1. INFECTIOUS DISEASES IN WASTE MANAGEMENT Tartu 10.3.-11.3.2004 Markku Seuri, FIOH, 2004

2. WASTE • infectious waste from hospitals etc • sharps waste • solid community waste • collecting • dumping ground • treatment • waste-water treatment Markku Seuri, FIOH, 2004

3. GENERAL ASPECTS • microbes found depend on the processes • exposure to a certain microbe in waste-water depend on the prevalence of that disease Markku Seuri, FIOH, 2004

4. INFECTIOUS WASTE • cultures • human or animal pathological waste • contaminated material • sharps • free flowing waste Markku Seuri, FIOH, 2004

5. LIMITING THE HAZARDS OF INFECTIOUS WASTE • policy • written • approved • based on present knowledge • guidelines • written and simple instructions • training Markku Seuri, FIOH, 2004

6. SOLID COMMUNITY WASTE • proper handling of waste (sharps) at home • good containers, easy to collect • no-touch handling of the waste • personal hygiene (smoking, eating, drinking, clothing) • at the dump site; preventing the dust • tetanus vaccination Markku Seuri, FIOH, 2004

7. WASTE-WATER TREATMENT PLANTS • waste-water contains many pathogenic microbes, which are common in that particular community: • hepatitis A • hepatitis C • Salmonella spp • intestinal parasites • waste-water treatment plant workers report more gastrointestinal tract symptoms than controls Markku Seuri, FIOH, 2004

8. EPIDEMIOLOGY OF WASTE-WATER TREATMENT PLANT WORKERS • waste-water treatment plant workers seem to have more hepatitis A • depends on the task • they do not experience any increased risk of clinical disease Markku Seuri, FIOH, 2004

9. WASTE-WATER TREATMENT AND SALMONELLA • Salmonella spp can be found in waste-water • in our study they waste-water treatment plant workers had less antibodies against salmonella than blood donors and reported less salmonellosis than food processing plant workers • could salmonella exposure by inhalation prevent gastrointestinal salmonellosis? Markku Seuri, FIOH, 2004

10. WASTE-WATER TREATMENT PLANT GI-SYMPTOMS • in several studies more gi-symptoms • habitual stomach pain • loose or watery stools • varying bowel habits • cause is probably some virus • more among the young workers (?) • not related to any later disease Markku Seuri, FIOH, 2004

11. SIMPLE PRINCIPLES FOR WASTE WORK • avoid cuts • avoid dust, do not let the waste dry • use protective proper protective device • in some cases exclusion of some workers may be considered: • immunocompromised • workers with asthma • workers with allergic rhinitis, conjunctivitis • dermatitis • remember tetanus vaccination Markku Seuri, FIOH, 2004