title: The occupational risk of Helicobacter pylori infection among gastroenterologists and their assistants.
abstract: BACKGROUND
  Helicobacter pylori is a widely spread bacterium that mainly inhabits the gastric mucosa and can lead to serious illnesses such as peptic ulcer disease, gastric carcinoma and gastric MALT lymphoma. The oral-oral route seems to be the main transmission route. The fact that endoscopes are contaminated after being used to perform a gastroscopy leads one to question whether gastroenterologists and endoscopy nurses and assistants run a higher risk of infection.
  
  
  METHODS
  A systematic search for literature was conducted in the MEDLINE and EMBASE databases and further publications were found in reference lists of relevant articles. Epidemiological studies on the occupational exposure of endoscopy personnel were collected and their quality was assessed. Pooled effect estimates were identified in a meta-analysis.
  
  
  RESULTS
  Of the 24 studies included in the analysis, 15 were considered to be methodologically good. Of these 15 studies, eight single studies showed a statistically significant increased risk of infection for gastroenterologists, and five for their assistants. Meta-analysis across all methodologically good studies found a statistically significant risk of 1.6 (95%CI 1.3-2.0) for doctors. The pooled effect estimates also indicated a statistically significant risk of Helicobacter pylori infection (RR 1.4; 95%CI 1.1-1.8) for assistants too.When studies are stratified by medical and non-medical control groups, statistically significant risks can only be recognised in the comparison with non-medical controls.
  
  
  CONCLUSIONS
  In summary, our results demonstrated an increased risk of Helicobacter pylori infection among gastroenterological personnel. However, the choice of control group is important for making a valid assessment of occupational exposure risks.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Institute for Health Service Research in Dermatology and Nursing, Hamburg, Germany. c.peters@uke.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Peters
authors.forename: Anja
authors.initials: A
authors.lastname: Schablon
authors.forename: Melanie
authors.initials: M
authors.lastname: Harling
authors.forename: Claudia
authors.initials: C
authors.lastname: Wohlert
authors.forename: José Torres
authors.initials: JT
authors.lastname: Costa
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
mesh_terms: D005773:Gastroscopy; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D009726:Nurses / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000453:epidemiology* / Q000382:microbiology; D016273:Occupational Exposure / Q000009:adverse effects*; D010823:Physician Assistants / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D012307:Risk Factors