Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-03T03:10:45.490Z Has data issue: false hasContentIssue false
  • English
  • Français

Hepatitis C Virus Infection in Employees of a Large University Hospital in Israel

Published online by Cambridge University Press:  02 January 2015

Simona Sermoneta-Gertel ,
Milka Donchin ,
Ruth Adler ,
Mario Baras ,
Tamar Perlstein ,
Noga Manny ,
Daniel Shouval  and
Eithan Galun
Simona Sermoneta-Gertel
Affiliation:
Liver Unit, Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Milka Donchin
Affiliation:
Occupational Health Unit, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Ruth Adler
Affiliation:
Liver Unit, Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Mario Baras
Affiliation:
Department of Social Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Tamar Perlstein
Affiliation:
Liver Unit, Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Noga Manny
Affiliation:
Blood Bank, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Daniel Shouval
Affiliation:
Liver Unit, Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
Eithan Galun*
Affiliation:
Liver Unit, Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
*
Liver Unit, Hadassah Medical Organization, POB 12000, 91120 Jerusalem, Israel
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To assess whether hospital work constitutes a risk factor for hepatitis C virus (HCV) infection among employees of a large hospital in Israel.

Design:

Seroprevalence survey.

Setting:

A 1,006-bed, tertiary-care university hospital in Jerusalem.

Participants:

All 5,444 employees (18-65 years old) were eligible; 4,287 (79%) participated in the survey.

Methods:

Sera were tested for antibodies to HCV (anti-HCV) using a third-generation enzyme immunoassay. A third-generation strip immunoblot assay was used for confirmation. Participants were interviewed regarding their occupational history, and they completed a self-administered questionnaire covering history of non-occupational exposure to blood and country of birth. Other demographic information was obtained from the personnel department. Rates and odds ratios (ORs) were calculated, and multivariate logistic-regression analyses were performed to adjust for potential confounding variables.

Results:

Anti-HCV was found in 0.9% of employees (37/4,287; 95% confidence interval, 0.6-1.1), ranging from 0.1% among those born in Israel to 5.7% among those born in Central Asia. After age, gender, social status, country of birth, and history of blood transfusion were controlled for in a logistic regression, occupational exposure to blood ≥10 years was significantly associated with the presence of antibodies (OR, 2.6; P=.01). Presence of anti-HCV also was associated with country of birth (range: Israel OR, 1; West OR, 3.8 [P=.1]; Central Asia OR, 48.6 [P<.0001]) and history of blood transfusion (OR, 2.7; P=.01). No significant associations were found between anti-HCV and age, gender, social status, history of tattoo, acupuncture, current occupation, department, exposure to blood in current occupation, adherence to safety precautions, or history of percutaneous injury. The association with length of exposure was stronger (OR, 3.6; P=.01) when the same logistic regression was run excluding the outlier ethnic group of Central Asia.

Conclusions:

Hospital work does not seem to constitute a major risk factor for HCV infection in Israel today. A higher prevalence of anti-HCV among employees with longer versus shorter lengths of occupational exposure may be due to a cumulative effect of exposure over the years. Infection control efforts in recent years may have contributed to this association.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 12 , December 2001 , pp. 754 - 761
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol 1982;115:26–39.Google Scholar
2. Snydman, DR, Munoz, A, Werner, BG, Polk, FB, Craven, DE, Piatt, R, et al. A multivariate analysis of risk factors for hepatitis B virus infection among hospital employees screened for vaccination. Am J Epidemiol 1984;120:684–693.Google Scholar
3. Donchin, M, Shouval, D. Occupational and non-occupational hepatitis B virus infection among hospital employees in Jerusalem: a basis for immunisation strategy. Br J Ind Med 1992;49:620–625.Google Scholar
4. Petrosillo, N, Puro, V, Ippolito, G, Di-Nardo, V, Albertoni, F, Chiaretti, B, et al. Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection in health care workers: a multiple regression analysis of risk factors. J Hosp Infect 1995;30:273–281.Google Scholar
5. Cariani, E, Zonaro, A, Primi, D, Magni, E, Incarbone, C, Scalia, P, et al. Detection of HCV RNA and antibodies to HCV after needlestick injury. Lancet 1991:337:850.Google Scholar
6. Seeff, L. Hepatitis C from a needlestick injury. Ann Intern Med 1991;115:411.CrossRefGoogle ScholarPubMed
7. Mitsui, T, Iwano, K, Masuko, K, Yamazaki, C, Okamoto, H, Tsuda, F, et al. Hepatitis C virus infection in medical personnel after needlestick accident. Hepatology 1992;16:1109–1114.Google Scholar
8. Suzuki, K, Mizokami, M, Lau, JYN, Koji, K, Mizuno, Y, Sodeyama, T, et al. Confirmation of hepatitis C virus transmission through needlestick accidents by molecular evolutionary analysis. J Infect Dis 1994;170:1575–1578.CrossRefGoogle ScholarPubMed
9. Mizuno, Y, Suzuki, K, Mori, M, Hayashi, K, Owaki, T, Hayashi, H, et al. Study of needlestick accidents and hepatitis C virus infection in healthcare workers by molecular evolutionary analysis. J Hosp Infect 1997;35:149–154.Google Scholar
10. Sartori, M, La Terra, G, Aglietta, M, Manzin, A, Navino, C, Verzetti, G. Transmission of hepatitis C via blood splash into the conjunctiva. Scand J Infect Dis 1993;25:270–271.Google Scholar
11. Blackmore, TK, Stace, NH, Maddocks, P, Hatfield, P. Prevalence of antibodies to hepatitis C virus in patients receiving renal replacement therapy and in the staff caring for them. Aust N Z J Med 1992;22:353–357.Google Scholar
12. Cooper, BW, Krusell, A, Tilton, RC, Goodwin, R, Levitz, RE. Seroprevalence of antibodies to hepatitis C virus in high-risk hospital personnel. Infect Control Hosp Epidemiol 1992;13:82–85.CrossRefGoogle ScholarPubMed
13. Jochen, A. Occupationally acquired hepatitis C virus infection. Lancet 1992;339:304.CrossRefGoogle ScholarPubMed
14. Kuo, MY-P, Hahn, L-J, Hong, C-Y, Kao, J-H, Chen, D-S. Low prevalence of hepatitis C virus infection among dentists in Taiwan. J Med Virol 1993;40:10–13.CrossRefGoogle ScholarPubMed
15. Amarapurkar, DN. Prevalence of hepatitis C antibodies in health-care workers. Lancet 1994;344:339.Google Scholar
16. De Brouwer, C, Lecomte, A. HCV antibodies in clinical health-care workers. Lancet 1994;344:962.Google Scholar
17. Gerberding, JL. Incidence and prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus and cytomegalovirus among healthcare personnel at risk for blood exposure: final report from a longitudinal study. J Infect Dis 1994;170:1410–1417.Google Scholar
18. Jadoul, M, el Akrout, M, Cornu, C, van Ypersele de Strihou, C. Prevalence of hepatitis C antibodies in health care workers. Lancet 1994;344:339.Google Scholar
19. Struve, J, Aronsson, B, Frenning, B, Forsgren, M, Weiland, O. Prevalence of antibodies against hepatitis C virus infection among health care workers in Stockholm. Scand J Gastroenterol 1994;29:360–362.CrossRefGoogle ScholarPubMed
20. Tokars, JI, Alter, MJ, Favero, MS, Moyer, LA, Miller, E, Bland, LA. National surveillance of dialysis associated diseases in the United States, 1992. ASAIOJ 1994;40:1020–1031.Google Scholar
21. Zuckerman, J, Clewley, G, Griffiths, P, Cockcroft, A. Prevalence of hepatitis C antibodies in clinical health-care workers. Lancet 1994;343:1618–1620.Google Scholar
22. Goetz, AM, Ndimbie, OK, Wagener, MM, Muder, RR. Prevalence of hepatitis C infection in health care workers affiliated with a liver transplant center. Transplantation 1995;59:990–994.Google Scholar
23. Lodi, G, Porter, SR, Teo, CG, Scully, C. Prevalence of HCV infection in health care workers of a UK dental hospital. Br Dent J 1997;183:329–332.CrossRefGoogle ScholarPubMed
24. Olubuyide, IO, Ola, SO, Aliyu, B, Dosumu, OO, Arotiba, JT, Olaleye, OA, et al. Hepatitis B and C in doctors and dentists in Nigeria. QJM 1997;90:417–422.Google Scholar
25. Campello, C, Majori, S, Poli, A, Pacini, P, Nicolardi, L, Pini, F. Prevalence of HCV antibodies in health-care workers from northern Italy. Infection 1992;20:224–226.Google Scholar
26. Germanaud, J, Barthez, J-P, Causse, X. The occupational risk of hepatitis C infection among hospital employees. Am J Pub Health 1994;84:122.CrossRefGoogle ScholarPubMed
27. Panlilio, AL, Shapiro, CN, Schalbe, CA, Mendelson, MH, Montecalvo, MA, Kunches, LM, et al. Serosurvey of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infection among hospital-based surgeons. J Am Coll Surg 1995;180:16–24.Google ScholarPubMed
28. Neal, KR, Dornan, J, Irving, WL. Prevalence of hepatitis C antibodies among healthcare workers of two teaching hospitals: who is at risk? BMJ 1997;314:179–180.CrossRefGoogle ScholarPubMed
29. Fischer, LR, Tope, DH, Conboy, KS, Hedblom, BD, Ronberg, E, Shewmake, DK, et al. Screening for hepatitis C virus in a health maintenance organization. Arch Intern Med 2000;160:1665–1673.Google Scholar
30. Abramson, JH, Gofin, R, Habib, J, Pridan, H, Gofin, J. Indicators of social class: a comparative appraisal of measures for use in epidemiological studies. Soc Sci Med 1982;16:1739–1746.Google Scholar
31. Bar-Shany, S, Green, MS, Slepon, R, Shinar, E. Ethnic differences in the prevalence of anti-hepatitis C antibodies and hepatitis B surface antigen in Israeli blood donors by age, sex, country of birth and origin. J Viral Hepat 1995;2:139–144.CrossRefGoogle ScholarPubMed
32. Polish, LB, Tong, MJ, Co, RL, Coleman, PJ, Alter, MJ. Risk factors for hepatitis C virus infection among health care personnel in a community hospital. Am J Infect Control 1993;21:196–200.Google Scholar
33. Puro, V, Petrosillo, N, Ippolito, G, Aloisi, MS, Boumis, E, Rava, L, et al. Occupational hepatitis C virus infection in Italian health care workers. Am J Public Health 1995;85:1272–1275.Google Scholar
34. Moens, G, Vranckx, R, De Greef, L, Jacques, P. Prevalence of hepatitis C antibodies in a large sample of Belgian healthcare workers. Infect Control Hosp Epidemiol 2000;21:209–212.Google Scholar
35. Centers for Disease Control. Perspective in disease prevention and health promotion update: Universal Precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings. MMWR 1988;37:377–388.Google Scholar
36. Kiyosawa, K, Sodeyama, T, Tanaka, E, Nakano, Y, Furuta, S, Nishioka, K, et al. Hepatitis C in hospital employees with needlestick injuries. Ann Intern Med 1991;115:367–369.Google Scholar
37. Francavilla, E, Rinaldi, R, Cattelan, AM, Vicariotto, M, Botolotti, F, Cadrobbi, P. Low prevalence of antibodies to hepatitis C virus in hospital employees. Infection 1992;20:295.Google Scholar
38. Hernandez, ME, Bruguera, M, Puyuelo, T, Barrera, JM, Sanchez Tapias, JM, Rodes, J. Risk of needlestick injuries in the transmission of hepatitis C virus in hospital personnel. J Hepatol 1992;16:56–58.Google Scholar
39. Perez-Trallero, E, Cilia, G, Saenz, JR. Occupational transmission of HCV. Lancet 1994;344:548.Google Scholar
40. Lanphear, BP, Linnemann, CC, Cannon, CG, DeRonde, MM, Pendy, L, Kerley, LM. Hepatitis C virus infection in health care workers: risk of exposure and infection. Infect Control Hosp Epidemiol 1994;15:745–750.Google Scholar
41. Serra, C, Torres, M, Campins, M. Occupational risk of hepatitis C virus infection after accidental exposure: The Catalan Group for the Study of the Occupational Risk of HCV Infection in Hospitals. J Hepatol 1997;27:1139.Google Scholar
42. Iashina, TL, Favorov, MO, Shakhgil'dian, IV, Iarasheva, DM, Nazarova, OI, Derevianko, EN, et al. The spread of hepatitis C markers among the population of regions of Russia and Central Asia [in Russian]. Zh Mikrobiol Epidemiol Immunobiol 1993;5:46–49.Google Scholar
43. Kato, T, Mizokami, M, Nakano, T, Kondo, Y, Ohba, K, Orito, E, et al. High prevalence of GB virus C/hepatitis G virus infection among the Jewish population in Uzbekistan. Virus Res 1997;48:81–87.Google Scholar
44. Glikberg, F, Brawer-Ostrovsky, J, Ackerman, Z. Very high prevalence of hepatitis B and C in Bukharian Jewish immigrants to Israel. J Clin Gastroenterol 1997;24:30–33.CrossRefGoogle Scholar
45. Flatau, E, Segol, O, Shneour, A, Tabenkin, H, Raz, R. Prevalence of markers of infection with hepatitis B and C viruses in immigrants of operation Solomon, 1991. Isr J Med Sci 1993;29:387–389.Google Scholar
46. Shemer-Avni, Y, El-Astal, Z, Kemper, O, el Najjar, KJ, Yaari, A, Hanuka, N, et al. Hepatitis C virus infection and genotypes in southern Israel and the Gaza Strip. J Med Virol 1998;56:230–233.Google Scholar
47. Bresters, D, Mausner-Bunschoten, EP, Reesink, HW, Roosendaal, G, Van-der Poel, CL, Chamuleau, RAFM, et al. Sexual transmission of hepatitis C. Lancet 1993;342:210–211.Google Scholar
48. Thomas, DL, Vlahov, D, Solomon, L, Cohn, S, Taylor, E, Garfein, R, et al. Correlates of hepatitis C virus infections among injection drug users. Medicine. 1995;74:212–220.Google Scholar