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首页> 美国卫生研究院文献>Environmental Health Perspectives >Two Outbreaks of Occupationally Acquired Histoplasmosis: More than Workers at Risk
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Two Outbreaks of Occupationally Acquired Histoplasmosis: More than Workers at Risk

机译：两起职业获得性组织胞浆菌病暴发：危险中的工人数量多

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Objective: The objective of this study was to determine the etiology and risk factors for acute histoplasmosis in two outbreaks in Illinois among laborers at a landfill in 2001 and at a bridge reconstruction site in 2003.Design: We performed environmental investigations during both outbreaks and also performed an analytic cohort study among bridge workers.Participants: Workers at the landfill during May 2001 and those at the bridge site during August 2003 participated in the study. At the landfill, workers moved topsoil from an area that previously housed a barn; at the bridge, workers observed bat guano on bridge beams.Evaluations/Measurements: We defined a case by positive immunodiffusion serology, a ≥ 4-fold titer rise in complement fixation between acute and convalescent sera, or positive urinary Histoplasma capsulatum (HC) antigen. Relative risks (RR) for disease among bridge workers were calculated using bivariate analysis.Results: Eight of 11 landfill workers (73%) and 6 of 12 bridge workers (50%) were laboratory-confirmed histoplasmosis cases. Three bridge workers had positive urinary HC antigen. At the bridge, seeing or having contact with bats [RR = 7.0; 95% confidence interval (CI), 1.1–43.0], jack-hammering (RR = 4.0; 95% CI, 1.2–13.3), and waste disposal (RR = 4.0; 95% CI, 1.2–13.3) were the most significant job-related risk factors for acquiring histoplasmosis.Conclusions: Workers performing activities that aerosolized topsoil and dust were at increased risk for acquiring histoplasmosis.Relevance to Professional and Clinical Practice: Employees should wear personal protective equipment and use dust-suppression techniques when working in areas potentially contaminated with bird or bat droppings. Urinary HC antigen testing was important in rapidly identifying disease in the 2003 outbreak.
机译：目的：本研究的目的是确定2001年在伊利诺伊州两次垃圾填埋场和2003年桥梁重建现场的工人中急性组织胞浆菌病的病因和危险因素设计：我们在爆发期间以及在爆发期间进行了环境调查参与者：2001年5月在垃圾填埋场的工人和2003年8月在桥梁填埋场的工人参加了该研究。在垃圾填埋场，工人将表土从先前安置谷仓的地方移走。评价/测量：我们通过阳性免疫扩散血清学，急性和恢复期血清之间补体固定滴度升高≥4倍，或阳性尿囊原体囊膜（HC）抗原定义了一个病例。 。结果：在实验室确认的组织胞浆菌病病例中，有11名垃圾填埋场工人中的8名（73％）和12名桥梁填埋场工人中的6名（50％）患病了相对风险（RR）。三名桥梁工人的尿HC抗原阳性。在桥上，看到或接触蝙蝠[RR = 7.0;最显着的是置信区间（CI）为95％CI（1.1–43.0），锤击（RR = 4.0； 95％CI为1.2–13.3）和废物处置（RR = 4.0； 95％CI为1.2–13.3）结论：进行雾化表土和粉尘活动的工人罹患组织胞浆菌的风险增加。与专业和临床实践的相关性：员工在区域工作时应穿戴个人防护设备并使用抑尘技术可能被鸟或蝙蝠的粪便污染。尿HC抗原检测对于快速识别2003年爆发的疾病很重要。

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