Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt.
Am J Infect Control. 2020 Mar;48(3):316-319. doi: 10.1016/j.ajic.2019.08.011. Epub 2019 Sep 11.
Hepatitis B virus (HBV) infection is a significant occupational hazard in health care settings and represents a public health concern. The aim of this study was to investigate the association between medical waste handling and HBV infection by conducting a meta-analysis of available evidence.
Pooled odds ratios (ORs) and confidence intervals (CIs) of the included studies were calculated, using the random-effects model, for medical waste handlers versus non-medical waste handlers. Publication bias was detected using the regression test for funnel plot asymmetry, and quality assessment was conducted according to the Newcastle-Ottawa Scale.
Nine cross-sectional studies, published between 1992 and 2018, were included. Medical waste handling was associated with higher odds of HBV infection compared to non-medical waste handling (pooled OR = 2.88; 95% CI, 1.40-5.93; I = 61.36%; P value for heterogeneity = .008). Subgroup analysis showed higher odds of HBV infection in studies conducted in Africa (pooled OR = 3.61; 95% CI, 1.19-11.00). Most studies were of poor to fair quality; yet, little evidence of publication bias was detected (P value for publication bias = .983). No single study showed a substantial impact on the pooled results.
The present meta-analysis supports the suggestion that medical waste handling is associated with HBV infection. This association was shown to be more obvious in African health care settings.
乙型肝炎病毒（HBV）感染是医疗保健环境中的一个重大职业危害，也是一个公共卫生关注的问题。本研究旨在通过对现有证据进行荟萃分析，调查医疗废物处理与 HBV 感染之间的关联。
使用随机效应模型计算纳入研究中医疗废物处理者与非医疗废物处理者之间的合并优势比（OR）和置信区间（CI）。使用漏斗图不对称回归检验检测发表偏倚，并根据 Newcastle-Ottawa 量表进行质量评估。
纳入了 9 项发表于 1992 年至 2018 年之间的横断面研究。与非医疗废物处理相比，医疗废物处理与 HBV 感染的几率更高（合并 OR=2.88；95%CI，1.40-5.93；I=61.36%；P 值用于异质性检验=0.008）。亚组分析显示，在非洲进行的研究中，HBV 感染的几率更高（合并 OR=3.61；95%CI，1.19-11.00）。大多数研究的质量较差或中等；然而，检测到的发表偏倚证据很少（发表偏倚 P 值=0.983）。没有一项研究对汇总结果产生重大影响。
本荟萃分析支持医疗废物处理与 HBV 感染之间存在关联的观点。这种关联在非洲的医疗保健环境中更为明显。
