Prevalence of hepatitis A virus infection in sewage plant workers of Central Italy: is indication for vaccination justified?

Prevalence of antibodies to hepatitis A virus (HAV) was studied in a group of 65 sewage plant workers living in Tuscany, Central Italy. In order to ev aluate the effect of several confounders (age, place of birth, income, educ ational degree, sea-food consumption, etc.), subjects under study were matc hed with 160 other workers residing in the same area. Anti-HAV was detected in about 51% of sewage workers and 44% of other employees. The difference was not statistically significant. Both univariate and multivariate analysi s showed that the main variables related to previous HAV infection were inc reasing age (P < 0.001), birth in Southern Italy (P < 0.01) and lower educa tional degree (P < 0.001). Although other studies in Northern and Central E urope showed a slightly higher risk of infection in sewage workers versus g eneral population, lack of evidence of occupational risk in Italy might-be explained by the relative importance of a higher degree of viral circulatio n in the past. The changing epidemiology of HAV infection in Italy with inc reasing numbers of susceptibles in adults and the potential occupational ri sk suggest that the present indication to immunize sewage plant workers aga inst hepatitis A should be maintained. (C) 2000 Elsevier Science Ltd. All r ights reserved.