title: Incidence Patterns and Occupational Risk Factors of Human Brucellosis in Greece, 2004-2015.
abstract: Brucellosis is the most common bacterial zoonosis worldwide. Greece has the highest reported incidence among EU countries. However, occupational risk factors have not been well described.
  
  
  
  To determine the incidence patterns and exposure risk factors of brucellosis in Greece.
  
  
  
  We used national-level surveillance and occupational denominator data to estimate the incidence patterns and exposure risk factors of brucellosis in Greece, with particular emphasis on occupation.
  
  
  
  Between November 2003 and December 2015 a total of 2159 human brucellosis cases was reported. The mean incidence rate was 1.62 per 100 000 population per year. A large majority of cases (77.1%) reported consumption of unpasteurized milk or contact with livestock animals. Most cases occured in farmers and livestock breeders (1079 [87.7%] of 1231 cases reporting their occupation), corresponding to an annual incidence of 7.1 per 100 000. However, there were other occupations with a similar or higher risk: butchers and abattoir workers (12.7 per 100 000), laboratory personnel (3.1 per 100 000), while the highest risk was for veterinarians (53.2 per 100 000).
  
  
  
  Brucellosis incidence in specific occupational groups was much higher than in the general population. These results underline the importance of collecting information on occupation, both during the diagnostic process and in the surveillance system. Besides efforts to control brucellosis in animals, organized prevention efforts are needed within an occupational health framework, especially for the most vulnerable workers.
authors.affiliation: Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece. thlytras@gmail.com.|Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Lytras
authors.affiliation: European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.|French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Danis
authors.affiliation: Department of Occupational and Industrial Hygiene, National School of Public Health, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Dounias
mesh_terms: D000003:Abattoirs / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000822:Animal Husbandry / Q000706:statistics & numerical data; D000818:Animals; D002006:Brucellosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007753:Laboratories / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016272:Occupational Health; D061352:Pasteurization; D012307:Risk Factors; D014730:Veterinary Medicine / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Brucella; Brucellosis; Communicable diseases; Epidemiology; Occupational diseases; Occupational exposure