PF of floor dust and surface dust correlated, and the PF was associated with the organic content of the dust. The schools with low prevalence of symptoms had a significantly lower PF than the schools with high prevalence. Using the cut point value of 4.5 ng IL-8/mg floor dust, significantly more high prevalence schools were found above the cut point than below. CONCLUSION: The PF of the floor dust samples correlated significantly with the prevalence of symptoms in the schools. The content of endotoxin and microorganisms did not seem to explain the inflammatory potential of the dust or BRS, and the substances in the dust causing the inflammatory potential are presently unknown.

Investigation of the adjuvant and immuno-suppressive effects of benzyl butyl phthalate, phthalic acid and benzyl alcohol in a murine injection model.

In a recent study, di-(2-ethylhexyl) phthalate (DEHP) and its metabolite, mono-2-ethylhexyl phthalate, were shown to possess adjuvant effect [Toxicology 169 (2001) 37; Toxicology Letters 125 (2001) 11]. The present study investigates the adjuvant effect of another important commercial phthalate plasticizer, benzyl butyl phthalate (BBP) as well as its degradation products, phthalic acid and benzyl alcohol (BA) in a murine model. The model antigen, ovalbumin (OA), was injected either alone (OA control group), together with one of the test substances (test group) or together with aluminium hydroxide, which served as the positive adjuvant control. The mice were boosted either once or twice with OA before blood was collected and assayed for the content of OA-specific IgE, IgG1 and IgG2a antibodies by ELISA methods. Adjuvant effect was defined as a statistically significant increased antibody level in the test groups compared with the OA control group. Conversely, if the antibody production in a test group was significantly lower than the OA control group, it was deemed to be immunosuppression. This study demonstrated that BBP, in contrast to DEHP, did not possess adjuvant effect. Furthermore, immunosuppression was apparent in the case of BA. The study also demonstrated that if the injections give rise to formation of wounds, it may cause false positive results.

Adjuvant and immuno-suppressive effect of six monophthalates in a subcutaneous injection model with BALB/c mice.

The prevalence of allergic airway diseases is rapidly increasing in Western Europe and North America. This increase in disease prevalence may be associated with environmental pollutants. The present study investigated the adjuvant and immuno-suppressive effect of a series of monophthalates which are considered to be important metabolites of commonly used phthalate plasticizers. The effects were studied in a screening model. Ovalbumin (OA), used as the model antigen, was injected subcutaneously in the neck region of BALB/cJ mice with or without one of the test substances, mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBnP), mono-n-octyl phthalate (MnOP), mono-2-ethylhexyl phthalate (MEHP), mono-iso-nonyl phthalate (MiNP) or mono-iso-decyl phthalate (MiDP). The levels of OA-specific IgE, IgG1 and IgG2a in sera were measured by ELISA. Immuno-suppressive effect, defined as a statistically significant reduction in IgE or IgG1 antibody production, was observed with MEHP (1000 microg/ml, IgE and IgG1), MnOP (1000 microg/ml, IgE and IgG1), MiNP (1000 microg/ml, IgE and 10 microg/ml, IgG1) and MiDP (100 microg/ml, IgE and IgG1). Adjuvant effect, defined as a statistically significant increase in IgE or IgG1 antibody level, occurred with MEHP (10 microg/ml, IgE), MnOP (100 microg/ml, and 10 microg/ml, IgG1) and MiNP (100 microg/ml, IgE). No statistically significant immune modulating effect was seen with MBnP and MnBP.

Study of adjuvant effect of model surfactants from the groups of alkyl sulfates, alkylbenzene sulfonates, alcohol ethoxylates and soaps.

The sodium salts of representatives of anionic surfactants, dodecylbenzene sulfonate (SDBS), dodecyl sulfate (SDS) and coconut oil fatty acids, and a nonionic surfactant, dodecyl alcohol ethoxylate, were studied for adjuvant effect on the production of specific IgE antibodies in mice. The surfactants were injected subcutaneously (sc) in concentrations of 1000, 100, 10 or 1 mg/l, respectively, together with 1 microg of ovalbumin (OVA). In addition, groups of mice received OVA in saline (control group) or in Al(OH)(3) (positive adjuvant control group). After the primary immunization the mice were boosted up to three times with OVA (0.1 microg sc) in saline. OVA-specific IgE antibodies were determined by the heterologous mouse rat passive cutaneous anaphylaxis test. The results were confirmed by a specific ELISA method. After the first booster, the Al(OH)(3) group and the 10 mg/l SDS group showed a statistically significant increase in OVA specific IgE levels. After two boosters, a statistically significant suppression in OVA-specific IgE production occurred with SDS (1000 mg/l), SDBS (1000 and 100 mg/l), coconut soap (1000 mg/l) and the alcohol ethoxylate (10 mg/l). This study suggests that a limited number of surfactants possess an adjuvant effect whereas all surfactants at certain levels can suppress specific IgE production.

Inflammatory potential of dust from waste handling facilities measured as IL-8 secretion from lung epithelial cells in vitro.

OBJECTIVES: Organic dust contains several different components which may cause pulmonary effects, and many health problems have been associated with the collection and recycling of organic waste. It is often difficult to obtain a precise measurement of the exposure to each component in dust, and organic dust samples obtained from different workplaces may vary profoundly in composition. The aim of this study was to evaluate the inflammatory potential of dust from different waste handling plants. Furthermore, we set out to investigate the role of endotoxin in the inflammatory potential of dust. METHODS: Dust samples were obtained from four incineration plants, three samples from a plant sorting household waste, five paper-sorting plants, two mail centres, four bottle-sorting plants, and two combined paper-sorting and composting plants. The samples were tested in a bioassay with the lung epithelial cell line A549. Cells were stimulated for 24h with dust samples at six concentrations, and subsequently the interleukin 8 (IL-8) secretion into the growth medium was measured. The initial slope of the dose response curves was used to calculate the potency factor (PF) of the dust samples, and correction against positive control samples was used to reduce day-to-day variation. The concentration of endotoxin in the dust samples was measured by the limulus amebocyte lysate (LAL) assay. RESULTS: The inflammatory potential of the dust samples for dust from the paper- and mail-sorting plants showed a significantly lower PF as compared with dust from the plants handling mixed household waste. A significantly lower PF for the dust samples from the bottle-sorting plants (excluding one outlier plant) compared with dust from the plants handling mixed household waste was also found. No correlation was observed between the PF and the concentration of endotoxin in the samples. CONCLUSION: The PFs obtained seem to reflect the material handled, with mixed household waste generating organic dust with the highest inflammatory potentials.

Exposure-response relationship between gastrointestinal problems among waste collectors and bioaerosol exposure.

OBJECTIVES: A high frequency of gastrointestinal problems has previously been reported for waste collectors. The present study relates the gastrointestinal problems to measurements of the bioaerosols that waste collectors are exposed to during work. METHODS: A job-exposure matrix was constructed from a combination of questionnaire data and field measurements. The questionnaire data were collected from 1747 male waste collectors and a comparison group of 1111 male municipal workers. Moreover a total of 189 full-shift personal samples was collected. The samples were used for characterizing the bioaerosol exposure described by viable fungi, total count of fungal spores, microorganisms, and endotoxins. RESULTS: In a multivariate analysis, high exposure to endotoxins was associated with nausea [prevalence proportion ratio (PPR) 1.60], and the risk of reporting nausea decreased with decreasing exposure so that workers with low exposure had the fewest reports (PPR 1.39) in the comparison with the unexposed group. High exposure to endotoxins was also associated with reports of diarrhea (PPR 5.60), and the risk of reporting diarrhea decreased with decreasing exposure so that the workers with low exposure had the fewest reports (PPR 3.02). The same pattern existed for exposure to fungi, for which high exposure resulted in the most reports (PPR = 4.59), and for diarrhea, for which low exposure resulted in the fewest reports (PPR = 3.15). CONCLUSIONS: An exposure-response relationship was found between nausea and endotoxin exposure and between diarrhea and exposure to both endotoxins and viable fungi.

Endotoxin potency in the A549 lung epithelial cell bioassay and the limulus amebocyte lysate assay.

The purpose of this study was to elucidate to what extent the potency of endotoxins measured by the limulus amebocyte lysate (LAL) assay is reflected in the potency in an in vitro assay based on release of interleukin-8 (IL-8) from a lung epithelial cell line, A549. Lipopolysaccharides (LPS) from Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella enteritidis and detoxified LPS from E. coli were applied in serial dilutions in the LAL assay and in the A549 bioassay. Also 19 organic dust samples from waste recycling plants were tested. The A549 cells were incubated for 24 h with LPS or dust, and the IL-8 secretion was determined by ELISA. The method for evaluation of the LAL assay showed linearity for the four endotoxins. Using the slope as a measure of the potency factor (PF), LPS from E. coli and S. enteritidis was about four times more potent than that for LPS from K. pneumoniae and P. aeruginosa. In the A549 bioassay each of the different types of endotoxin had characteristic and very different dose-response curves. The potency of the LPS, in the A549 bioassay, ranked as follows K. pneumoniae > P. aeruginosa > E. coli > or = S. enteritidis. The content of endotoxin in the dust samples did not correlate with their potency in the A549 bioassay. The present study indicates a poor correlation between the potency of endotoxin in the LAL assay compared with the A549 bioassay. The lack of correlation when organic dust samples are tested may reflect the fact that these samples contain biological active compounds, which are non-reactive in the LAL-assay but stimulate IL-8 secretion from epithelial cells.

Respiratory effects in mice exposed to airborne emissions from Stachybotrys chartarum and implications for risk assessment.

Stachybotrys chartarum, a mycotoxin producing mould found in some damp buildings, was grown in aluminum dishes in closed exposure chambers. The loading factor, 5.12 m2/m3, corresponded to 2.8 times the loading in a normal room with all surfaces covered by mould. Sensory irritation, bronchoconstriction and pulmonary irritation effects were investigated using a sensitive mouse bioassay in which the airway reactions were measured plethysmographically. Little effect was seen from the vapours in agreement with the predicted effects of the low concentrations of volatile organic compounds measured. Even under the influence of an airflow about four times that measured in normal buildings, the concentration of liberated spores and other particles was very low, corresponding to the biological effects observed, and probably reflecting the high water content of the substrate. These results demonstrate that many factors are important for the transport of biologically active mould metabolites from building material to occupants and that no direct relationship may exist between immediate biological effects and surface area covered with mould. Therefore, risk assessments should be based on estimated effects of emitted vapours, effects of liberated particles, e.g. sensitization potentials of the mould spores and effects of the generated metabolites (mycotoxins).

Season, equipment, and job function related to gastrointestinal problems in waste collectors.

OBJECTIVES: Informal reports have suggested that work as a waste collector entails exposures that cause gastrointestinal symptoms--such as nausea and diarrhoea. This study explores this hypothesis by correlating data on the type of waste collected, the persons' job function, the equipment used, and the times of the week and the year of reported nausea and diarrhoea. METHODS: 1747 male waste collectors and a control group for comparison of 1111 male municipality workers answered a questionnaire on work environment, work related exposure, and health status. RESULTS: In a multivariate analysis collection of organic and residual waste (prevalence proportion ratio (PPR) 1.45) and mixed household waste (PPR 1.43) were associated with reported nausea and so was the job loader (PPR 1.51). More symptoms were reported in the summer. Multivariate analysis of diarrhoea showed that the job front runner was associated with reported diarrhoea (PPR 1.22) and so was the job loader (PPR 1.26). More symptoms occurred in the summer. The workers stated that the gastrointestinal symptoms were related to the smell of rotten waste. This may support the hypothesis that microbial compounds were the causal agents. CONCLUSION: The gastrointestinal symptoms were associated with the job of waste collector and moreover the symptoms predominantly occurred in the summer.

The aggregation-mediated conjugation system of Bacillus thuringiensis subsp. israelensis: host range and kinetics of transfer.

The aggregation-mediated conjugation system in Bacillus thuringiensis subsp. israelensis encoded on the plasmid pXO16 is characterized by the formation of aggregates when Agr+ and Agr- cells are socialized in exponential growth. Using the aggregation phenotypes, we have identified potential recipients of the aggregation-plasmid pXO16 among Bacillus cereus, Bacillus subtilis, Bacillus megaterium, Bacillus sphaericus, and 24 subspecies of B. thuringiensis. We found 14 Agr- strains, i.e., potential recipients of the aggregation system encoded by plasmid pXO16. Five strains contained a conjugative apparatus of their own and were excluded from further examinations. To monitor the transfer of plasmid pXO16, we constructed a transposon insertion of the plasmid with Tn5401. The study of the plasmid transfer of pXO16::Tn5401 indicated the secretion of bacteriocins from both donor strain and recipient strains. Only one out of the nine strains examined was unable to receive the aggregation-plasmid pXO16 and express the aggregation phenotype and the conjugative abilities. It was found that the transfer of plasmid pXO16 to Bacillus thuringiensis subsp. israelensis Agr- strains was 100%. All recipients had acquired the aggregation-plasmid pXO16 and converted to the Agr+ phenotype.

Sample collection guidelines for trace elements in blood and urine. IUPAC Commission of Toxicology.

This paper presents an organized system for element-specific sample collection and handling of human blood (whole blood, serum or plasma, packed cells or erythrocytes) and urine also indicating a proper definition of the subject and sample. Harmonized procedures for collection, preparation, analysis and quality control are suggested. The aim is to assist scientists worldwide to produce comparable data which will be useful on a regional, national and international scale. The guidelines are directed to the elements aluminium, arsenic, cadmium, chromium, cobalt, copper, lead, lithium, manganese, mercury, nickel, selenium and zinc. These include the most important elements measured for their occupational or clinical significance, and serve as examples of principles that will guide development of methods for other elements in the future.

Geltape method for measurement of work related surface contamination with cobalt containing dust: correlation between surface contamination and airborne exposure.

OBJECTIVES: The geltape method is a new method for optical measurement of total amount of dust on surfaces. The objectives were to study the potential applicability of this method to measurements of work related cobalt exposure during painting of plates with cobalt dye. METHODS: Consecutive series of work related geltape prints were taken from surfaces inside and outside the ventilation cabins of two plate painters during two full working days. The amount of dust picked up by the geltapes was measured optically with a field monitor. Also, personal air samples were collected on filters at the different work processes. In the laboratory the contents of cobalt on the geltape prints and the filters were measured with inductive coupled plasma atomic emission spectroscopy. RESULTS: The key results were: (a) when the geltape prints were taken from surfaces inside the cabins the optically measured area of the geltapes covered with total dust (area (%)) correlated well with the chemically measured amount of cobalt present on the geltapes. Linear correlation coefficient (R2) was 0.91 for geltape prints taken on the floor and 0.94 for prints taken on the ceiling; (b) the cumulative airborne cobalt exposure, calculated from data on work related exposure by personal sampling, correlated with the area (%) of geltape prints taken from the ceiling of the cabin (R2 = 0.98); (c) the geltape method could be used to distinguish both between work processes with different levels of cobalt exposure, and between plate painters subjected to significant differences in airborne cobalt exposure. CONCLUSION: The geltape method could produce measures of the work related exposures as well as whole day exposure for cobalt. The geltape results correlated with measurements of personal airborne cobalt exposure. In this industry the profile of exposure is well-defined in time, and it seems reasonable to apply this fast and low cost method in routine exposure surveillance to obtain a more detailed description of the exposure than can be obtained by the use of airborne measurements only.

Collection of domestic waste. Review of occupational health problems and their possible causes.

During the last decade, a growing interest in recycling of domestic waste has emerged, and action plans to increase the recycling of domestic waste have been agreed by many governments. A common feature of these plans is the implementation of new systems and equipment for the collection of domestic waste which has been separated at source. However, only limited information exists on possible occupational health problems related to such new systems. Occupational accidents are very frequent among waste collectors. Based on current knowledge, it appears that the risk factors should be considered as an integrated entity, i.e. technical factors (poor accessibility to the waste, design of equipment) may act in concert with high working rate, visual fatigue due to poor illumination and perhaps muscle fatigue due to high work load. Musculoskeletal problems are also common among waste collectors. A good deal of knowledge has accumulated on mechanical load on the spine and energetic load on the cardio-pulmonary system in relation to the handling of waste bags, bins, domestic containers and large containers. However, epidemiologic studies with exposure classification based on field measurement are needed, both to further identify high risk work conditions and to provide a detailed basis for the establishment of occupational exposure limits for mechanical and energetic load particularly in relation to pulling, pushing and tilting of containers. In 1975, an excess risk for chronic bronchitis was reported for waste collectors in Geneva (Rufèner-Press et al., 1975) and data from the Danish Registry of Occupational Accidents and Diseases also indicate an excess risk for pulmonary problems among waste collectors compared with the total work force. Surprisingly few measurements of potentially hazardous airborne exposures have been performed, and the causality of work-related pulmonary problems among waste collectors is unknown. Recent studies have indicated that implementation of some new waste collection systems may result in an increased risk of occupational health problems. High incidence rates of gastrointestinal problems, irritation of the eye and skin, and perhaps symptoms of organic dust toxic syndrome (influenza-like symptoms, cough, muscle pains, fever, fatigue, headache) have been reported among workers collecting the biodegradable fraction of domestic waste. The few data available on exposure to bio-aerosols and volatile compounds have indicated that these waste collectors may be simultaneously exposed to multiple agents such as dust containing bacteria, endotoxin, mould spores, glucans, volatile organic compounds, and diesel exhaust. Several studies have reported similar health problems as well as high incidence rates of pulmonary disease among workers at plants recycling domestic waste.(ABSTRACT TRUNCATED AT 400 WORDS)

Rapid increase in skin problems among dental technician trainees working with acrylates.

A panel of trainees at The Danish School of Dental Technicians was asked to fill in questionnaires 2X a year, to elucidate whether the prevalence of skin problems on their hands increased during the study and to compare the results to the general population. At the beginning of the study, trainees had a prevalence of skin problems not statistically significantly different from that in the general population. 8 months later, an increase of 23% in the prevalence was observed. Compared to the general population the standardized prevalence ratio (SPR) increased to 4.78, and compared to dental technicians at work, an SPR of 0.71 was found after 1 year of study. Very few trainees experienced relief in symptoms during the 1st year of study (5%), whereas 33% developed worse symptoms. The results demonstrate that trainees shortly after beginning their education have the same very high magnitude of skin problems as dental technicians at work. Trainees were exposed to acrylates more extensively than dental technicians. It is far from acceptable that this educational experience involves such a great risk to individuals with no experience or knowledge of the hazards of their occupational environment. Preventive actions are called for, e.g., increased use of encapsulated systems, use of gloves with a well documented protective effect and mandatory courses on the hazardous effects of dental materials.

Comparison of lipases from different strains of the fungus Geotrichum candidum.

The type A lipase and the cis-9 18:1 specific type B lipase of different strains of Geotrichum candidum were compared. Comparing the enzyme activity of crude lipase preparation and purified type A and type B lipases and the protein pattern of these preparations in denaturing polyacrylamide gel electrophoresis (SDS-PAGE) revealed that the specific activity for cis-9 18:1 fatty acids was related to the content of the type B lipase. Tandem-crossed immunoelectrophoresis was used to demonstrate immunological identity between type A and type B lipase of G. candidum ATCC 66592. Partial immunological identity was observed between type B lipase of this strain and type A lipase of G. candidum ATCC 34614 and two commercial crude G. candidum lipase preparations (Amano and Biocatalyst), i.e., the type B lipase of G. candidum ATCC 66592 had immunogenic epitopes which are not present on the other lipases. Enzymatic deglycosylation of the lipases did not alter this pattern. After partial proteolysis of purified type A and type B lipases of G. candidum ATCC 66592, Amano and Biocatalyst, no difference between the type A lipase of the three strains was observed in SDS-PAGE. For all strains the type B lipase exhibited a distinctly different peptide pattern to that of the type A lipase. In addition, the type B lipase of G. candidum ATCC 66592 differed from the type B lipase of Amano and Biocatalyst by having an additional peptide band. The results indicate that the G. candidum ATCC 66592 should be considered a distinct strain regarding the protein chemical characteristics of its type B lipase, whereas the two commercial lipase preparations appear to be very similar.

Skin problems among Danish dental technicians. A cross-sectional study.

Our objective was to evaluate changes in the prevalence of skin problems on the hands among dental technicians during the last 10 years by comparison with results of a previous study, to study whether the presence and location of skin problems could be related to work with acrylates, and to study whether the use of gloves had any influence on the prevalence of the skin problems. A cross-sectional questionnaire study among 192 dental technicians at work was performed using an expanded version of a questionnaire from a Danish survey 10 years ago. The cumulative prevalence of skin problems on the hands was 53%. The 1-year prevalence of skin problems on the hands was 43%. The point prevalence of skin problems on the hands was 36%. These prevalence figures were profoundly higher than the figures reported for the general population, and the figures did not differ from those obtained in the study 10 years ago. The point prevalence of skin problems on the hands among individuals handling acrylates was 38% higher than among individuals who never worked with acrylates. No difference in the occurrence of skin problems was observed between individuals using gloves and individuals who did not use gloves while handling acrylates. The prevalence difference of skin problems on the fingertips was 7.3% between individuals handling acrylates daily or several times a week and individuals handling acrylates less frequently.(ABSTRACT TRUNCATED AT 250 WORDS)

Sorting and recycling of domestic waste. Review of occupational health problems and their possible causes.

In order to reduce the strain on the environment from the deposition of waste in landfills and combustion at incineration plants, several governments throughout the industrialized world have planned greatly increased recycling of domestic waste by the turn of the millennium. To implement the plans, new waste recycling facilities are to be built and the number of workers involved in waste sorting and recycling will increase steadily during the next decade. Several studies have reinforced the hypothesis that exposure to airborne microorganisms and the toxic products thereof are important factors causing a multitude of health problems among workers at waste sorting and recycling plants. Workers at transfer stations, landfills and incineration plants may experience an increased risk of pulmonary disorders and gastrointestinal problems. High concentrations of total airborne dust, bacteria, faecal coliform bacteria and fungal spores have been reported. The concentrations are considered to be sufficiently high to cause adverse health effects. In addition, a high incidence of lower back injuries, probably due to heavy lifting during work, has been reported among workers at landfills and incineration plants. Workers involved in manual sorting of unseparated domestic waste, as well as workers at compost plants experience more or less frequent symptoms of organic dust toxic syndrome (ODTS) (cough, chest-tightness, dyspnoea, influenza-like symptoms such as chills, fever, muscle ache, joint pain, fatigue and headache), gastrointestinal problems such as nausea and diarrhoea, irritation of the skin, eye and mucous membranes of the nose and upper airways, etc. In addition cases of severe occupational pulmonary diseases (asthma, alveolitis, bronchitis) have been reported. Manual sorting of unseparated domestic waste may be associated with exposures to large quantities of airborne bacteria and endotoxin. Several work functions in compost plants can result in very high exposure to airborne fungal spores and thermophilic actinomycetes. At plants sorting separated domestic waste, e.g. the combustible fraction of waste composed of paper, cardboard and plastics, the workers may have an increased risk of gastrointestinal symptoms and irritation of the eyes and skin. At such plants the bioaerosol exposure levels are in general low, but at some work tasks, e.g. manual sorting and work near the balers, exposure levels may occasionally be high enough to be potentially harmful. Workers handling the source-sorted paper or cardboard fraction do not appear to have an elevated risk of occupational health problems related to bioaerosol exposure, and the bioaerosol exposure is generally low.(ABSTRACT TRUNCATED AT 400 WORDS)