Background:The adverse health effects associated with mass burn incineration are of great concern as large population groups and workers may be exposed to derived toxic substances. Objectives: 1) determining some of the immunological, reproductive, and cytogenetic changes among workers exposed to waste incineration emissions at the waste incineration area of the compost fertilizer plant in Zagazig City, 2) determining the blood lead levels of the studied workers, and 3) assessing airborne particulate matter concentrations at the open dump and waste incineration area. Subjects and methods: This comparative cross-sectional study was conducted on 42 waste incineration workers, who were exposed to waste incineration emissions at the compost fertilizer plant in Zagazig City and a non-exposed control group (51 workers from 2 sweet factories). All workers were subjected to questionnaires, clinical examinations, and laboratory investigations, that included blood lead levels estimation, immunoglobulins estimation, flow cytometric analysis, and conventional cytogenetic of the respirable particulate matter in the open dump and waste incineration area was 0.47 mg/m 3 , which exceeds its threshold limit value (TLV). Conclusion and recommendations: unprotected occupational exposure to waste incineration emissions can cause serious immunological, reproductive, and cytogentic changes. So, a well designed control program is recommended, which should include; avoiding open burning of waste products and promote the use of non-incineration treatment technolo-gies, using incinerators equipped with proper emission control system, continuous environmental and biological monitoring for lead, particulate matter, and other hazardous materials, using immune system parameters, semen quality, and chromosomal aberrations as biomarkers of effect in such workers, and using suitable protective equipment during work.

This study was carried out in a slaughterhouse in Zagazig City during the year 2005-2006 among a group of 115 slaughterhouse workers selected randomly and performing sustained intensive manual work. Another group of 80 clerks working in Zagazig Faculty of medicine performing light manual work was selected randomly as a control group.The study was done in 2 stages : The 1st stage was a comparative cross-sectional study, aiming to determine the prevalence of shoulder impingement syndrome ( SIS) among the study workers.The 2nd stage was an intervention study, done to assess the effect of exercise and manual physical therapy program on shoulder function among workers with shoulder impingement syndrome. A total number of one-hundred and ninety five workers were interviewed using a preconstructed questionnaire. Those workers who had recurrent 144 El-Laithy N. et. al shoulder pain during the previous 3 months or more were subjected to standardized physical examination using impingement sign, assessment of shoulder function and magnetic resonance imaging to those clinically diagnosed as SIS. Also an intervention program of exercise and manual therapy for a period of 6-weeks was carried out to those workers with SIS.The results revealed that the prevalence of SIS was higher among the slaughterhouse workers (13.9 % ) compared to the control workers(2.5%). SIS symptoms and signs were more frequently recorded among the slaughterhouse workers when compared with the controls. Also among those currently complaining of SIS symptoms or those who has had SIS signs, only 15.6% and 2.5% have positive impingement sign among slaughterhouse workers and their controls respectively.The most reliable findings of magnetic resonance imaging were the presence of indentations upon the subacromial fat denoting impingement in 12 patients (66.7%), supraspinatus tendonitis with indentation upon subacromial fat denoting impingement in 4 patients (22.2%) & left supraspinatus tear in 2 patients (11.1%) from 18 slaughterhouse workers diagnosed clinically as SIS and supraspinatus tendonitis with impingement in 2 patients (100.0%) from the control group with a total percentage of 13.9% and 2.5% workers with SIS among slaughterhouse workers and their controls respectively. Studying some personal and occupational factors thought to be related to the prevalence of SIS revealed that, SIS was prevalent in middle aged workers who smoke and were worked in the current occupation for more than ten years.The results of the intervention program illustrated that there were significant improvement in range of motion, pain, strength and function of the shoulder in workers with SIS after 6-weeks of exercise and manual physical therapy program.In conclusion, sustained intensive manual work such as in slaughterhouse workers was associated with high frequency of SIS. A 6 week exercise with manual physical therapy program in patients with SIS was resulted in improvement of range of motion, pain and function of the shoulder. So, work organization especially reduction of e...