P-1222 - Comparison of LUR, satellite LUR and Bayesian NO2 exposure measures on effect estimates of respiratory and allergic disease in a children’s cohort
Abstract Control Number
2435
Abstract Body
Background/Aim Effect estimates in air pollution epidemiology studies can vary depending on the exposure method used, due to error. We aimed to compare estimates for respiratory outcomes in a childhood cohort using three exposure methods. Methods We used: an intra-city land use regression (LUR) model; a national satellite-LUR (Sat-LUR) model; and a regional Bayesian blended model (BME); to estimate annual mean NO2, a marker of traffic pollution, for 398 children (8 years) from the Childhood Asthma Prevention Study, Sydney. We collected questionnaire information on current asthma, wheeze, eczema, and rhinitis, and measured spirometry (FEV1, FVC, airway hyper-responsiveness (AHR)), exhaled nitric oxide (eNO), and atopy. We used logistic and linear regression to analyse binary and continuous variables respectively. Adjusted models included covariates chosen using directed acyclic graphs: sex; father’s education; gas cooking; and environmental tobacco smoke. Results The annual NO2 means from LUR, Sat-LUR and BME models were 7.64 (SD 1.82), 8.77 (1.96) and 8.37 (1.81) ppb respectively. We generally found similar and non-significant (NS) effect estimates for most health outcomes across the three exposure methods after adjustment, with a few variations. We found significantly increased OR for any atopy (1.30 (1.02, 1.68)) and house dust mite atopy (1.35 (1.05, 1.74)) for LUR, and increased but NS effects for Sat-LUR and BME. Conversely, ORs were higher for current asthma for BME 1.31 (0.91, 1.69) than for Sat-LUR 1.24 (0.91, 1.68) or LUR 1.08 (0.82, 1.42) (all NS). Estimates for AHR were similarly increased with ORs varying from 24% (LUR) to 27% (BME), although NS. Conclusions Use of the three exposure measures resulted in similar effect estimates, albeit with subtle variations, illustrating the importance of exposure derivation. It is unclear which measure is most accurate and choice will depend on geography of models and cohorts and confidence in model inputs.
P-0992 - Long-term impact of PM2.5 on health in the city of Korhogo (Côte d’Ivoire, West africa)
Abstract Control Number
1692
Abstract Body
Background/ Aim Air quality and it impacts capture more attention of governments and public opinion. Indeed, air pollution has consequences on the health of populations. Epidemiological studies contributed much to the understanding of the effects. In order to understand this, an epidemiological study was done in the regional hospital of Korhogo in regards to the PM 2.5 concentration levels in the city. The objective of this study was to assess the impact of PM2.5 concentration on health in Korhogo, with special attention to cardiorespiratory and skin diseases. Methodology All subjects coming to consultation in the regional hospital of Korhogo were selected in relation to the lungs, skin, and heart symptoms for 3 months beginning from December 2018 to March 2019. Patients to include were identified by a Medical Doctor tthrough a questionnaire after their informed consent. The relationship between exposure to air pollution and health was done through time series. The main outcomes of the study were the incidence of cardiorespiratory and skin diseases (95% CI) and the indicator of health impact. An existence of a significant relationship between exposure to air pollution and health outcomes was done. Results The preliminary results showed that 3410 patients consulted a physician during the 3 months visits in the regional hosptal of Korhogo. Within those patients, 527 (17.46%) were recruted for pollution issues. More than 95% of the patients had cardiopulmonary diseases in the city of Korhogo. The average of PM2.5 concentration was higher than the daily recommended by WHO. A strong relationship was seen to be associated to cardiopulmonary disease in that regional hospital Conclusion The average of PM2.5 concentration was higher than the daily recommended by WHO. A strong relationship was seen to be associated to cardiopulmonary disease in that regional hospital Where a special attention should be taken for patients
P-0812 - Factors influencing household organophosphate pesticide levels in agricultural communities
Abstract Control Number
2823
Abstract Body
Background Organophosphate (OP) pesticide exposure is associated with various cancers, neurodegenerative diseases, and respiratory health outcomes. Proximity to agricultural operations and direct occupational contact are hypothesized to be important routes of exposure. Understanding these routes and exploring methods to estimate exposure will improve epidemiological studies, especially among agricultural communities where pesticide exposure due to drift and indirect contact is disproportionally high. To understand factors that influence household environmental exposures to OPs, we collected dust samples from homes in the Central Valley of California. We hypothesized that OP levels would be higher among samples collected during the agricultural spraying season and from homes in which a household member worked in agriculture. Methods Household dust samples were collected using a high-volume small surface sampler during the agricultural spraying (June) and non-spraying (January) seasons from 28 households located within 200 feet of agricultural fields. T-tests and paired t-tests were conducted to assess differences in total OP levels by occupational status and spraying season. Results A total of 50 samples were analyzed for the presence of OPs. Homes in which a household member worked in agriculture had significantly higher OP levels (130.0 parts per billion (ppb), SD 168.5), compared to homes without anyone working in agriculture (28.7 ppb, SD 24.2; p-value=0.001). No statistically significant differences were detected by spraying season (t=0.41, p-value = 0.69). Conclusions Our results demonstrate that detectable levels of OPs are prevalent in households within 200 feet of agricultural fields. Additionally, OPs may persist indoors for extended periods of time. Although the California Pesticide Use Registry indicates that OP application in our study area is seasonal, dust samples had similar levels across seasons. Our work will inform future research by revealing important factors related to routes of exposure to harmful pesticides experienced by agricultural workers and their families.
P-0866 - Associations ofPerfluoroalkyl Substances withIncident Natural Menopause: the Study of Women’s Health Across the Nation
Abstract Control Number
2279
Abstract Body
Context: Previous epidemiologic studies of per- and polyfluoroalkyl substances (PFAS) and menopausal timing conducted in cross-sectional settings were limited by reverse causation because PFAS serum concentrations increase after menopause.
Objectives: To investigate associations between PFAS serum concentrations and incident natural menopause.
Design and Setting: A prospective cohort of midlife women, the Study of Women’s Health Across the Nation, from 1999 to 2017.
Participants: 1120 multi-racial/ethnic premenopausal women (White, Black, Chinese and Japanese) aged 45-56 years in 1999-2000.
Methods: Serum PFAS concentrations were measured using an online solid phase extraction-high performance liquid chromatography-isotope dilution-tandem mass spectrometry. The final menstrual period was determined during the annual follow-up visits. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared to the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95%CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend=0.03), 1.27 (95%CI: 1.01-1.59) for branched-PFOS (Ptrend=0.03), and 1.31 (95%CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend=0.01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared to the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.44-1.84), which is interpreted as 2.0 years earlier experience of natural menopause.
Conclusion: This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
Objectives: To investigate associations between PFAS serum concentrations and incident natural menopause.
Design and Setting: A prospective cohort of midlife women, the Study of Women’s Health Across the Nation, from 1999 to 2017.
Participants: 1120 multi-racial/ethnic premenopausal women (White, Black, Chinese and Japanese) aged 45-56 years in 1999-2000.
Methods: Serum PFAS concentrations were measured using an online solid phase extraction-high performance liquid chromatography-isotope dilution-tandem mass spectrometry. The final menstrual period was determined during the annual follow-up visits. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared to the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95%CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend=0.03), 1.27 (95%CI: 1.01-1.59) for branched-PFOS (Ptrend=0.03), and 1.31 (95%CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend=0.01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared to the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.44-1.84), which is interpreted as 2.0 years earlier experience of natural menopause.
Conclusion: This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
P-0732 - Influence of nutrient intake and AS3MT polymorphisms on the association between type 2 diabetes mellitus and arsenic metabolism among women from Northern Mexico
Abstract Control Number
1988
Abstract Body
Background/Aim: Ingested inorganic arsenic (iAs) is eliminated through urine mainly as monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). %MMA and the primary methylation ratio [PMR] (MMA/iAs), have been negatively associated with type 2 diabetes mellitus (T2DM). iAs metabolism is also related to arsenic exposure magnitude, genetic and dietary factors, that may influence the relationship between iAs and T2DM, however, insufficient evidence is available. Our aim was to assess T2DM association with iAs metabolism, considering the dietary intake of selected micronutrients (methionine, choline, folate, selenium and vitamin B12) and polymorphisms (AS3MT Met287Thr and AS3MT G12390C). Methods: We conducted a cross-sectional study with 227 diabetic women matched by age (±5 years) with two non-diabetics (n=454). They were identified in a population-based control group of a previous breast cancer study in northern Mexico. Women were interviewed with a validated semi-quantitative food frequency questionnaire. Urinary arsenic metabolites were measured by High Performance Liquid Chromatography coupled with mass spectrometry and iAs metabolism was assessed by metabolites percentages and ratios. Genotypes were determined by allelic discrimination. Results: Total urinary arsenic (TAs) ranged from 1.24 to 99.97 µg/L. Diabetics had significantly lower %MMA, PMR, choline and selenium intake than non-diabetics. TAs, %Asi+3, %Asi+5, %DMA, second methylation ratio [SMR] (DMA/MMA) and selected polymorphisms were not significantly different between diabetics and non-diabetics. We did not find an association between T2DM and iAs metabolism. Polymorphisms and dietary variables of interest did not modify nor confuse the potential association assessed. Other T2DM co-factors, such as hypertension and waist-hip ratio were significantly associated with T2DM (ORHypertension YesvsNo: 3.50, 95%CI: 2.46, 4.97; ORWaist-hip ratio >0.91vs≤0.91: 1.97, 95%IC: 1.37, 2.82). Conclusions: Our findings do not support an association between iAs metabolism and T2DM, but it is important to reduce the exposure considering iAs has been considered a risk factor for cancer and cardiovascular diseases.
P-0722 - Road traffic noise exposure and annoyance in two large cities in Slovakia
Abstract Control Number
3324
Abstract Body
Backgroud. Environmental noise has attracted widespread attention in recent decades as a major environmental health concern. In Slovakia, the rapid development in traffic density connected with the economic transformation since 1990 has brought new problems in relation to environmental noise, particularly road traffic noise. Aim. The aim of the study was to determine the impact of environmental noise on the psychosocial well-being of young healthy individuals in the two largest Slovak urban agglomerations Bratislava and Kosice and to assess and to compare noise annoyance as the most prevalent community response. Methods. The validated ICBEN methodology was used to assess noise annoyance, interference with activities and sleep disturbance; noise levels were objectified by direct measurement using sound level analyzer with a module for frequency analysis. The source population in Bratislava (533 respondents, 155 males) and Kosice (355 respondents, 111 males) who filled the anonymous validated “Noise annoyance questionnaire was composed of young adults in the age category from 20-30 years old. Results. The results showed that in both cities most of the subjects were in the medium noise exposure category (LAeq, 24h=≥ 60 dB). In Bratislava there were 27.82 % of respondents in the higher noise exposure category (LAeq, 24h =≥ 70 dB) and in Košice there were 39.9 % of respondents in the lower noise exposure category (LAeq, 24h=≥ 50 dB). Traffic noise annoys respondents especially in the higher noise exposure category in Bratislava (63.51 %) and interferes with reading and mental work, sleep and falling asleep even in the lower noise exposure category in Kosice (46.51 %). Conclusion. This study has shown the traffic noise as the environmental problem in large cities and emphasizes the need of protection of the possible vulnerable groups, especially during night-time.
P-0725 - Dietary Fiber Intake and Urinary Creatinine: Methodological Implications for Epidemiological Studies
Abstract Control Number
1532
Abstract Body
Background/Aim: Creatinine is used to estimate renal function and to correct for urinary dilution. However, urinary creatinine (UCR) is determined by genetic, morphological, and lifestyle characteristics that should be accounted for to increase comparability throughout epidemiological studies. Recently, dietary fiber has been proposed as a mediator of renal function. The aim of this study was to evaluate the relationship between dietary fiber and UCR, with an eye towards methodological implications for studies that utilize UCR-corrected measurements.
Methods: Available information regarding UCR, dietary fiber intake, age, and other UCR-related factors were analyzed in 801 women residing in Northern Mexico.
Results: Using linear regressions, we estimated a significant age-adjusted increase of 10.04 mg/dL UCR for a 10 g/day increase in dietary fiber intake.
Conclusion: Our results suggest that epidemiological studies should adjust UCR by dietary fiber intake in order to improve comparability of studies and overall accuracy.
Methods: Available information regarding UCR, dietary fiber intake, age, and other UCR-related factors were analyzed in 801 women residing in Northern Mexico.
Results: Using linear regressions, we estimated a significant age-adjusted increase of 10.04 mg/dL UCR for a 10 g/day increase in dietary fiber intake.
Conclusion: Our results suggest that epidemiological studies should adjust UCR by dietary fiber intake in order to improve comparability of studies and overall accuracy.
P-0329 - A Systematic Review on Lagged Association in Environmental Studies
Abstract Control Number
1723
Abstract Body
The delayed association in environment-health studies has been acknowledged in recent years. However, the misspecification of lag dimension in time-series models, particularly distributed lag non-linear models (DLNM), would induce considerable deviation of effect estimate. This study reviewed the existing climate-health English literature with time-series and case-crossover design published during 2000-2019 to summarize the statistical methodologies used and the reported delays of association between meteorological variables and 14 common causes of morbidity and mortality. Generalized linear or additive model was the most widely employed method for regression analysis. Different types of lag design were adopted for infectious disease modeling, including cross-correlation analysis, single lag model, moving average lag model, unconstrained or polynomial distributed lag model, and DLNM, whereas studies on non-communicable diseases predominantly used DLNM to assess the delays of association. For infectious outcomes, the association of daily mean temperature was found to be lagged for one to two weeks for influenza, followed by two to five weeks for diarrhea, and eight to twelve weeks for dengue fever. Meanwhile, the association of both cardiovascular and respiratory diseases with hot temperatures lasted for less than five days, whereas the association of cardiovascular diseases with cold temperatures was observed for ten to twenty days. Additionally, rainfall, as a potential risk factor for infectious diseases, showed a four to eight weeks’ lagged association with diarrheal diseases, while the effect was further delayed to eight to twelve weeks for vector-borne diseases. This is the first systematic review that comprehensively provides epidemiological evidence on the delay of association of common meteorological parameters. Biologically plausible and reasonable definition of effect lag in the modeling process is warranted in further environmental epidemiological studies.
P-0909 - Systematic Review on the Health Effects of Long-term Exposure to Nontailpipe Traffic Emissions
Abstract Control Number
2563
Abstract Body
With reductions in tailpipe emissions of particulate matter, there is an increasing interest in public health impacts of non-tailpipe emissions, specifically tire and brake wear and road dust. Following its well-cited 2010 critical review, a new Health Effects Institute (HEI) expert panel is conducting a systematic review of the epidemiological literature on the health effects of long-term exposure to TRAP, including non-tailpipe emissions. The Panel is using a systematic approach to search the literature, assess study quality, summarize results, and reach conclusions about the body of evidence. They developed a review protocol and registered it in Prospero. An extensive search was conducted of literature published between January 1980 and July 2019. Selected health outcomes include all-cause and cause-specific mortality, respiratory effects, cardiovascular effects, diabetes, and birth outcomes. In addition, the Panel has developed an exposure framework to guide the selection and evaluation of epidemiological studies on TRAP. The review is now well underway, and preliminary results will be presented. After a broad search identifying 1100 studies potentially relevant to the broader review, the panel included 14 studies reporting both relevant health outcomes and epidemiological results for non-tailpipe pollutants. Effect estimates were reported for all-cause mortality (3 papers), circulatory mortality (1 paper), cardiovascular effects (2 papers), respiratory effects (3 papers), and neurodevelopment in children (2 papers). Ten of the papers evaluated effects of copper (Cu) and iron (Fe); others evaluated only Cu (2 papers) or non-exhaust PM2.5 mass (2 papers). Further evaluation of these papers will inform future research questions related to health effects of non-tailpipe emissions from motor vehicles.
P-1230 - Respiratory Outcomes in an Environmental Justice Community Near Urban Oil Drilling
Abstract Control Number
2666
Abstract Body
Background/Aim: Los Angeles, California is the largest urban oil field in the country and home to thousands of active oil wells in very close proximity to homes, schools and parks, yet little is known about potential health impacts. In this study, we used community-driven methodology to assess respiratory health among community residents living within 500 m of either an active or idle oil well in the Las Cienagas oil field in South Los Angeles. Methods: A cross-sectional community-based study was conducted between January 2017 and August 2019 near two oil wells in the Las Cienagas oil field. We collected acute health symptoms and measured FEV1 (forced expiratory volume in the first second of exhalation) and FVC (forced vital capacity). We related lung function measures to distance and direction from active or idle oil site using generalized linear models adjusted for covariates. Results: A total of 919 residents with valid spirometry measurements living <1000 m from an active or idle oil well were included in this analysis. Adjusting for freeway distance, on average, participants near the active oil site had lower percent predicted FVC (-13.9%, p=0.047) and lower percent predicted FEV1 (-11.6%, p=0.09) as compared to residents near the idle site. Among only residents near the active site, we observed that residents living downwind and <200m from the active well have significantly lower FEV1 (-.42L, p<0.001) compared to residents living upwind after controlling for age, height, race/ethnicity, sex and distance to freeway. Among residents near the idle site, we observed no significant differences based on proximity or direction. Conclusions: Living nearby and downwind of active urban oil drilling sites is associated with lower lung function among residents, which may contribute to environmental health disparities.
P-0175 - Short-term effects of particulate matter concentrations on Pulmonary Embolism and Deep Vein Thrombosis at national level in Italy
Abstract Control Number
2118
Abstract Body
Background: Several studies reported a link between increases of particulate matter (PM) air pollution and cardiovascular diseases. However, only few reported consistent associations with Venous Thromboembolism (VTE), i.e., Pulmonary Embolism (PE) and Deep Vein Thrombosis (DVT), the third most frequent cardiovascular disease. Our aim was to estimate the association between hospital admissions for these clinical manifestation of VTE and PM concentrations at the national level in Italy.
Methods: We collected all hospital discharges during 2006-2015 from the Italian Ministry of Health. Daily counts of VTE, PE and DVT admissions in all the 8,094 municipalities were merged with daily and concentrations estimated by a satellite-based spatiotemporal model. First, we applied multivariate Poisson regression models at province level; then, we aggregated results by random-effects meta-analysis and obtained the overall effect at national level. We analyzed each outcome at different temporal latencies (lags), in the warm period (defined as April to September) and in the main urban areas.
Results: Analysis were conducted on 432,245 VTE hospitalizations (PE= 219,952; DVT= 275,506). National daily mean (standard deviation) concentrations of and were 23 (14) and 17 (12) , respectively. Meta-analytical results showed weak associations between PM concentrations and the study outcomes in the full year analysis. During the warm season and in the main urban areas, the daily relative increase of VTE admissions per 10 increment in same day was 3.4% (95% Confidence Intervals [CI]: -0.01; 6.93). Corresponding estimate for PE and DVT were 3.9% (95% CI: -0.51; 8.68) and 1.4% (95% CI: -2.61; 5.50).
Conclusions: This is the first study conducted in Europe to investigate the association between air pollutants and PE-DVT at national level. We found an immediate effect of on VTE only during the warm months and in the main urban areas.
Methods: We collected all hospital discharges during 2006-2015 from the Italian Ministry of Health. Daily counts of VTE, PE and DVT admissions in all the 8,094 municipalities were merged with daily and concentrations estimated by a satellite-based spatiotemporal model. First, we applied multivariate Poisson regression models at province level; then, we aggregated results by random-effects meta-analysis and obtained the overall effect at national level. We analyzed each outcome at different temporal latencies (lags), in the warm period (defined as April to September) and in the main urban areas.
Results: Analysis were conducted on 432,245 VTE hospitalizations (PE= 219,952; DVT= 275,506). National daily mean (standard deviation) concentrations of and were 23 (14) and 17 (12) , respectively. Meta-analytical results showed weak associations between PM concentrations and the study outcomes in the full year analysis. During the warm season and in the main urban areas, the daily relative increase of VTE admissions per 10 increment in same day was 3.4% (95% Confidence Intervals [CI]: -0.01; 6.93). Corresponding estimate for PE and DVT were 3.9% (95% CI: -0.51; 8.68) and 1.4% (95% CI: -2.61; 5.50).
Conclusions: This is the first study conducted in Europe to investigate the association between air pollutants and PE-DVT at national level. We found an immediate effect of on VTE only during the warm months and in the main urban areas.
P-0575 - Intestinal Parasitism and Associated Risks in a University Dinning Hall Food Handlers
Abstract Control Number
1814
Abstract Body
Background
Various studies have addressed the relationship between intestinal parasitism and associated risk factors in food handlers. Very few studies have done in Ethiopia in general and none exist in Wachemo town, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and related risks among food handlers of Wachemo University students’ cafeteria.
Methods
Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from February-March, 2019. Structured and pre-tested questionnaire was used to collect data on socio-demographic and related risk factors. Standard laboratory procedures were employed to collect stool and finger specimens and analyzed for intestinal parasites using standard methods. The data were entered into a computer, edited and analyzed using SPSS for windows version 20.0. Stepwise logistic regression model was used to calculate the Odds ratios and 95% confidence interval for the different risk factors.
Results
From 212, the majority 63.7 % were females and 48.1% attended grades 9-10. Of the stool and finger nail specimens examined, about 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbercoids (12.7%) followed by Hookworms (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and Mixed infection (3.3%). Although several factors showed significant association with intestinal parasitism on bivariate analysis, sex, education, finger nail status and hand washing with soap and water after toilet use were the only significant variables on multivariate analysis (P< 0.05).
Conclusions
Though prevalence of intestinal parasites among food handlers is moderate, still appropriate intervention programmes need to be formulated focused on identified risk factors to avoid further infection transmission to students and the general population.
Various studies have addressed the relationship between intestinal parasitism and associated risk factors in food handlers. Very few studies have done in Ethiopia in general and none exist in Wachemo town, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and related risks among food handlers of Wachemo University students’ cafeteria.
Methods
Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from February-March, 2019. Structured and pre-tested questionnaire was used to collect data on socio-demographic and related risk factors. Standard laboratory procedures were employed to collect stool and finger specimens and analyzed for intestinal parasites using standard methods. The data were entered into a computer, edited and analyzed using SPSS for windows version 20.0. Stepwise logistic regression model was used to calculate the Odds ratios and 95% confidence interval for the different risk factors.
Results
From 212, the majority 63.7 % were females and 48.1% attended grades 9-10. Of the stool and finger nail specimens examined, about 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbercoids (12.7%) followed by Hookworms (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and Mixed infection (3.3%). Although several factors showed significant association with intestinal parasitism on bivariate analysis, sex, education, finger nail status and hand washing with soap and water after toilet use were the only significant variables on multivariate analysis (P< 0.05).
Conclusions
Though prevalence of intestinal parasites among food handlers is moderate, still appropriate intervention programmes need to be formulated focused on identified risk factors to avoid further infection transmission to students and the general population.