Fraser V, Spitznagel E, Medoff G, Dunagan W C
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110.
Am J Epidemiol. 1993 Nov 1;138(9):756-64. doi: 10.1093/oxfordjournals.aje.a116913.
The Barnes Hospital Employee Health Service (St. Louis, Missouri) rubella screening program was evaluated over the 5-year period between January 1, 1986, and December 31, 1990. A total of 6,969 new employees were hired, and 6,115 (87.7%) were screened for evidence of rubella immunity by the Employee Health Service. Rubella serology was performed on 5,893 (96.4%) of the screened employees, while 222 (3.6%) had documentation of prior rubella vaccination or rubella infection. The absence of immunity was identified in 325 employees or 5.3% of all those screened. Women were more frequently screened by the Employee Health Service than were men (p < 0.0001), and blacks were more frequently screened than were non-Hispanic Caucasians (p < 0.0001). Physicians were less frequently screened than were other departmental groups (p < 0.0001). The rate of seronegativity for each year of hire varied from 4.45 to 6.76%, but these differences were not significant. Logistic regression analysis demonstrated that 5-year birth cohorts correlated significantly with serologic status. Employees born in 1960-1964 were least likely to be seronegative, and employees born in 1970 or later were most likely to be seronegative. Sex, race, and department group were not predictive of serologic status, although significant differences in results from different rubella assays were detected. Only 13.8% of seronegative employees were subsequently vaccinated by the Employee Health Service. This study demonstrates a lower seronegativity rate than did previous studies. It identifies groups of employees likely to escape rubella screening and low vaccination rates. It finds increasing seronegativity among employees born after 1964 that correlates with the reported increasing rates of rubella in the United States.
对巴恩斯医院员工健康服务部（密苏里州圣路易斯）在1986年1月1日至1990年12月31日这5年期间的风疹筛查项目进行了评估。共雇佣了6969名新员工，员工健康服务部对其中6115名（87.7%）员工进行了风疹免疫证据筛查。5893名（96.4%）接受筛查的员工进行了风疹血清学检测，222名（3.6%）有既往风疹疫苗接种或风疹感染记录。在325名员工中发现无免疫力，占所有接受筛查员工的5.3%。员工健康服务部对女性的筛查频率高于男性（p<0.0001），对黑人的筛查频率高于非西班牙裔白种人（p<0.0001）。对医生的筛查频率低于其他部门组（p<0.0001）。每年入职员工的血清阴性率在4.45%至6.76%之间变化，但这些差异不显著。逻辑回归分析表明，5年出生队列与血清学状态显著相关。1960 - 1964年出生的员工血清阴性可能性最小，1970年或以后出生的员工血清阴性可能性最大。性别、种族和部门组不能预测血清学状态，尽管不同风疹检测结果存在显著差异。血清阴性的员工中只有13.8%随后由员工健康服务部进行了疫苗接种。本研究显示的血清阴性率低于以往研究。它确定了可能未接受风疹筛查的员工群体以及疫苗接种率较低的情况。它发现1964年后出生的员工血清阴性率增加，这与美国报告的风疹发病率上升相关。
