MICROBIAL FLORA OF THE RESPIRATORY TRACT AND SKIN OF ARTISANAL MUNICIPAL SOLID WASTE HANDLERS IN ABA, ABIA STATE, NIGERIA.

Municipal solid waste handling carries occupational risk for waste handlers due to exposure to diverse microorganisms and hazardous substances which cause respiratory and skin infections. This study assessed the sociodemographic characteristics, health-related complaints, health-seeking behaviour and the bacterial and fungal microflora of the respiratory tract and skin of artisanal municipal solid waste handlers and some controls in Aba, Nigeria. This cross-sectional study recruited 150 respondents using simple random sampling technique. Ethical clearance and informed consent of participants were obtained. An interviewer administered structured questionnaire was used to obtain relevant information and data were statistically analyzed using IBM SPSS version 25. Nasal and skin swabs were collected for culture and isolation of bacteria and fungi colonizing the respiratory tract and skin of the study subjects using bacteria and fungi culture media. Findings show that Municipal solid waste handling in Aba is mostly carried out by males (95%). The mean age of the waste handlers is 30 years, with the age group of 21-40 years constituting the highest proportion (65%) of the workforce. Health-related complaints were higher (95%) amongst the waste handlers compared to the control subjects (4%). Findings show high prevalence of respiratory (57%), eye (34%) and skin (87%) complaints among the waste workers compared to 6%, 0%, and 2% respectively among the control subjects. Majority (78%) of the waste workers indulge in self-medication via over the counter (OTC) drugs, 17% access diagnostic laboratories and only 4% visit hospitals for treatment as against the control subjects that recorded 2% for OTC drugs, 92% (Laboratories) and 4% (hospitals). Acquisition (15%) and use (3%) of personal protective equipment (PPE) were very low amongst the waste handlers. 704 bacterial isolates and 191 fungal organisms were obtained from the study subjects. S. epidermidis (24%), B. cereus (13%) and S.aureus (29%), S. epidermidis (19%) predominated in the respiratory tract and skin respectively, of the waste handlers. Similarly, S. aureus (34.3%), B. cereus (20.9%) and B. cereus (37.9%), S. epidermidis (18.1%) predominated the respiratory tract and skin respectively among the control subjects. Candida spp was most predominant fungi in the respiratory tract (81.4%) and skin (42.9%) of the waste handlers as well as in the respiratory tract (85%) and skin (78%) of the controls. Colonization by bacteria and fungi following occupational exposure to waste results in high prevalence of health complaints among the waster handlers and this may be connected to the low use of PPE and poor health seeking behaviour. Health education, sensitization and improvement in working conditions are necessary to mitigate the occupational challenges of the waste handlers.