Sewage workers are exposed to a wide range of chemicals and biological agents, including the hepatitis A virus. Inasmuch as Israel is an endemic area for hepatitis A, it is unclear if sewage workers are at increased risk for hepatitis A or which factors contribute to such risk. The authors compared seropositivity of hepatitis A in 100 sewage workers with that in 100 blue-collar worker controls. Hepatitis A seropositivity was highly prevalent, but nonsignificant, in both sewage workers and controls (82% and 91%, respectively). In sewage workers, the major risk for serological positivity was age (odds ratio = 4.5, 95% confidence interval = 1.6, 12.4 for every 10 y). The factors associated negatively with seropositivity were years of education and years of seniority. The authors concluded that exposure to sewage is not a risk factor for hepatitis A infection in Israel, and, therefore, sewage workers do not require special attention in this regard.
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Article Synopsis
- Continuous monitoring of Hepatitis A Virus (HAV) in Israel revealed that between 2019 and 2022, there were 158 reported cases and 12.9% of sewage samples tested positive for HAV RNA, with a notable peak in 2019.
- The COVID-19 pandemic led to a decrease in HAV cases and positive sewage samples during 2020, likely due to lockdown measures affecting virus transmission.
- The predominant sub-genotype identified was IB, with small clusters of transmission among various community groups, emphasizing the need for combined clinical and environmental tracking for effective HAV management and vaccination efforts targeting at-risk adults.
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