Lerman Y, Chodik G, Aloni H, Ribak J, Ashkenazi S
Occupational Health and Rehabilitation Institute, Ra'annana, Israel.
Am J Epidemiol. 1999 Aug 1;150(3):312-20. doi: 10.1093/oxfordjournals.aje.a010004.
The recent licensing of active hepatitis A vaccines raises the question of vaccine candidates. Although various groups of workers are at theoretical occupational risk of hepatitis A infection, no comprehensive quantitative 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 relative risk of hepatitis A among 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 occupations showed a significant increased risk of hepatitis A: yeshiva students (standardized incidence ratio (SIR) = 9.98, 99% confidence interval: 7.55, 13.18), day care center and kindergarten staff (SIR = 5.47, 99% confidence interval: 3.50, 8.57), food industry workers (SIR = 5.41, 99% confidence interval: 1.92, 15.25), teachers (SIR = 4.02, 99% confidence 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 hepatitis A infection. It emerged that the authors' approach can provide a yardstick for measuring samples in both large and small countries that have a socioeconomic background similar to that of Israel.
近期甲型肝炎活性疫苗的获批引发了候选疫苗的问题。尽管各类工作人员在理论上存在感染甲型肝炎的职业风险，但尚无全面的定量数据来确定哪些职业群体应接种活性疫苗。因此，本研究的目的是确定有感染甲型肝炎风险的职业，并确定其相对风险。在这项全国性的历史性前瞻性研究中，根据1993年和1994年不同职业中甲型肝炎的发病率与两个标准人群中甲型肝炎的发病率相比较，确定了以色列不同职业中甲型肝炎的相对风险。在控制了年龄、性别、种族和移民到以色列的时间后，某些职业显示出甲型肝炎风险显著增加：犹太教神学院学生（标准化发病率比（SIR）=9.98，99%置信区间：7.55，13.18）、日托中心和幼儿园工作人员（SIR=5.47，99%置信区间：3.50，8.57）、食品工业工人（SIR=5.41，99%置信区间：1.92，15.25）、教师（SIR=4.02，99%置信区间：2.92，5.48）、医生和牙医（SIR=3.77，99%置信区间：1.78，8.14）以及治疗师和医学技术人员（SIR=3.75，99%置信区间：1.75，8.14）。污水处理工人和护士未显示出任何显著增加的风险。通过与另一个标准人群进行比较，验证了结果。这项首次全国性研究确定了有感染甲型肝炎风险的职业。结果表明，作者的方法可以为测量社会经济背景与以色列相似的大国和小国的样本提供一个标准。
