Cytological Assessment of Nuclear Abnormalities in the Buccal Epithelial Cells of Waste Handlers at ESUTH Teaching Hospital and ESUT College of Medicine Parklane, ENUGU, Nigeria

Background: Environmental and occupational exposures to hazardous agents are a growing public health concern, as they can cause genomic damage and increase the risk of developing long-term health problems. In regions like Enugu, Nigeria, waste handlers are particularly vulnerable to these exposures. The micronuclei (MN) assay, along with other nuclear abnormalities such as binucleated cells, nuclear buds, and karyorrhexis, serves as a reliable and minimally invasive biomarker for assessing this cellular damage Aim: This cross-sectional, observational, and analytical study was conducted at the Enugu State University Teaching Hospital and Enugu State University College of Medicine to investigate cytological abnormalities in the exfoliated buccal cells of waste handlers. Methods: A total of 60 participants were recruited, comprising 30 healthy controls and 30 waste handlers from three distinct groups: Enugu State Waste Management Authority (ESWAMA), hospital, and hostel. After obtaining ethical clearance and informed consent, buccal smears were collected, stained using the Papanicolaou procedure, and analyzed for nuclear abnormalities. Data were assessed using SPSS, with a significance level of p<0.05. Results: The results revealed that waste handlers, as a collective group, had significantly higher mean frequencies of micronuclei (p=0.00), binucleated cells (p=0.03), nuclear buds (p=0.00), and karyorrhexis (p=0.00) compared to the control group. Sub-group analysis showed that ESWAMA waste handlers exhibited the most severe cytological damage, with significantly elevated levels of all four nuclear abnormalities (p<0.001 for MN, BN, NB; p=0.01 for KH). Conversely, while hospital cleaners showed a significant increase in micronuclei (p<0.001), their rates of other nuclear changes were not statistically significant, and hostel cleaners showed no significant difference from the control group. Furthermore, lifestyle factors, including smoking and alcohol consumption, were independently associated with a significant increase in multiple nuclear abnormalities. Conclusion: These findings suggest that occupational exposure to waste, particularly for ESWAMA workers, poses a significant genotoxic risk and highlights the critical need for improved health and safety protocols for this population.