RISK OF HEPATITIS-A INFECTION IN SEWAGE WORKERS

Objective-To evaluate the risk of hepatitis A virus (HAV) infection am ong sewage workers from occupational exposure to raw sewage. Methods-A n analytical cross sectional study of 241 company employees with possi ble occupational exposure to sewage in a large water and sewerage comp any was carried out. Previous exposure to hepatitis A virus infection was assessed, as were its associations with possible risk factors. Res ults-Frequent occupational exposure to raw sewage was a significant ri sk factor for HAV infection, independently of other known risk factors (odds ratio 3.73, 95% confidence interval 1.48 to 9.37). Of 50 employ ees who reported occupational exposure to raw sewage most of the time, 30 (60%) had had HAV infection. Conclusion-Employees who are likely t o be at risk of frequent exposure should have their immunity ensured. The salivary assay for IgG anti-HAV used in the study was highly speci fic and would be suitable for prevaccination testing of older employee s, who are more likely to be immune.