Occupational hepatitis B virus infection in sewage workers

In a cross-sectional study the employees of a Sewage Company were tested for hepatitis B virus (HBV) markers--HBsAg, anti-HBs, anti-HBc--to determine the prevalence of HBV infection and assess the risk of exposed sewage workers becoming infected, so as to evaluate the necessity for appropriate vaccination. The overall prevalence of HBV markers was 43.9% and 6.6% of the employees were HBsAg carriers. In the univariate analysis the prevalence of past and current infection was significantly associated with exposure to sewage (p < 0.001), age (p < 0.001) and with educational level (p < 0.001). However, the logistic regression analysis confirmed that only exposure to sewage was independently associated with positivity for HBV infection (p < 0.001). Workers exposed to sewage should therefore be considered for vaccination against hepatitis B virus.     

Occupational hazards of municipal solid waste workers

The removal of municipal solid waste is a job associated with a variety of physical, chemical, and biological hazards. Municipal solid waste workers (MSWWs) have a risk of fatal occupational injuries that is much higher than for the general workforce. Among this group of workers, non-fatal injuries are mainly musculoskeletal. Other common injuries are fractures, ocular trauma, and bites, and diseases include skin and gastrointestinal disorders. Workers at municipal solid waste incinerators are exposed to a variety of concerning substances, such as heavy metals, respirable quartz dust, dioxins, furans, and mutagens. Workers can be protected by using safety procedures on and around garbage trucks and with personal protective equipment. The burden of morbidity due to occupational exposure to bioaerosols and carcinogens among MSWWs is unknown.     

The prevalence of serological markers to hepatitis A and hepatitis B in drug abuse personnel

A seroepidemiologic survey was conducted in 25 clinical and 31 nonclinical personnel engaged in substance abuse research and treatment. The antibody to hepatitis A virus (anti-HAV) was identified in 16 percent of the clinical employees and 39 percent of the nonclinical personnel, for a total prevalence of 29 percent. The prevalence of anti-HAV was age related, and the overall frequency was not greater than expected attack rates. Hepatitis B virus (HBV) markers were present in 16 percent of the clinical personnel tested but in only 3 percent of nonclinical personnel, for a total prevalence of 9 percent among the two groups. The nonclinical risk did not exceed the background prevalence of the disease, but the risk for clinical employees was three to five times greater. This risk appeared to be associated with exposure to blood and other potentially infectious body fluids; however, in no case could an employee with HBV markers recall a percutaneous injury, and covert means of transmission could not be excluded. Only one case (20 percent) of HBV infection manifested clinical symptomatology. Even though proper environmental safety measures may decrease the incidence of HBV infection in at-risk groups, some health care workers and researchers in the field of substance abuse may be at sufficiently increased risk of HBV infection to warrant immunization with hepatitis B vaccine.     

Prevalence of hepatitis B and C virus infection in the general population and selected groups in South-Western Greece

Greece is a country of intermediate endemicity for hepatitis B and low endemecity for hepatitis C with a downward trend during the last years. In the present study we investigated the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the region of South-Western Greece and tried to identify the most important risk factors of transmission. This is a unique epidemiological study, as it is the first community based study in the general population of Greece, with a methodological approach based on multi-staged random sampling. The prevalence of HBV infection seems to be decreasing with a 22.6% rate of HBV markers and a 2.1% rate of chronic HBV carriers. We found male sex, old age and intrafamiliar exposure as the major independent risk factors of HBV transmission, while sexual contact, absence of condom prophylaxis and living in rural areas seem to have also a significant impact for HBV infection. No relation was found between HBV transmission and working in health care facilities, pre-existing hospital admissions and history of transfusion. The prevalence of anti-bodies to the HCV was found 0.5%, even lower than the rate reported in the Mediterranean region. Parenteral exposure was the main risk factor for the transmission of HCV infection.     

Hand-arm vibration syndrome in South African gold miners

BACKGROUND: Hand-arm vibration syndrome (HAVS) is associated with the use of hand-held vibrating tools. Affected workers may experience symptoms of tingling, numbness, loss of grip strength and pain. Loss of dexterity may impair everyday activities, and potentially increase the risk of occupational accidents. Although high vibration levels (up to 31 m/s(2)) have been measured in association with rock drills, HAVS has not been scientifically evaluated in the South African mining industry. AIMS: The aim of this study was to determine the prevalence and severity of HAVS in South African gold miners, and to identify the tools responsible. METHODS: A cross-sectional study was conducted in a single South African gold-mine. Participants were randomly selected from mineworkers returning from annual leave, comprising 156 subjects with occupational exposure to vibration, and 140 workers with no exposure. Miners who consented to participate underwent a clinical HAVS assessment following the UK Health and Safety Laboratory protocol. RESULTS: The prevalence of HAVS in vibration-exposed gold miners was 15%, with a mean latent period of 5.6 years. Among the non-exposed comparison group, 5% had signs and symptoms indistinguishable from HAVS. This difference was statistically significant (P < 0.05). All the cases of HAVS gave a history of exposure to rock drills. CONCLUSIONS: The study has diagnosed the first cases of HAVS in the South African mining industry. The prevalence of HAVS was lower than expected, and possible explanations for this may include a survivor population, and lack of vascular symptom reporting due to warm-ambient temperatures.     

Prevalence of hepatitis B and C virus infection in barbers in the Sivas region of Turkey

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most devastating health problems in the world, including Turkey. The route of transmission of HBV and HCV is mainly parenteral, a small number of epidemiological studies demonstrating that perinatal, sexual, household and occupational transmission occurs. Contact of a patient's blood or bodily fluids with non-intact skin is another mode of HBV and HCV transmission. Barbers in Turkey may often be exposed accidentally to the blood and bodily fluids of their customers. The aim of this study was to determine the prevalence of HBV and HCV infection in barbers. We conducted a study to determine the prevalence of antibodies against HBV and HCV among 176 barbers and 180 control subjects in the Sivas region of Turkey. The prevalence of HBV and HCV was found to be higher in barbers (39.8 and 2.8%, respectively) than in a comparison group (28.3 and 1.1%, respectively). No significant relationship was found with the duration of occupation. Among the seropositive subjects, it was found that most had been exposed to needle pricks or scissor cuts. Our data suggest that both HBV and HCV infections may constitute occupational hazards for barbers. The sources of infection could be not only such personal risk factors as 'sharps' injuries and scissor cuts, but may also include other unknown factors.     

Lung cancer mortality at a UK tin smelter

BACKGROUND: An earlier study of mortality among male former employees at a tin smelter in Humberside, UK, had identified excess mortality from lung cancer, which appeared to be associated with occupational exposure. AIMS: The aim of the present study was to investigate the relationship between lung cancer mortality and quantitative measures of exposure. METHODS: Using available records of occupational hygiene measurements, we established exposure matrices for arsenic, cadmium, lead, antimony and polonium-210 ((210)Po), covering the main process areas of the smelter. We established work histories from personnel record cards for the previously defined cohort of 1462 male employees. Three different methods of extrapolation were used to assess exposures prior to 1972, when no measurement results were available. Lung cancer mortality was examined in relation to cumulative inhalation exposure by Poisson regression analysis. RESULTS: No significant associations could be found between lung cancer mortality and simple cumulative exposure to any of the substances studied. When cumulative exposures were weighted according to time since exposure and attained age, significant associations were found between lung cancer mortality and exposures to arsenic, lead and antimony. CONCLUSIONS: The excess of lung cancer mortality in the cohort can most plausibly be explained if arsenic is the principal occupational carcinogen (for which the excess relative risk diminishes with time since exposure and attained age) and if there is a contribution to excess mortality from an enhanced prevalence of smoking within the cohort. The implications of the dose-response for arsenic exposure for risk estimation merit further consideration.     

Hepatitis B virus infection among health care workers at an urban teaching hospital in southern Italy: A low occupational hazard?

A prevalence study of HBV serologic markers was carried out among hospital employees of ten departments of the Second School of Medicine in Naples, an urban area with a high prevalence of HBV infection.Departments and occupational categories were selected to represent a spectrum of different exposure to B virus infection. Workers in a large electronic plant in the same geographical area were screened as controls. HBsAg prevalence was 4.8% in the hospital community and 4.0% in control group. It rises to 4.3% in the Campania Region, where all screened workers live, and in some specific areas of the same region it rises to 12%. But no significant difference among seropositivities for at least 1 marker of HBV, considered to be a better indicator of occupational hazard, was found among personnel of different departments or belonging to different occupational categories. None of the occupational and non-occupational risk factors studied was found to be significantly associated with HBV infection.Two years later, an incidence study was carried out among susceptible subjects. Seropositivity for 1 marker was 2.2% among hospital workers and 2.8% in the control group. These figures are lower than the annual attack rate (5%) required for an acceptable cost-benefit ratio of vaccination against hepatitis B.Our results indicate that in a geographical area with HBV endemicity the occupational hazard for B virus infection is low in hospital workers because of the high number of immunized subjects and the contacts with infected people out of the hospital.     

Epidemiological evidence for vaccinating wastewater treatment plant workers against hepatitis A and hepatitis B virus

Exposed to sewage workers of a wastewater treatment plant and a control group in Thessaloniki, Greece, were examined for antibodies against hepatitis A (anti-HAV) and hepatitis B virus (HBV) infection markers. The main objective of this study was to investigate for epidemiological evidence so as to recommend vaccination of the occupationally exposed workers against these viral infections. Antibodies against hepatitis A virus were detected in 65.7% of the wastewater treatment plant workers and in 32.6% of the control group. The prevalence of anti-HAV was significantly higher in less educated persons and was increasing with age (p < 0.001), whereas in logistic regression analysis the adjusted seroprevalence of wastewater treatment plant workers was 3.5 times higher (p < 0.01) than the control population. Serologic evidence of past HBV infection was observed in 32.4% of the exposed to sewage population and in 5.8% of the controls. Multivariate analysis showed that variables significantly and independently related to previous HBV infection was occupational exposure to sewage (OR: 5.81; 95% CI: 2.07-16.29) and age over 40 years old (OR: 4.49; 95% CI: 1.51-13.33). These results support the vaccination policy of young and sensitive to hepatitis A and B virus wastewater treatment plant workers in our region.     

2004～2010年某部食品和公共场所从业人员乙肝病毒感染状况分析

[目的]掌握某部食品、公共场所从业人员HBV感染情况及其动态变化,为开展乙肝防治工作提供依据。[方法]对2004～2010年在某部防疫队体检的解放军某部食品和公共场所从业人员血清HBV感染标志物检测资料进行分析。[结果]2004～2010年累计检测某部食品和公共场所从业人员19 008名,检出HBV感染者7 569人,年均感染率为39.82%,各年感染率分别为52.81%、52.66%、45.76%、42.95%、28.73%、28.25%、27.62%(P<0.01)。HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc年均阳性率分别为5.12%、35.23%、2.08%、5.96%、6.01%。HBV年均感染率,男性、女性分别为45.88%、28.58%,农村籍、城镇籍的分别为43.47%、25.10%,公共场所、食品从业人员分别为45.92%、21.02%,有、无乙肝疫苗接种史者分别为12.36%、53.55%,差异均有统计学意义(P<0.01);HBV感染率随着年龄的增长而降低(P<0.01);12 672名无乙肝疫苗接种史者中,单纯HBsAg阳性的占6.91%,单纯HBeAg阳性的占2.71%,单纯抗-HBe阳性的占7.40%,单纯抗-HBc阳性者占6.64%,抗-HBe、抗-HBc阳性的占4.60%,"小三阳"占2.51%,"大三阳"占2.11%。[结论]某部食品和公共场所从业人员HBV感染状况不严重。     

Prevalence of hepatitis B and C viruses infection in chronic alcoholics with or without liver disease in Ioannina, Greece: Low incidence of HCV infection

Intravenous heroin abusers comprise a high risk group for hepatitis B and C viruses (HBV and HCV) infection. Chronic alcoholics with liver disease (LD) also comprise a high risk group for HBV infection whereas the frequency of antibodies to HCV (anti-HCV) ranges from 27–42.6%. In this study, HBV and HCV infection markers were determined in alcoholic patients with (83 patients) or without LD (68 patients) in order to assess the prevalence of these markers (HBsAg, HBsAb, HBcAb and anti-HCV). The reason for the study was a lack of established data in this group of patients in Greece. The disease control groups consisted of 70 non-alcoholic hospitalized patients and 60 heroin addicts, whereas 1342 healthy blood donors were also investigated. Our results showed significantly increased prevalence of HBV infection markers in chronic alcoholic patients compared to healthy controls and non-alcoholic hospitalized patients. The findings were independent of the presence or absence of LD. In contrast to heroin addicts, where anti-HCV antibodies were observed in 90%, there was no difference in the prevalence of anti-HCV antibodies in chronic alcoholics (with or without LD), nonalcoholic hospitalized patients or healthy controls. In conclusion, we found that in this area of northwestern Greece, chronic alcoholics, independent of the presence of LD, comprise a high risk group for HBV infection but very rarely have HCV infection. The latter finding may reflect technical or socioeconomic differences regarding the lifestyle of our patients, and our population in general.     

The prevalence and transmission of hepatitis B virus infection in urban, rural and institutionalized black children of Natal/KwaZulu, South Africa

The sera of statistically selected urban (805), rural (238) and institutionalized (127) black children were tested for markers of hepatitis B virus (HBV) infection. The age-standardized (6-14 years) prevalence rates of HBs antigenaemia for comparison between urban, rural and institutionalized children were 10%, 18.5% and 25.1% and the HBV exposure rates were 31.4%, 62.1% and 72.0% respectively. In the newborn to six years age group the prevalence rates of HBsAg and HBV exposure were 2.5% and 7.1% for urban children and 53.1% and 70.3% for institutionalized children. Peak prevalences of HBsAg occurred in the 6-8 year age group and were 14.4% and 22.6% in urban and rural children respectively. Hepatitis Be Antigen (HBeAg) was detected in 46.5% and antibodies to hepatitis Be antigen (HBeAb) in 10.0% of all HBsAg positive children. Multiple mechanisms involving horizontal rather than vertical transmission appeared to be important in urban children, with HBV exposure in females being significantly associated with ear-piercing (p less than 0.001) and scarification (p less than 0.05). In addition, HBsAg was detected in 25 of 29 pools of bloodfed mosquitoes caught at the children's institution and was negative in all four pools of unfed mosquitoes, suggesting that these arthropods may also be one factor in the horizontal spread of HBV infection. Familial clustering of HBV infection was suggested by a significantly higher (p less than 0.01) prevalence of HBsAg amongst family contacts of HBsAg positive urban children (17.7%) than in the control groups of family contacts of HBsAb positive children (8%) and children who were negative for all HBV markers (2.4%). The significance and implications of these findings are discussed.     

Risk of chronic effects on the central nervous system at low toluene exposure

This study evaluates the chronic effects on the central nervous system of exposure to low concentrations of toluene (TWA < 20 ppm) on workers in a rotogravure plant. Ninety-eight male workers from a selection pool of 107 (92%) were examined neuropsychologically using a Cognitive Function Scanner, and neurologically by computerized methods measuring co-ordination ability, tremor and position stability. In addition measures of symptoms and former exposure were obtained by questionnaire. The workers were divided into three groups: Group 0 with no exposure to organic solvents (n = 19); Group 1 with exposure to TWA < 20 ppm of toluene for less than 13 years (n = 30) and Group 2 with exposure for more than 12 years (n = 49). Within Group 2, 37 (75%) had been exposed at levels exceeding 100 ppm for 10+ years before 1983. No significant differences were found between Group 0 and Group 1 regarding symptoms and results of the applied tests. Group 2 differed significantly from the two other groups in scoring higher on a symptom index (p = 0.04), particularly regarding concentration ability, reduced memory and fatigue. Group 2 scored significantly poorer on tests for visuospatial function, number learning and word recognition, while no differences regarding neurological functions were observed. The study showed no differences regarding neuropsychological and neurological functions between a non-exposed group of male workers and workers exposed to toluene less than 13 years at TWA < 20 ppm. However, long-term exposure to TWA (time weighted average) of toluene exceeding 100 ppm was associated with impaired neuropsychological function.     

Small bakeries--a cross-sectional study of respiratory symptoms, sensitization and dust exposure.

This cross-sectional study investigated the prevalence of respiratory symptoms and sensitization to dust components in 224 individuals in 18 small bakeries in Scotland. Each work practice in the bakeries was characterized by an assessment of dust exposure and assigned to a category with either a direct exposure to flour dust of an indirect exposure to flour dust. We found that work-related respiratory symptoms were significantly associated with specific IgE to wheat flour and amylase but not to exposure category (except for nasal/eye symptoms). However, specific IgE to wheat flour was significantly associated with exposure category. There was a higher prevalence of immunological sensitization, reporting of work-related respiratory symptoms and exposure to dust than in other studies and of the 144 personal dust sample results taken, 21 (14.6%) of the total exceeded 10 mg/m3, the substantial dust concentration as outlined by the COSHH Regulations. Follow-up of those with work-related asthma symptoms (questionnaire response) was inconclusive of the work-relatedness of their symptoms, although it did confirm respiratory morbidity.     

Low back pain and occupation among Irish health service workers

BACKGROUND: The health services sector has been identified as a high-risk work sector for low back pain (LBP) and related absenteeism. AIMS: To establish levels and predictors of LBP prevalence and associated sick leave among health service workers. To identify if levels of LBP or related absenteeism differ between occupational groups. METHODS: A postal survey using a standardized questionnaire and disproportionate random sampling of occupational groups was conducted at a single Dublin hospital. Overall hospital LBP prevalence and sickness absence were calculated using weighted analysis methods. Univariate analysis included the use of Chi-square, Fisher's exact and Mann-Whitney tests. Multivariate logistic regression techniques were used to explore for independent predictors of lifetime LBP prevalence and LBP-related sickness absence. RESULTS: An overall response rate of 62% (n = 246) was achieved. Lifetime, annual and point prevalence rates for the hospital employees were calculated at 46, 30 and 15.5%, respectively. No significant difference in prevalence was found between occupational groups but sick leave did differ with the highest level among general support and nursing staff. Multivariate analysis confirmed that occupation was an independent predictor for LBP-related sick leave (P < 0.05). CONCLUSIONS: LBP prevalence rates did not differ significantly between occupational groups but occupation was found to be an independent predictor of LBP-related sick leave. Involvement in manual handling did not predict either LBP or related sick leave.     

Prevalence of markers for hepatitis B and hepatitis D in a municipal house of correction.

Following an outbreak of hepatitis B (HBV) in a municipal house of correction, HBV markers were detected in 173/406 (43 percent) inmates and 10/129 (8 percent) staff. Of the 173 HBV-infected inmates, 14 (8 percent) had hepatitis D (HDV) markers compared to 0/10 staff members. Intravenous drugs use (IVDU) was most strongly associated with HBV marker presence. Increasing duration of imprisonment, history of hepatitis B and especially IVDU were associated with the prevalence of HDV markers.     

Overweight and obesity among Kuwait Oil Company employees: a cross-sectional study

BACKGROUND: Overweight and obesity are considered major risk factors for many diseases, and their prevalence is known to be high in Kuwait from previous studies. AIM: To assess the prevalence of overweight and obesity and related risk factors among Kuwait Oil Company (KOC) employees. METHOD: A cross-sectional study of full-time KOC employees was carried out using a structured questionnaire that was completed during periodic medical examinations. The questionnaire included demographic details, frequency and duration of physical activity, history of chronic diseases and medication. All participants were counselled and examined. Blood pressure, body mass index and fasting glucose were recorded. RESULTS: Some 3282 out of 3900 employees completed the study; 85% of participants were male, 62%were field workers and 38%were office workers. The overall prevalence of overweight and obesity among KOC employees was 75%. Males showed a higher level of overweight and obesity (79%) than females (56%). Field workers had a higher level of overweight and obesity (78%) and higher inactivity (65%) than office workers (72% and 56%, respectively). CONCLUSION: Overweight and obesity, together with inactivity, are highly prevalent among KOC employees, and more so among field workers than office workers. Encouraging an active lifestyle, healthy eating habits and weight control programmes are all possible interventions to reduce the prevalence of overweight and obesity.     

乙肝病毒血清学标志物检出模式及其临床报告

目的 通过分析乙型肝炎(乙肝)病毒(HBV)血清学标志物模式，对规范乙肝临床报告的可行性进行探讨。方法 用酶联免疫吸附试验(ELISA)对51746例临床标本常规HBV检测，对常见模式组用荧光定量聚合酶链反应(FQ-PCR)检测HBV DNA，对罕见模式组用ELISA进行复检。结果 常见模式组占总阳性率的98％。罕见模式组经复检后，模式发生了显著变化，有的出现了多达三种不同模式的改变。结论 对于HBV罕见模式，应综合分析，规范处理，方可发出HBV临床报告。     

Inequality in the health status of workers in small-scale enterprises

BACKGROUND: Small-scale enterprises (SSEs) usually share poorer resources for promoting occupational health. AIM: To investigate inequality of health status among SSEs in Japan. METHOD: A cross-sectional, multiple-centred study was carried out using the periodical health check-up data for the fiscal year 2000 to compare the age-adjusted proportions of workers with hypertension (HT), hyperlipidaemia, impaired glucose tolerance (IGT) and obesity and of current smokers by size of enterprise, i.e. or=1000 employees in Japan. RESULTS: From five leading occupational health organizations, data were collected for 9833 enterprises with a total of 436 729 subjects, 302 383 males and 134 346 females. The proportions of workers in SSEs with or=50 male employees. The prevalence of smokers in SSEs with or=50 male employees. These proportions showed a significantly increasing tendency with decreasing size of male workforce. CONCLUSION: Despite the cross-sectional design and only adjusting age as a potential confounder, higher proportions of HT, IGT, obesity and smoking in male workers were found in SSEs compared to larger organizations.     

Occupational factors associated with low back pain in urban taxi drivers

BACKGROUND: Urban taxi drivers differ from other professional drivers in their exposures to physical and psychosocial hazards in the work environment. Epidemiological data on low back pain (LBP) of this occupational group are very scarce. AIMS: To examine LBP in taxi drivers and its association with prolonged driving and other occupational factors. METHODS: We analyzed the cross-sectional data from the Taxi Drivers' Health Study. Standardized instruments were used to collect information on personal factors, work-related physical and psychosocial factors and driving time profiles. LBP prevalence was assessed using the modified Nordic Musculoskeletal Questionnaire. Multiple logistic regression models were employed for statistical analyses. RESULTS: Of 1242 drivers, 51% reported LBP in the past 12 months, significantly (P < 0.001) higher than other professional drivers (33%) in Taiwan. After adjusting for the effects of demographic characteristics, lifestyle factors, anthropometric measures and socioeconomic positions, we found that driving time >4 h/day [prevalence odds ratio (POR) 1.78; 95% CI 1.02-3.10], frequent bending/twisting activities while driving (adjusted OR 1.86; 95% CI 1.15-2.99), self-perceived job stress (POR 1.75; 95% CI 1.20-2.55), job dissatisfaction (POR 1.44; 95% CI 1.05-1.98) and registration type were the major occupational factors significantly associated with higher LBP prevalence in taxi drivers. CONCLUSIONS: We have identified that long driving time and several physical and psychosocial factors are associated with high prevalence of LBP in taxi drivers. This should be further investigated in prospective studies. Future studies are needed to examine the potential adverse effects of prolonged exposure to low levels of whole-body vibration.