title: Hepatitis B virus infection and waste collection: prevalence, risk factors, and infection pathway.
abstract: BACKGROUND
  Waste collectors have a potential risk of infectious diseases. The aim of the study was to assess; the prevalence of hepatitis B (HBV), risk factors for infection and possible ways of virus transmission among municipal solid waste workers (MSWWs) in a municipality of central Greece.
  
  
  METHODS
  A cross-sectional study was conducted among the employees of a municipality in Central Greece. The prevalence of an HBV infection biological marker (anti-Hbc) and its association with exposure to waste, socio-demographic factors, and history of occupational injuries with sharp objects/needle sticks was examined among 208 employees.
  
  
  RESULTS
  The prevalence of HBV infection among the municipal waste collectors was 23%. Logistic regression analysis showed that exposure to waste (OR = 4.05;95%CI = 1.23-13.33) and age (OR = 5.22;95% CI = 1.35-20.1) were independently associated with the anti-Hbc positivity. Moreover, waste collectors who reported occupational injuries with needle sticks were at higher risk of HBV infection (RR = 2.64; 95% CI = 1.01-6.96).
  
  
  CONCLUSIONS
  Occupational exposure to waste is a possible risk factor for HBV infection. Occupational injury with sharp instruments could be a means of hepatitis B virus transmission. Immunization of MSWWs and adoption of more safe ways for waste collection could be considered in order to control the risk of HBV infection.
authors.affiliation: Medical Faculty, Department of Hygiene and Epidemiology, School of Science, University of Thessaly, Larissa, Greece. gsrachmed@yahoo.com
authors.forename: George
authors.initials: G
authors.lastname: Rachiotis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papagiannis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Markas
authors.forename: Efthimios
authors.initials: E
authors.lastname: Thanasias
authors.forename: George
authors.initials: G
authors.lastname: Dounias
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005735:Garbage; D006115:Greece / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016602:Needlestick Injuries / Q000150:complications*; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires