Occupations at Increased Risk of Hepatitis A: A 2-Year Nationwide Historical Prospective Study

Abstract

The recent licensing of active hepatitis A vaccines raises the question of vaccine candidates. Although various groups of workers are at theoretical occupational risk of hepatitis A infection, no comprehensive quantitative data exist to determine which occupational groups should receive active vaccination. Therefore, the aims of this study were to identify occupations at risk for hepatitis A infection and to determine their relative risk. In this nationwide historical prospective study, the relative risk of hepatitis A among different occupations in Israel was determined according to the incidence of hepatitis A in different occupations during 1993 and 1994 compared with the incidence of hepatitis A in two standard populations. After age, gender, ethnicity, and time of immigration to Israel were controlled for, certain occupations showed a significant increased risk of hepatitis A: yeshiva students (standardized incidence ratio (SIR) = 9.98, 99% confidence interval: 7.55, 13.18), day care center and kindergarten staff (SIR = 5.47, 99% confidence interval: 3.50, 8.57), food industry workers (SIR = 5.41, 99% confidence interval: 1.92, 15.25), teachers (SIR = 4.02, 99% confidence interval: 2.92, 5.48), physicians and dentists (SIR = 3.77, 99% confidence interval: 1.78, 8.14), and therapists and medical technicians (SIR = 3.75, 99% confidence interval: 1.75, 8.14). Sewage workers and nurses did not show any significantly increased risk. The results were validated by comparison with an additional standard population. This first nationwide study identified occupations at risk of hepatitis A infection. It emerged that the authors' approach can provide a yardstick for measuring samples in both large and small countries that have a socioeconomic background similar to that of Israel.

Seroprevalence of Hepatitis A and Associated Socioeconomic Factors in Young Healthy Korean Adults

“…Seroprevalence of HAV in children increases with lower levels of parental education; 6 physicians, dentists, therapists and paramedical workers were reported to have a high risk of hepatitis A in a previous study. 23 In the current study, a low educational level and participants in occupational group B such as farmers, students, soldiers, guards, employees, and retailers were at high risk for HAV-seropositivity, however, these differences were not statistically significant. The different criteria used for educational and occupational classification in studies might explain the inconsistent results.…”

Hepatitis A: Old and New

“…A swimming pool with potential sewage contamination was implicated as the common source in another (157). Hepatitis A is considered an occupational hazard for sewage workers in some countries (65) but not in Israel or the United States (150,247). HAV was detected in the final effluent from wastewater treatment plants in the Mediterranean (71), demonstrating a potential source for seafood contamination.…”

Arbeidsgebonden gezondheidsrisico’s voor tandartsassistenten in Vlaanderen

“…Via patiënten kan men besmet worden met biologische agentia zoals virussen (influenzavirus, hepatitis-B-virus (HBV), hepatitis-C-virus (HCV), humaan immunodeficiëntievirus (hiv), herpessimplexvirus-type 1 (HSV-1) en bacteriën (Corynebacterium diphtheriae, Bordetella pertussis en Mycobacterium tuberculosis). Ook kan men blootstaan aan ioniserende straling bij het nemen van röntgenopnamen (Sepkowitz, 1996;Piirilä et al, 1998;Lerman et al, 1999;Bol, 2001;Ohlson en Svensson, 2002;Bouard et al, 2003;Zielinski et al, 2005;Huber et al, 2006;Cleveland et al, 2007). Additionele risico's houden verband met ergonomische factoren, zoals langdurig staand werken en een asymmetrische werkhouding, en psychosociale factoren, zoals stress, hoge werkdruk en agressie (Rice et al, 1996;Finsen et al, 1998;Plasschaert, 1999;Lulamandier en McPhee, 2001;Lindfors et al, 2006).…”