A63 FIRST REPORTED PEDIATRIC CASES OF SEWER WORKER’S DISEASE
Notice bibliographique
Résumé
Abstract Background Sewer worker’s disease, often recognized as a workplace hazard for sewer workers, has never been described in pediatric subjects. Aims We report a case series of two siblings who developed chronic nasopharyngeal discharge, sore throat, diarrhea and irritability secondary to airborne supersaturation of E. Coli from an improperly vented household septic tank. Methods Case Series- Retrospective Chart and Literature Review Results The affected subjects were a six year old boy and his three year old sister. The boy presented with chronic diarrhea. The girl presented with six to eight watery stools per day and nocturnal stooling. Parents reported that both children also had a chronic purulent nasal discharge and complained of sore throats. Her parents also endorsed anorexia along with increased fussiness. Both siblings had been treated with metronidazole for Giardia Lamblia five years earlier. Repeat examination of stool for ova & parasites was negative. CBC and D-xylose were normal. Both children underwent upper GI endoscopy. Biopsy was normal in one and diffuse duodenal inflammation was noted in the second child. A heavy growth of E. Coli was cultured from the nares of both children. The children both slept in a basement bedroom. Their father had installed a toilet in the basement 18 months prior to their presentation. The babysitter and the patient’s grandmother both developed similar symptoms after spending prolonged periods of time in the bedroom. Their symptoms resolved when they were away from the house. The mother recalled “a sewer” smell that had been present in the basement since her husband had installed a basement toilet. Professional inspection noted that the absence of a ”stack” to properly vent the toilet which was directly connected to the home septic tank. This left the basement air supersaturated with E. Coli. All the children’s symptoms resolved after the basement toilet was removed and the related drain sealed. It is presumed that the growth of E. Coli as well as exposure to sewer gas was responsible for their ENT and GI symptoms. Lundholm, M. et al. describe how sewer worker’s symptoms including skin disorders and diarrhea were directly related to the concentration of airborne gram-negative bacilli. As these children’s symptoms were directly related to exposure to an improperly vented sewage system and immediately resolved following corrective action, the most likely explanation was supersaturation. This should prompt Pediatricians to take a broader environmental history, particularly when multiple patients develop symptoms which are similar in character and time of onset. References Lundholm, M., & Rylander, R. (1983). Work related symptoms among sewage workers. Occupational and Environmental Medicine, 40(3), 325-329. Conclusions When confronted with a cluster of common symptoms in uncommon places, physicians should consider the possibility of environmental diseases. Funding Agencies None
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».