Association between exposure to airborne norovirus and gastroenteritis (Aerosol exposure)

  • Pedersen, Karl (Project Manager)
  • Schultz, Anna Charlotte (Project Participant)
  • Uhrbrand, Katrine (Project Participant)
  • Madsen, Anne Mette (Project Participant)
  • Kølsen Fischer, Thea (Project Participant)
  • Fonager, Jannik (Project Participant)

Project Details



Workers at wastewater treatment plants (WWTPs) frequently report episodes of acute gastroenteritis. It has previously been shown that WWTP workers are exposed to high levels of airborne human norovirus. It is believed that virus particles and endotoxin is inhaled and subsequently swallowed to reach the intestine. However, whether there is a direct link between this exposure and the increased risk of acute gastroenteritis has not been established. In the present study, we will examine the relation between exposure to airborne aerosolized pathogens and acute gastroenteritis among sewer workers in a prospective cohort design using identification, quantification and phylogenetic analyses of pathogens in air and human stools from symptomatic and asymptomatic WWTP workers. Airborne exposure to norovirus and other enteric viruses as well as bacterial endotoxins will be studied, and modern technology such as sequencing and bioinformatics will be employed. The study is unique in its cross-disciplinary collaborative platform, which involves both working environment, food and environmental virology, and human medical viral molecular epidemiology. The present project will contribute with new important knowledge on the transmission routes of norovirus and the extent of occupational exposure to airborne norovirus. It will be investigated whether exposure to airborne norovirus is a contributing cause of the acute gastroenteritis reported among workers at WWTPs. The results are expected to provide knowledge to facilitate the use of proper interventions to reduce risk of illness following aerosolized viral exposure.


The overall objectives of this project is to investigate whether and to what extent exposure to airborne bacterial endotoxin, and to human norovirus, sapovirus or rotavirus contributes to the over-representation of gastrointestinal problems, which is known to occur among workers at wastewater treatment plants. During the project we will characterize the exposure of workers to these agents, identify the sources of exposure, and thereby provide the requirements for protecting workers from the most problematic work processes. Ultimately this will lead to reduced frequency of gastrointestinal symptoms among workers at wastewater treatment plants.

Project financing

Research and Innovation -

Danish Council for Independent Research
AcronymAerosol eksponering
Effective start/end date01/07/201331/10/2016

Collaborative partners

  • Technical University of Denmark (lead)
  • Technical University of Denmark (Project partner)
  • National Research Centre for the Working Environment (Project partner)
  • Statens Serum Institut (Project partner)


  • Norovirus
  • Aerosols
  • Exposure
  • Sewage water


Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.