Note: When clicking on a Digital Object Identifier (DOI) number, you will be taken to an external site maintained by the publisher.
Some full text articles may not yet be available without a charge during the embargo (administrative interval).
What is a DOI Number?
Some links on this page may take you to non-federal websites. Their policies may differ from this site.
-
more » « less
Abstract The 2013–2016 Ebola epidemic revived concerns about infection risks to wastewater workers. Prior research has shown that wastewater can contain a variety of known and emerging pathogens and that wastewater workers are at increased risk of infectious illnesses. However, guidelines on using personal protective equipment (PPE) to decrease these risks are lacking. We engaged 34 wastewater utility personnel and public health experts to conduct a job safety analysis identifying tasks in which workers could be exposed to pathogens and to develop a PPE selection matrix for preventing those exposures. We identified 43 relevant job tasks. Recommended PPE ranges from durable gloves (all tasks) to safety glasses (24 tasks), Tyvek suits or coveralls (4 tasks), and respiratory protection (N95 mask or face mask, depending on the activity, 10 tasks). The PPE selection matrix can serve as a guide for protecting the 120,000 wastewater workers in the United States from known and emerging pathogens.
Practitioner points Wastewater workers are at increased risk of infectious illnesses.
Policies to protect wastewater workers from these illnesses are lacking.
We developed guidelines for use of personal protective equipment by wastewater workers to prevent exposure to infectious agents.
-
more » « less
Abstract The World Health Organization has declared antibiotic resistance “one of the biggest threats to global health.” Mounting evidence suggests that antibiotic use in industrial‐scale hog farming is contributing to the spread of antibiotic‐resistant
Staphylococcus aureus . To capture available evidence on these risks, we searched peer‐reviewed studies published before June 2017 and conducted a meta‐analysis of these studies’ estimates of the prevalence of swine‐associated, antibiotic‐resistantS. aureus in animals, humans, and the environment. The 166 relevant studies revealed consistent evidence of livestock‐associated methicillin‐resistantS. aureus (MRSA) in hog herds (55.3%) raised with antibiotics. MRSA prevalence was also substantial in slaughterhouse pigs (30.4%), industrial hog operation workers (24.4%), and veterinarians (16.8%). The prevalence of swine‐associated, multidrug‐resistantS. aureus (MDRSA)—with resistance to three or more antibiotics—is not as well documented. Nonetheless, sufficient studies were available to estimate MDRSA pooled prevalence in conventional hog operation workers (15.0%), workers’ household members (13.0%), and community members (5.37%). Evidence also suggests that antibiotic‐resistantS. aureus can be present in air, soil, water, and household surface samples gathered in or near high‐intensity hog operations. An important caveat is that prevalence estimates for humans reflect colonization, not active infection, and the health risks of colonization remain poorly understood. In addition, these pooled results may not represent risks in specific locations, due to wide geographic variation. Nonetheless, these results underscore the need for additional preventive action to stem the spread of antibiotic‐resistant pathogens from livestock operations and a streamlined reporting system to track this risk.
