Polakoff S
Br Med J (Clin Res Ed). 1986 Jul 5;293(6538):33-6. doi: 10.1136/bmj.293.6538.33.
The frequency of transmission of hepatitis B virus infection from health service staff to patients was assessed from reports of confirmed cases of acute clinical hepatitis in 1980-3. During the four years 4505 reports (91% of the total) included replies to a question about recent operations; 153 patients (3.4%) had this history. Transfused blood or blood products were considered the source for 27 cases (0.06%). Eleven patients (0.02%) were infected in two clusters, both in cardiac surgery units; six were caused by a perfusion technician, who was a symptomless carrier, and five by a surgical registrar during the incubation period of an acute hepatitis B infection. The estimated average annual risk of a patient developing acute hepatitis B as part of a cluster caused by staff during surgical procedures was one in a million operations. For another 11 patients blood transfusion could not be excluded as a source. Where no association between surgery and hepatitis was found the incidence of a history, lay between 2.3 and 2.6%. The Hospital In-Patient Enquiry data showed that about 2.4% of the population had had operations in a six month period. These findings suggest that transmission of hepatitis B infection from staff to patients is rare in Britain and that the small risk could be eliminated by attention to measures to preserve asepsis and by immunising staff at risk.
根据1980 - 1983年急性临床型肝炎确诊病例报告，对医护人员将乙肝病毒传染给患者的传播频率进行了评估。在这四年间，4505份报告（占总数的91%）包含了对近期手术问题的答复；153名患者（3.4%）有过这种经历。27例（0.06%）被认为是输血或血液制品所致。11名患者（0.02%）在两个群体中被感染，均在心脏外科病房；6例由一名无症状携带者灌注技师所致，5例由一名外科住院医师在急性乙肝感染潜伏期所致。估计在外科手术过程中，患者因医护人员导致的群体感染而发生急性乙肝的年均风险为百万分之一手术。另有11名患者不能排除输血作为感染源的可能性。在未发现手术与肝炎之间存在关联的情况下，有手术史的发生率在2.3%至2.6%之间。医院住院患者调查数据显示，约2.4%的人群在六个月内接受过手术。这些发现表明，在英国，医护人员将乙肝传染给患者的情况很少见，通过注意保持无菌措施和对高危医护人员进行免疫接种，可消除这种小风险。
