Possible Role of Plasma Ceruloplasmin and Erythrocyte Sedimentation Rate in Assessing Compliance with Occupational Hygiene and Safety Practices in Waste Management Workers


  • Olabisi Onabanjo University, Department of Chemical Pathology
  • Federal Medical Centre, Department of Anaesthesia, Abeokuta
  • Babcock University, Department of Public Health, Ilishan‑Remo, Nigeria
  • School of Medical Sciences, University of Cape Coast, Department of Pharmacology, Cape Coast, Ghana


Objectives: Work‑related health and safety risks are common among waste management workers (WMWs). This study investigated the level of compliance with safety measures in relation to levels of inflammatory markers among WMWs in Sagamu, South‑West Nigeria. Materials and Methods: WMWs comprising 30 cart pushers (CPs) and 50 truck users (TUs) were recruited alongside 45 people from the normal population as control. Data on health complaints were obtained from questionnaire surveys. Inflammation was assessed by measuring plasma ceruloplasmin (Cp), erythrocyte sedimentation rate (ESR), C‑reactive protein (CRP), and albumin. Results: WMWs exhibited a significantly higher prevalence of respiratory and gastrointestinal symptoms and poor compliance with health and safety measures. Significant (P < 0.001) differences were observed in the use of masks, hand gloves, protective clothing, and footwear between TUs and CPs. ESR, Cp, and CRP increased significantly (P < 0.001) by 145, 28.7, and 42.5% in TUs and by 164, 50.5, and 74.3% in CPs, respectively, relative to control. Negative correlation was observed between use of mask (r = −0.225, P < 0.01), use of gloves (r = −0.184, P < 0.05), and Cp and between ESR and washing of hands with soap (r = −0.185, P < 0.05). The use of goggles (r = +0.285, P < 0.001), washing of hands with soap (r = +0.203; P < 0.01), use of masks (r = +0.317, P < 0.001), and use of gloves correlated positively in WMWs. Conclusions: A higher prevalence of work‑related symptoms and elevated inflammatory markers in WMWs was related to poor compliance with safety measures. ESR and Cp may be useful predictors of occupational hygiene and compliance with safety measures among Nigerian WMWs.


Compliance, inflammatory markers, municipal solid wastes, occupational exposure, safety assessment

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Rushton L. Health hazards and waste management. Br Med Bull 2003;68:183‑97.

Kuijer PP, Sluiter JK, Frings‑Dresen MH. Health and safety in waste collection: Towards evidence‑based worker health surveillance. Am J Ind Med 2010;53:1040‑64.

Douwes J, Wouters I, Dubbeld H, van Zwieten L, Steerenberg P, Doekes G. Upper airway inflammation assessed by nasal lavage in compost workers: A relation with bio‑aerosol exposure. Am J Ind Med 2000;37:459‑68.

Lavoie J, Dunkerley CJ. Assessing waste collectors’ exposure to bioaerosols. Aerobiologia 2002;18:277‑85.

Lavoie J, Dunkerley CJ, Kosatsky T, Dufresne A. Exposure to aerosolized bacteria and fungi among collectors of commercial, mixed residential, recyclable and compostable waste. Sci Total Environ 2006;370:23‑8.

Wouters IM, Spaan S, Douwes J, Doekes G, Heederik D. Overview of personal occupational exposure levels to inhalable dust, endotoxin, beta (1 → 3)‑glucan and fungal extracellular polysaccharides in the waste management chain. Ann Occup Hyg 2006;50:39‑53.

Widmeier S, Bernard A, Tschopp A, Jeggli S, Dumont X, Hilfiker S, et al. Surfactant protein A, exposure to endotoxin, and asthma in garbage collectors and in wastewater workers. Inhal Toxicol 2007;19:351‑60.

Yang CY, Chang WT, Chuang HY, Tsai SS, Wu TN, Sung FC. Adverse health effects among household waste collectors in Taiwan.Environ Res 2001;85:195‑9.

Heldal K, Halstensen AS, Thorn J, Eduard W, Halstensen TS.Airway inflammation in waste handlers exposed to bioaerosols assessed by induced sputum. Eur Respir J 2003;21:641‑5.

Ray MR, Roychoudhury S, Mukherjee G, Roy S, Lahiri T.Respiratory and general health impairments of workers employed in a municipal solid waste disposal at an open landfill site in Delhi. Int J Hyg Environ Health 2005;208:255‑62.

De Mee G, Heederik D, Wouters IM. Change in airway responsiveness over a workweek in organic waste loaders. Int Arch Occup Environ Health 2007;80:649‑52.

Ray MR, Roychoudhury S, Mukherjee G, Siddique S, Banerjee M, Akolkar AB, et al. Airway inflammation and upregulation of β2 Mac‑1 integrin expression on circulating leukocytes of female rag pickers in India. J Occup Health 2009;51:232‑8.

Dounias G, Rachiotis G. Prevalence of hepatitis A virus infection among municipal solid‑waste workers. Int J Clin Pract 2006;60:1432‑6.

Rozman MA, Alves IS, Porto MA, Gomes PO, Ribeiro NM, Nogueira LA, et al. HIV and related infections in a sample of recyclable waste collectors of Brazil. Int J STD AIDS 2007;18:653‑4.

Luksamijarulkul P, Sujirarat D, Charupoonphol P. Risk behaviors, occupational risk and seroprevalence of hepatitis B and A infections among public cleansing workers of Bangkok Metropolis. Hepat Mon 2008;8:35‑40.

Cointreau S. Occupational and environmental health issues of solid waste management: Special emphasis on middle and lower‑income countries. The International Bank for Reconstruction and Development/The World Bank.

H Street, NW Washington D.C; 2006.

Athanasiou M, Makrynos G, Dounias G. Respiratory health of municipal solid waste workers. Occup Med 2010;60:618‑23.

Nwanta JA, Onunkwo J, Ezenduka E. Analysis of Nsukka metropolitan abattoir solid waste and its bacterial contents in south eastern Nigeria: Public health implication. Arch Environ Occup Health 2010;65:21‑6.

Odewabi AO, Ogundahunsi OA, Ebesunu MO, Ekor M. The levels of inflammatory markers and oxidative stress in individuals occupationally exposed to municipal solid waste in Ogun State, South West Nigeria. Toxicol Ind Health 2012. 19.

Wilson DC, Velis C, Cheeseman C. Role of informal sector recycling in waste management in developing countries. Habitat Int 2006;30:797‑808.

Mba OO. Intestinal parasites among waste‑handlers in jos metropolitan area of plateau state, Nigeria. Sahel Med J 2004;7:13‑7.

Confidence WK, Eleanya EU. Health impact assessment of solid waste disposal workers in Port Harcourt, Nigeria. J Appl Sci 2007;7:3562‑6.

Oyelola OT, Babatunde AI, Odunlade AK. Health implications of solid waste disposal: Case study of Olusosun dumpsite, Lagos, Nigeria. Int J Pure Appl Sci 2009;3:1‑8.

Nzeadibe TC. Solid waste reforms and informal recycling in Enugu urban area, Nigeria. Habitat Int 2009;33:93‑9.

Nguyen HT, Chalin CG, Lam TM, Maclaren VW. Health and social needs of waste pickers in Vietnam. Research paper CIDA‑WASTE‑ECON Project, Southeast Asia, 2003.

Lazovich D, Murray DM, Brosseau LM, Parker DL, Milton FT, Dugan SK. Sample size considerations for studies of intervention efficacy in the occupational setting. Ann Occup Hyg 2002;46:219‑27.

Tielemans E, Kupper LL, Kromhout H, Heederik D, Houba R.Individual based and group‑based occupational exposure assessment: Some equations to evaluate different strategies.Ann Occup Hyg 1998;42:115‑9.

Mbeng LO. The impact of public attitudes and behaviour on the effective valorization of household waste into agricultural compost: Case study Limbe and Douala, Cameroon. Ph.D.dissertation, School of Applied Sciences, University of Northampton, Northampton, UK; 2009.

Mbeng LO, Phillips PS, Fairweather R. Developing sustainable waste management practice: Application of Q methodology to construct new strategy component in Limbe – Cameroon. Open Waste Manag J 2009;2:33‑42.

Odewabi AO, Ogundahunsi OA, Odewabi AA, Oritogun KS, Ekor M.Adenosine deaminase activity and immunoglobulin levels as potential systemic biomonitors of occupational hazards and health status in municipal solid waste management workers.Environ Toxicol Pharmacol 2013;35:1‑12.

Wardlaw AJ, Brightling CE, Green R, Woltmann G, Bradding P, Pavord ID. New insights into the relationship between airway inflammation and asthma. Clin Sci 2002;103:201‑11.

Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest 2006;116:1793‑801.

Savoia C, Sciffrin EL. Inflammation in hypertension. Curr Opin Nephrol Hypertens 2006;15:152‑8.

Thevenon AD, Zhou JA, Megnekou R, Ako S, Leke RG, Taylor DW.Elevated levels of soluble TNF receptors 1 and 2 correlate with plasmodium falciparum parasitemia in pregnant women: Potential markers for malaria‑associated inflammation.J Immunol 2010;185:7115‑22.

World Medical Organization. Declaration of Helsinki. Br Med J 1996;313:1448‑9.

Schoslnsky KH, Lehmann HP, Beeler MF. Measurement of ceruloplasmin from its oxidase activity in serum by use of o‑dianisidine dihydrochloride. Clin Chem 1974;20:1556‑63.

Eda S, Kaufmann J, Molwitz M, Vorberg E. A new method of measuring C‑reactive protein with a low limit of detection, suitable for risk assessment of coronary heart disease. Scand J Clin Lab Invest 1999;59:32‑5.

Doumas BT, Watson WA, Biggs HG. Albumin standards and the measurement of serum albumin with bromocresol green reaction. Clin Chem 1971;22:616‑22.

Westergren A. Studies of the suspension stability of the blood in pulmonary tuberculosis. Acta Med Scand 1921;54:247.

Marusteri M, Bacarea V. Comparing groups for statistical differences: How to choose the right statistical test? Biochem Med 2010;20:15‑32.

Coker AO, Adeshiyan RA, Oluremi JR, Sridhar MK, Coke ME, Booth CA, et al. Challenges of waste management in a Nigerian leper colony. Int J Environ Stud 2008;65:183‑95.

Kalahasthi R, Pradyuonna A, Narendran P, Rao RH. Evaluation of the relationship between pro‑inflammatory cytokines and health hazards in workers involved in hazardous waste sites at Karnataka. Indian J Res Health Sci 2010;10:7‑14.

National Daily Newspaper. Worrisome unemployment rate in Nigeria. Available from: http://www.nationaldailyngr.com/ index.php? [Last accessed in 2012].

Cloutier E. The effect of age on safety and work practices among domestic trash collectors in Quebec. Saf Sci 1994;17:291‑308.

Pandey R. Solid waste management practice and health implication: A case of Kathmandu Metropolitan city, Nepal (2004‑2005). Himalayan Rev 2005;35:33‑47.

Memishi R. Safety doesn’t always come first in waste. Waste News 998;4:13‑25.

Becker P, Morawetz J. Impacts of health and safety education: Comparison of worker activities before and after training. Am J Ind Med 2004;46:63‑70.

Levine SP. The role of air monitoring techniques in hazardous waste site personnel protection and surveillance strategies.Occup Med 1990;5:109‑16.

Scarlett JM, Babish JG, Blue JT. Urinary mutagens in municipal refuse incinerator workers and water treatment workers.J Toxicol Environ Health 1990;31:11‑27.

Gelberg KH. Health study of New York city department of sanitation landfill employees. J Environ Med 1997;39:1103‑10.

Malkin R, Brandt‑Rauf P, Graziano J, Parides M. Blood lead levels in incinerator workers. Environ Res 1992;59:265‑70.


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