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A Meta-Analysis of Hepatitis B Serologic Marker Prevalence in EMS Personnel

Published online by Cambridge University Press:  28 June 2012

James Menegazzi
James Menegazzi*
Affiliation:
Research Director, Center for Emergency Medicine, Research Assistant Professor, School of Medicine, University of Pittsburgh, Pittsburgh, Pa., USA
*
Center for Emergency Medicine, 230 McKee Place, Suite 500, Pittsburgh, PA 15213, USA
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Abstract

Introduction:

The risk of exposure to the Hepatitis B Virus (HBV) is a known occupational health risk in medical personnel. The specific risk in emergency medical services (EMS) personnel in the United States (U.S.) is not known. Estimates have ranged from 0.6 to 30.0% The purpose of this investigation was to provide an estimate of the prevalence of this exposure, to determine if this risk is homogeneous throughout the U.S., and to provide an estimate of relative risk. The study hypothesis was that the risk of exposure to HBV is not homogeneous throughout the U.S.

Methods:

All articles containing HBV studies of non-immunized EMS personnel (physicians, nurses, and emergency medical service technicians [EMTs]) were considered, provided they reported at least two of the following seromarkers: hepatitis B (HB) surface antigen; HB surface antibody; and/or HB core antibody. A computerized literature search of a database (MEDLARS) from 1980–1989 was performed. Reference sections of relevant articles and texts also were searched. The chi-square test of homogeneity of proportion was used, assuming binomial distribution. The alpha error rate was set at 0.05.

Results:

Seven articles from 1982 to 1989 qualified for inclusion. The average rate of prevalence for all studies was 14.04% (160/1,140), with a 95% confidence interval of 11.40 to 16.68%. The chi-square test was statistically significant (chi-square=12.59, 6 df, p<.01), suggesting that the risk of exposure is not homogeneous throughout the U.S., and may not be homogeneous within a city, nor between prehospital and hospital personnel. When compared to CDC estimates for the general population in the U.S., this analysis suggests that the EMS personnel tested run three times (2.8) greater risk of HBV exposure than does the general population.

Conclusion:

EMS personnel run a great risk of exposure to HBV with a nationwide prevalence of 14.04%, but this risk is not spread homogeneously throughout the country.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 6 , Issue 3 , September 1991 , pp. 299 - 302
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1991

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Footnotes

This paper was Presented at the 6th Annual NAEMSP Conference in Houston, Texas, June 1990.

References

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