RT Journal Article SR Electronic T1 Work-related Helicobacter pylori infection among sewage workers in municipal wastewater treatment plants in Belgium JF Occupational and Environmental Medicine JO Occup Environ Med FD BMJ Publishing Group Ltd SP 91 OP 97 DO 10.1136/oem.2008.040436 VO 67 IS 2 A1 Wim Van Hooste A1 Anne-Marie Charlier A1 Paul Rotsaert A1 Simon Bulterys A1 Guido Moens A1 Marc van Sprundel A1 Antoon De Schryver YR 2010 UL http://oem.bmj.com/content/67/2/91.abstract AB Introduction Most studies among sewage workers of wastewater treatment plants (WWTPs) have found a higher prevalence of gastrointestinal symptoms than among non-sewage exposed workers. Waterborne transmission of Helicobacter pylori (H pylori) has been hypothesised, as the bacteria can survive into an aqueous environment and has been detected in sewage. A health and hygiene questionnaire has demonstrated a higher prevalence of peptic ulcers among Belgian WWTP operators and maintenance workers than among non-sewage exposed colleagues.Objectives To assess the seroprevalence of H pylori infection in Belgian sewage workers at municipal WWTPs, and to determine whether sewage exposure is an important risk factor for acquisition of H pylori and the possible association with gastrointestinal symptoms.Methods A seroprevalence study of H pylori antibodies was conducted among 317 WWTP employees (operators, maintenance workers, laboratory personnel, other job). Information about demographic variables, possible H pylori risk factors, working history, and history of current gastrointestinal symptoms during last 3 months was obtained by a questionnaire. The presence of H pylori IgG was investigated with an ELISA. The results were compared with those of 250 employees of a pharmaceutical company (operators, maintenance workers, laboratory personnel).Results The prevalence of H pylori IgG antibodies among sewage workers was 16.7% (95% CI 12.6 to 20.8%) compared to 13.6% (95% CI 9.4 to 17.8%) among the control group. In a logistic regression model with controlling for age and educational levels, OR study/control group was 1.02 (95% CI 0.58 to 1.80 with p=0.93). No significant associations were found between the H pylori status and gastrointestinal symptoms, occupational exposures in different tasks, nor with hygienic practices.Conclusions Our results do not suggest that H pylori infection is a probable cause of part of gastrointestinal symptoms among Flemish municipal sewage workers of WWTPs.