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American Journal of Epidemiology Vol. 150, No. 3: 312-320
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health

other

Occupations at Increased Risk of Hepatitis A: A 2-Year Nationwide Historical Prospective Study

Yehuda Lerman1,3, Gabriel Chodik2, Have Aloni2, Joseph Ribak1,3 and Shai Ashkenazi2,3

1Occupational Health and Rehabilitiation Institute Ra'annana, Israel
2Schneider Children‘s Medical Center Petach-Tiqva, Israel
3Sackler Faculty of Medicine, Tel Aviv University Tel Aviv, Israel

The recent licensing of active hepatitis A vaccines rasies the question of vaccine candidates. Although various groups of workers are at theoretical occupational risk of hepatitis A infection, no comprehensive quantitavlive data exist to determine which occupational groups should receive active vaccination. Therefore, the aims of this study were to identify occupations at risk for hepatitis A infection and to determine their relative risk. In this nationwide historical prospective study, the rlative risk of hepatitis A amon different occupations in israel was determined according to the incidence of hepatitis a in different occupations during 1993 and 1994 compared with the incidence of hepatitis A in two standard populations. After age, gender, ethnicity, and time of immigration to israel were controlled for, certain occuaptions showed a significant increased risk of hepatitis A: yestive students (standardized incidence ratio (SIR) =9.98% confidence interval: 7.55, 13.18), day care center and kindergarten staff (SIR =5.47, 99% contidence interval; 3.50, 8.57), food industry workers (SIR = 5.41, 99% confidence interval: 1.92, 15.25), teachers (SIR = 4.02, 99% contidence interval: 2.92, 5.48), physicians and dentists (SIR = 3.77, 99% confidence interval: 1.78, 8.14), and therapists and medical technicians (SIR = 3.75, 99% confidence interval: 1.75, 8.14). Sewage workers and nurses did not show any significantly increased risk. The results were validated by comparison with an additional standard population. This first nationwide study identified occupations at risk of hepatitils A infection. It emerged that the authors' approach can prodive a yardstick for measuring samples in both large and small countries that have a socioeconomic background similar to that of lsrael. Am J Epidemiol 1999; 150; 312–20.

Child day care centers; health personnel; hepatitis A; nurses; occupations; physicians; prospective studies


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