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Will sewage workers with endotoxin related symptoms have the benefit of reduced lung cancer?
  1. J H Lange1,
  2. G Mastrangelo2,
  3. K W Thomulka3
  1. 1Envirosafe Training and Consultants, Inc., PO Box 114022, Pittsburgh, PA 15239, USA;
  2. 2Department of Environmental Medicine and Public Health, Section of Occupational Health, University of Padova, Via Giustiniani, 2-35128 Padova, Italy
  3. 3University of the Sciences in Philadelphia, 600 South 43rd Street, Philadelphia, PA 19104, USA

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    Thorn and colleagues1 reported that sewage workers suffer from various symptoms which can be related to bacterial endotoxin (lipopolysaccharide) exposure. Other studies2–5 have shown that some members of this occupational group are commonly exposed to endotoxin. However, there appears to be a large discrepancy in endotoxin exposure among those categorised within this group.2 Endotoxin exposure to some of these workers appears to be sufficient to induce a respiratory response characteristically associated with endotoxin.2 Workers that have the highest exposure in sewage treatment are suggested to be associated with the waste treatment process.3 Professor Rylander pointed out that endotoxin exposure to this occupational group is low overall (personal communication with Professor Rylander). Rapiti and colleagues6 suggested that the lack of an increased lung cancer rate in one study7

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