Thorburn D, Dundas D, McCruden E A, Cameron S O, Goldberg D J, Symington I S, Kirk A, Mills P R
Gastroenterology Unit, Gartnavel General Hospital, Glasgow G12 0YN, UK.
Gut. 2001 Jan;48(1):116-20. doi: 10.1136/gut.48.1.116.
Whether healthcare workers have an increased prevalence of hepatitis C virus infection as a result of exposure to patient's blood and body fluids is controversial. This study assesses the prevalence of hepatitis C virus infection in healthcare workers, and its relation to the performance of exposure prone procedures and duration of occupational exposure, allowing an estimate to be made of the incidence of occupationally acquired hepatitis C infection among medical staff.
In this anonymous retrospective cohort study, we estimated the prevalence of hepatitis C infection in 10 654 healthcare workers. ELISA-3 testing was performed on pools of five sera collected during immunisation against hepatitis B. Healthcare workers were arranged into five occupational groups, according to the degree of patient exposure, and three age bands (<30 years, 30-39 years, >40 years).
Prevalence of antibodies to hepatitis C was 0.28% (30/10 654), comparable in all occupational groups (p=0.34) and unrelated to duration of potential exposure. Assuming that all detected infections had been occupationally acquired, the maximum estimated risk of hepatitis C infection in exposure prone medical staff was low: 1.4% for surgeons and 1.0% for physicians over a 35 year professional career.
Hepatitis C infection is infrequent in healthcare workers in Glasgow. Those conducting exposure prone procedures do not seem to be at higher risk than other healthcare staff.
医护人员因接触患者血液和体液而感染丙型肝炎病毒的患病率是否增加存在争议。本研究评估了医护人员中丙型肝炎病毒感染的患病率,及其与易暴露操作的执行情况和职业暴露持续时间的关系,从而对医务人员中职业性获得性丙型肝炎感染的发生率进行估计。
在这项匿名回顾性队列研究中,我们估计了10654名医护人员中丙型肝炎感染的患病率。对在乙型肝炎免疫接种期间采集的五份血清样本进行ELISA-3检测。根据接触患者的程度,医护人员被分为五个职业组,并分为三个年龄组(<30岁、30-39岁、>40岁)。
丙型肝炎抗体的患病率为0.28%(30/10654),在所有职业组中相当(p=0.34),且与潜在暴露持续时间无关。假设所有检测到的感染都是职业性获得的,那么在35年的职业生涯中,易暴露操作的医务人员感染丙型肝炎的最大估计风险较低:外科医生为1.4%,内科医生为1.0%。
格拉斯哥的医护人员中丙型肝炎感染并不常见。进行易暴露操作的人员似乎并不比其他医护人员面临更高的风险。