“…These observations were consistent with the reports of Ray et al (2005) among landfill workers, Heldal et al (2003) in waste handlers exposed to bioaerosols, Wouters et al (2002) in domestic waste collectors, and Poulsen et al (1995) in garbage collectors. It was observed during the course of this study that a sizeable number of WMWs seldom used personal protective equipment during the process of handling waste, which should predispose them to inhalation of large amount of biological aerosols already implicated in impairment of respiratory health (Adeyeba and Akinbo, 2002; Krajewski, 2001; Mbeng, 2009). A major problem in an occupational cross-sectional study is selection bias, especially the healthy worker effect (Östlin, 1989).…”