Occupational Risk Factors for Seropositive Leptospirosis among Town Service Workers in Northeastern Malaysia

Mohd Nazri Shafei, Mohamad Azfar Zainuddin, Nor Azwany Yaacob, Zahiruddin Wan Mohammad, Nabilah Awang, Siti Asma’ Hassan, Fairuz Amran, Aziah Daud
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Abstract

Leptospirosis is speculated to be one of the most prevalent re-emerging zoonotic diseases to date, and town service workers are continuously exposed to occupational hazards that may increase their risk of infection. This study aimed to determine the occupational risk factors for leptospirosis among town service workers in northeastern Malaysia. A cross-sectional study was conducted among town service workers from four municipal councils. All sera samples were tested for the presence of anti-leptospiral antibodies using an enzyme-linked immunosorbent assay (ELISA) followed by a microscopic agglutination test (MAT). We found that 82 serum samples from 321 respondents were positive in the MAT (seroprevalence rate of 25.5%). Multiple logistic regression analysis identified overtime work (adj. OR 2.13; 95% CI 1.19, 3.84), contact with animals while working (adj. OR 2.09; 95% CI 1.06, 4.11), sighting of rats at the worksite (adj. OR 2.17; 95% CI 1.11, 4.25) and living less than 200 m from a river (adj. OR 1.84; 95% CI 1.03, 3.28) as risk factors for leptospiral infection. Whereas age (adj. OR 0.95; 95% CI 0.93, 0.98), wearing boots while working (adj. OR 0.44; 95% CI 0.25, 0.80) and washing hands with soap after work (adj. OR 0.20; 95% CI 0.10, 0.42) were recognised as protective factors. In conclusion, an association was observed between leptospirosis seropositivity among town service workers and the occupational factors. Prevention and control strategies for leptospirosis will require more focus on curbing the possible sources of leptospirosis transmission and maintaining safe work practices in high-risk working environments.
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马来西亚东北部城镇服务人员血清阳性钩端螺旋体病的职业危险因素
据推测,钩端螺旋体病是迄今为止最普遍的再次出现的人畜共患疾病之一,城镇服务工作者持续暴露于可能增加其感染风险的职业危害中。本研究旨在确定马来西亚东北部城镇服务人员钩端螺旋体病的职业危险因素。对来自四个市议会的城市服务人员进行了一项横断面研究。采用酶联免疫吸附试验(ELISA)和显微凝集试验(MAT)检测所有血清样本是否存在抗钩端螺旋体抗体。我们发现321名应答者的82份血清样本MAT阳性(血清阳性率为25.5%)。多元逻辑回归分析发现加班(adj. OR 2.13;95% CI 1.19, 3.84),工作时接触动物(OR 2.09;95% CI 1.06, 4.11),在工作场所发现大鼠(OR 2.17;95%可信区间1.11,4.25),居住在距离河流不到200米的地方(形容词OR 1.84;95% CI 1.03, 3.28)为钩端螺旋体感染的危险因素。而年龄(adj. OR 0.95;95% CI 0.93, 0.98),工作时穿靴子(形容词OR 0.44;95%置信区间为0.25,0.80)和下班后用肥皂洗手(相对值或比值为0.20;95% CI 0.10, 0.42)被认为是保护因素。综上所述,城镇服务人员钩端螺旋体病血清阳性率与职业因素存在相关性。钩端螺旋体病的预防和控制战略将需要更加注重遏制钩端螺旋体病可能的传播来源,并在高风险工作环境中保持安全的工作做法。
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