Characterization of bioaerosol exposures in wastewater treatment plant workers and serum levels of lung and inflammatory markers

Wastewater treatment plant (WWTP) workers are exposed to bioaerosols containing bacteria, fungi, and endotoxin, potentially posing health risks to workers. This study quantified personal exposure levels to airborne bacteria and fungi, endotoxin, and dust among 44 workers during two seasons at four WWTPs. Associations between the exposure measurements and serum levels of biomarkers CRP, SAA, and CC16 were also assessed. The potential deposition of viable microorganisms in workers' airways were explored using stationary fractionating samplers. Microbial communities were characterized using long-read nanopore amplicon sequencing and MALDI-TOF mass spectrometry to identify species, including pathogenic or allergenic microorganisms. We found that bacterial and fungal exposure levels were significantly associated with work task (p < 0.001 and p = 0.00041, respectively), with high exposure variability within and between tasks. Workshop, sewer system inspection, and sewer cleaning were associated with the highest exposure levels. A significant positive correlation was found between CRP and bacterial exposure (p = 0.013), while significant negative correlations were found between CRP and endotoxin and dust exposures (p = 0.012 and p = 0.018, respectively). No significant associations were found between SAA or CC16 and the exposure measures. Microbial community composition in bioaerosols differed significantly between some work tasks while others showed similar compositions. Viable hazardous microorganisms such as Clostridium perfringens and Aspergillus fumigatus were found in workers' exposures and in respiratory fractions of stationary air samples, indicating potential lung deposition. Further research is needed to assess possible long-term health risks from bioaerosol exposure at WWTPs.