Occupational exposure to Brucella spp.: A systematic review and meta-analysis

PLoS Negl Trop Dis. 2020 May 11;14(5):e0008164. doi: 10.1371/journal.pntd.0008164. eCollection 2020 May.

Abstract

Brucellosis is a neglected zoonotic disease of remarkable importance worldwide. The focus of this systematic review was to investigate occupational brucellosis and to identify the main infection risks for each group exposed to the pathogen. Seven databases were used to identify papers related to occupational brucellosis: CABI, Cochrane, Pubmed, Scielo, Science Direct, Scopus and Web of Science. The search resulted in 6123 studies, of which 63 were selected using the quality assessment tools guided from National Institutes of Health (NIH) and Case Report Guidelines (CARE). Five different job-related groups were considered greatly exposed to the disease: rural workers, abattoir workers, veterinarians and veterinary assistants, laboratory workers and hunters. The main risk factors and exposure sources involved in the occupational infection observed from the analysis of the articles were direct contact with animal fluids, failure to comply with the use of personal protective equipment, accidental exposure to live attenuated anti-brucellosis vaccines and non-compliance with biosafety standards. Brucella species frequently isolated from job-related infection were Brucella melitensis, Brucella abortus, Brucella suis and Brucella canis. In addition, a meta-analysis was performed using the case-control studies and demonstrated that animal breeders, laboratory workers and abattoir workers have 3.47 [95% confidence interval (CI); 1.47-8.19] times more chance to become infected with Brucella spp. than others individuals that have no contact with the possible sources of infection. This systematic review improved the understanding of the epidemiology of brucellosis as an occupational disease. Rural workers, abattoir workers, veterinarians, laboratory workers and hunters were the groups more exposed to occupational Brucella spp. infection. Moreover, it was observed that the lack of knowledge about brucellosis among frequently exposed professionals, in addition to some behaviors, such as negligence in the use of individual and collective protective measures, increases the probability of infection.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Abattoirs / statistics & numerical data
  • Animals
  • Brucella / genetics
  • Brucella / isolation & purification
  • Brucella / physiology
  • Brucellosis / epidemiology*
  • Brucellosis / microbiology
  • Humans
  • Laboratory Personnel / statistics & numerical data
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / microbiology
  • Occupational Exposure / adverse effects
  • Veterinarians / statistics & numerical data

Grants and funding

This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (http://cnpq.br/), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) (https://www.capes.gov.br/) and Fundação de Amparo à Pesquisa do Estado de Minas Gerais (Fapemig) (https://fapemig.br/pt/). APL, LJP and MGZ are greatful to CNPq for their fellowships. CRP thanks Fapemig for her fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.