2016-06-22 04:37:34
During their professional activity, sewer workers are exposed to numerous chemical and biological agents present in the air and/or in water, by inhalation of gases, vapors or aerosols, by cutaneous-mucous contact and by ingestion.
In 2004, INRS published the results of a mortality study among Parisian sewer workers, carried out at the request of the City of Paris. It revealed excess mortality, including a significant proportion from digestive diseases, cancers and suicides. the specific health risks of the sewer worker profession and to identify the causes of this excess mortality.
Workers exposed to many compounds
ANSES undertook a campaign of individual measurements among sewer workers in the City of Paris, between October 2014 and March 2015, in order to confirm the all too rare data in the literature. These exploratory measurements show that sewer workers are exposed to a cocktail of chemical and biological agents present in the water and in the air of the sewers. In general, the concentrations of pollutants in the air of the sewers are higher than the concentrations measured outside, due to the lack of air renewal and containment, and the presence of sources of contamination specific to the sewers.
This measurement campaign has in particular made it possible to highlight exposure to carcinogenic, mutagenic and reprotoxic (CMR) compounds, and to identify tasks that are more exposing than others, such as cleaning out desilting basins, cleaning screens high pressure or cleaning with machine. In the majority of situations, the concentrations measured for each of the identified compounds are however low compared to the reference values (occupational exposure limit values = OEL or toxicological reference values = TRV), which does not however guarantee the absence of health effect linked to particularly numerous co-exposures, possible synergies between pollutants, and concentration peaks of certain pollutants.
Long-term health effects associated with the job of sewer worker linked to a multiplicity of risk factors
With regard to health effects, the symptoms most frequently reported by workers exposed to wastewater are digestive and respiratory symptoms, irritation of the nose, throat and skin. An increase in the frequency of certain infectious pathologies can also be observed, the majority of them being of limited duration and very rarely lethal.
Mortality studies show significant excess mortality mainly for liver and lung cancers, without it being possible to precisely identify one or more responsible risk factor(s), in particular chemical or biological agents exposing the workers.
Finally, the devaluation of the job of sewer worker, the weakening of work groups and the anxiety-provoking dimension of sewer work are factors potentially associated with increased suffering at work.
ANSES’s recommendations
The Agency recalls the general prevention principles of the Labor Code, in particular the priority to be given to collective protection measures over individual protection measures.
In view of the conclusions of its expert appraisal, the Agency recommends better understanding the chemical, microbiological and psychosocial risks, in order to take the necessary measures to ensure the safety and protection of the health of sewer workers. long-term.
It recommends optimizing the measures aimed at reducing the exposure of workers to microbiological and chemical agents, by:
- developing compulsory vocational training for anyone required to work in an underground sewer network;
- paying particular attention to the most exposing tasks (optimization of the ventilation of the sewerage network, mechanization of these tasks, etc.);
- implementing hygiene measures and safety instructions in conjunction with the occupational health service;
- setting up network risk maps (identification, centralization and updating of knowledge relating to sewer areas with specific conditions).
The Agency considers it necessary to strengthen self-monitoring, to check more regularly the compliance of non-domestic wastewater discharges with discharge authorizations, and to promote the establishment of networks whose hydraulicity allows self-regulation. -cleaning.
ANSES also recommends ensuring enhanced medical monitoring of the health of sewer workers, complying with the opinions of the Technical Committee on Vaccinations of the High Council for Public Health (HCSP) in force concerning anti-leptospirosis and anti-hepatitis A vaccination and to ensure the traceability of exposures.
In terms of research, the Agency recommends continuing and setting up epidemiological studies to monitor long-term health effects in sewer workers, to assess the effectiveness of preventive measures that can be implemented, such as as the mechanization of certain tasks, organizational changes to work, to continue measuring individual exposure to pollutants and to study the usefulness of developing research into biomarkers to improve the monitoring of multiple exposures of sewer workers.
Awareness campaigns should be organized in order, on the one hand, to remind the general population that the sanitation network often called “mains drainage” is not intended to receive everything and, on the other hand, to specify good rejection practices.
ANSES also emphasizes that the recommendations issued are part of a global context of climate change which risks having an impact on the sanitation of urban areas (modification of the volume of water passing through the networks, the temperature of the water waste collected and transported, etc.). It is necessary to anticipate these impacts in terms of prevention and protection of the professionals required to work in the sanitation networks.
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