Prevalence of hepatitis A virus infection among sewage workers in Georgia

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Abstract
Background: Wastewater (WW) workers could have opportunity for direct contact with raw sewage, which might contain hepatitis A virus (HAV).Methods: A serologic survey of WW workers and a comparison population of roads and drainage workers (RD). Factors potentially associated with anti‐HAV positivity were evaluated in univariate and multivariate analyses.Results: Among the 365 WW workers, overall anti‐HAV prevalence was 38%, similar to that (35%) of the 166 RD workers (P = 0.5). Prevalence varied by wastewater job type from 45% among the 164 field crew workers to 32% among the 201 treatment plant workers. In multivariate modeling, factors associated with anti‐HAV positivity included age ≥ 40 years (odds ratio [OR] = 2.4; 95% CI = 1.6–3.7), black compared to other races (OR = 2.4; 95% CI = 1.5–3.8), birth outside the United States (OR = 7.5; 95% CI = 3.0–18.6), a high school education or less (OR 2.1; 95% CI = 1.4–3.2) and work on the field crew compared to RD work (OR 1.6; 95% CI = 1.1–2.4).Conclusions: These results are consistent with no or a small increased risk of hepatitis A among WW workers, and do not provide a clear mandate for hepatitis A vaccination of these workers. Am. J. Ind. Med. 43: 172–178, 2003.