Prevalence of hepatitis A virus infection among sewage workers in Georgia.

Background: Wastewater (WW) workers could have opportunity for direct contact with raw sewage, which might contain hepatitis A virus (HAV).

Methods: A serologic survey of WW workers and a comparison population of roads and drainage workers (RD). Factors potentially associated with anti-HAV positivity were evaluated in univariate and multivariate analyses.

Results: Among the 365 WW workers, overall anti-HAV prevalence was 38%, similar to that (35%) of the 166 RD workers (P = 0.5). Prevalence varied by wastewater job type from 45% among the 164 field crew workers to 32% among the 201 treatment plant workers. In multivariate modeling, factors associated with anti-HAV positivity included age > or = 40 years (odds ratio [OR] = 2.4; 95% CI = 1.6-3.7), black compared to other races (OR = 2.4; 95% CI = 1.5-3.8), birth outside the United States (OR = 7.5; 95% CI = 3.0-18.6), a high school education or less (OR 2.1; 95% CI = 1.4-3.2) and work on the field crew compared to RD work (OR 1.6; 95% CI = 1.1-2.4).

Conclusions: These results are consistent with no or a small increased risk of hepatitis A among WW workers, and do not provide a clear mandate for hepatitis A vaccination of these workers. Am. J. Ind. Med. 43: 172-178, 2003.