title: Hepatitis c virus infection in employees of a large university hospital in Israel.
abstract: OBJECTIVE
  To assess whether hospital work constitutes a risk factor for hepatitis C virus (HCV) infection among employees of a large hospital in Israel.
  
  
  METHODS
  Seroprevalence survey.
  
  
  METHODS
  A 1,006-bed, tertiary-care university hospital in Jerusalem.
  
  
  METHODS
  All 5,444 employees (18-65 years old) were eligible; 4,287 (79%) participated in the survey.
  
  
  METHODS
  Sera were tested for antibodies to HCV (anti-HCV) using a third-generation enzyme immunoassay. A third-generation strip immunoblot assay was used for confirmation. Participants were interviewed regarding their occupational history, and they completed a self-administered questionnaire covering history of non-occupational exposure to blood and country of birth. Other demographic information was obtained from the personnel department. Rates and odds ratios (ORs) were calculated, and multivariate logistic-regression analyses were performed to adjust for potential confounding variables.
  
  
  RESULTS
  Anti-HCV was found in 0.9% of employees (37/4,287; 95% confidence interval, 0.6-1.1), ranging from 0.1% among those born in Israel to 5.7% among those born in Central Asia. After age, gender, social status, country of birth, and history of blood transfusion were controlled for in a logistic regression, occupational exposure to blood > or = 10 years was significantly associated with the presence of antibodies (OR, 2.6; P=.01). Presence of anti-HCV also was associated with country of birth (range: Israel OR, 1; West OR, 3.8 [P=.1]; Central Asia OR, 48.6 [P<.0001]) and history of blood transfusion (OR, 2.7; P=.01). No significant associations were found between anti-HCV and age, gender, social status, history of tattoo, acupuncture, current occupation, department, exposure to blood in current occupation, adherence to safety precautions, or history of percutaneous injury. The association with length of exposure was stronger (OR, 3.6; P=.01) when the same logistic regression was run excluding the outlier ethnic group of Central Asia.
  
  
  CONCLUSIONS
  Hospital work does not seem to constitute a major risk factor for HCV infection in Israel today. A higher prevalence of anti-HCV among employees with longer versus shorter lengths of occupational exposure may be due to a cumulative effect of exposure over the years. Infection control efforts in recent years may have contributed to this association.
authors.affiliation: Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Sermoneta-Gertel
authors.forename: M
authors.initials: M
authors.lastname: Donchin
authors.forename: R
authors.initials: R
authors.lastname: Adler
authors.forename: M
authors.initials: M
authors.lastname: Baras
authors.forename: T
authors.initials: T
authors.lastname: Perlstein
authors.forename: N
authors.initials: N
authors.lastname: Manny
authors.forename: D
authors.initials: D
authors.lastname: Shouval
authors.forename: E
authors.initials: E
authors.lastname: Galun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D010564:Personnel, Hospital; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D013997:Time Factors