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Hepatitis C virus infection among public safety workers.
Hales T; Boal WL; Ross CS
J Occup Environ Med 2002 Mar; 44(3):221-223
In an interesting and timely article, Upfal and colleagues conducted a cross-sectional study of hepatitis C virus (HCV) infection among three categories of public safety workers (PSW): police, firefighters, and emergency medical service (EMS) personnel. 1 Using the enzyme immunoassay (EIA-2) test to define HCV seropositivity, the authors found a seroprevalence of 0.6% among police officers, 2.3% among firefighters, and 2.8% among EMS personnel. Multivariate analysis revealed significant associations between HCV seropositivity and EMS personnel (odds ratio [OR], 9.5), firefighters (OR, 5.2), "guilty about drinking" (OR, 4.4), surgery before 1990 (OR, 2.7), age (OR, 1.9), and "life dissatisfaction/misfortunes" (OR, 1.6). The analysis found no significant associations with (1) reported frequency of encounters with blood on the job, (2) actual percutaneous or mucosal exposure incidents, or (3) employees currently working in the "field" versus the "office." The authors concluded that "the overall prevalence was- lower than that typical of urban populations" and that "no significant occupational exposure risk" was observed, but they cautioned readers from drawing firm conclusions, given the study limitations. We would like to comment on these limitations and discuss their impact on the study's results. The use of the general population as a comparison group in this study is problematic for two reasons. First, the method to determine HCV seropositivity differed between the two groups. The Upfal et al study used a single positive EIA-2 test, whereas the general population study required all EIA-2 positive tests to have confirmatory testing (HCV MATRIX). 2 The Centers for Disease Control and Prevention estimates that in populations with an HCV-infection prevalence of 0% to 10%, between 20% and 50% of EIA repeatedly reactive results are false-positive. (3-5) This limitation overestimates the HCV seropositivity among PSW in this study.
Hepatitis; Infectious-diseases; Workers; Police-officers; Fire-fighters; Medical-personnel; Enzymes; Occupational-exposure; Emergency-responders; Health-care-personnel; Bloodborne-pathogens
Issue of Publication
Journal of Occupational and Environmental Medicine
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division