title: The Prevalence of Hepatitis B Virus Among Municipal Solid Waste Workers: Necessity for Immunization of At-Risk Groups.
abstract: BACKGROUND
  Hepatitis B virus (HBV) is likely to be more prevalent in certain populations and occupational groups, such as municipal solid waste workers (MSWWs).
  
  
  OBJECTIVE
  The current study aimed to estimate the prevalence of HBV and its risk factors among MSWWs compared to other municipal employees not exposed to waste.
  
  
  METHODS
  The current cross-sectional study included 654 municipal employees in Zahedan (south-eastern Iran). A sample of blood was taken from each participant and tested for HBsAg through the enzyme-linked immunosorbent assay (ELISA). Demographic and other data on high risk behaviors were also collected through in-depth interviews. Data were analyzed using chi-square test and multiple regression analysis by STATA.
  
  
  RESULTS
  The overall prevalence of HBV among municipal employees was 3.06% (95% CI: 1.70 - 4.30); however, it varied among the different employee subgroups as follows: 6.20% (95% CI: 2.70 - 9.70) in MSWWs, 3.3% (95% CI: 0.08 - 5.80) in drivers and 1% among staff who were not exposed to waste. Multiple regression analysis showed that exposure to waste [OR = 9.36; 95% CI = 2.01 - 43.7], lack of vaccination against HBV [OR = 3.83; 95% CI = 1.86 - 25.2], jaundice [OR = 6.91; 95% CI = 1.51 - 31.5], history of endoscopy [OR = 2.86; 95% CI = 1.08 - 7.62], and high risk behaviors [OR = 4.80; 95% CI = 1.96 - 27.2] were independently associated with HBV.
  
  
  CONCLUSIONS
  Greater encouragement for immunization against HBV as well as better education on HBV transmission routes and work safety precautions should be implemented to reduce the prevalence of HBV in MSWWs.
authors.affiliation: Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ansari-Moghaddam
authors.affiliation: Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ansari
authors.affiliation: Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Zahedan Blood Transfusion Center, Zahedan, IR Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Khosravi
authors.affiliation: Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Zahedan Blood Transfusion Center, Zahedan, IR Iran.
authors.forename: Esmail
authors.initials: E
authors.lastname: Sanei-Moghaddam
authors.affiliation: Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Mohammadi
authors.affiliation: Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatollah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Seyed Moayed
authors.initials: SM
authors.lastname: Alavian
authors.affiliation: Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
keywords: Hepatitis B; Municipality; Zahedan