title: Risk of hepatitis A infection in sewage workers.
abstract: OBJECTIVE
  To evaluate the risk of hepatitis A virus (HAV) infection among sewage workers from occupational exposure to raw sewage.
  
  
  METHODS
  An analytical cross sectional study of 241 company employees with possible occupational exposure to sewage in a large water and sewerage company was carried out. Previous exposure to hepatitis A virus infection was assessed, as were its associations with possible risk factors.
  
  
  RESULTS
  Frequent occupational exposure to raw sewage was a significant risk factor for HAV infection, independently of other known risk factors (odds ratio 3.73, 95% confidence interval 1.48 to 9.37). Of 50 employees who reported occupational exposure to raw sewage most of the time, 30 (60%) had had HAV infection.
  
  
  CONCLUSIONS
  Employees who are likely to be at risk of frequent exposure should have their immunity ensured. The salivary assay for IgG anti-HAV used in the study was highly specific and would be suitable for prevaccination testing of older employees, who are more likely to be immune.
authors.affiliation: Immunisation Division, Public Health Laboratory Service, Communicable Disease Surveillance Centre, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Brugha
authors.forename: J
authors.initials: J
authors.lastname: Heptonstall
authors.forename: P
authors.initials: P
authors.lastname: Farrington
authors.forename: S
authors.initials: S
authors.lastname: Andren
authors.forename: K
authors.initials: K
authors.lastname: Perry
authors.forename: J
authors.initials: J
authors.lastname: Parry
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D003430:Cross-Sectional Studies; D006506:Hepatitis A / Q000209:etiology*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D012307:Risk Factors; D012722:Sewage
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D012722:Sewage