Risk of infection with Helicobacter pylori and hepatitis A virus in different groups of hospital workers

The purpose of this study was to determine whether different staff groups in an acute care hospital are at increased risk of acquiring Helicobacter pylori and hepatitis A virus infection.

We examined staff members of an acute care hospital for serum antibodies to H. pylori IgG (n = 457) and to hepatitis A virus (n = 434). The staff members were assigned to three groups: 1) nonmedical staff (n = 110), 2) medical and nursing staff (n = 272), and 3) medical and nursing staff working in a gastroenterology and endoscopy unit (n = 75). Serum antibodies were measured by validated enzyme immunoassays. A questionnaire inquiring about medical and professional history, history of upper GI pain and ulcer, as well as about the use of nonsteroidal anti-inflammatory drugs or medication for GI complaints and smoking habits was completed by each person.

The seroprevalence of H. pylori was 35.5% in group I, 34.6% in group II, and 24.0% in group III (not significant). The seroprevalence of H. pylori antibodies increased with age (p < 0.001), and antibodies were present more frequently in women than in men (36.2 vs 25.4%, p < 0.05). After adjustment for age, duration of experience and the number of years working in the gastroenterology or endoscopy unit did not increase H. pylori seropositivity. No significant association was found between H. pylori seropositivity and history of upper GI pain, ulcers, use of nonsteroidal anti-inflammatory drugs or medication for GI complaints, or tobacco use. The prevalence of hepatitis A antibodies was similar in the three groups (group I, 26.4%; II, 26.5% III, 21.7%; not significant). Cross-tabulation showed that 67 subjects (15.4%) were seropositive for both H. pylori and hepatitis A (p < 0.001) and that 245 (56.5%) were negative for both. Seventy-seven (17.7.%) and 45 (10.4%) were seropositive for only H. pylori and for only hepatitis A, respectively.

Occupational exposure to patients in an acute care hospital as well as to patients and to endoscopic procedures of a gastroenterology and endoscopy unit does not increase the rate of infection with H. pylori. The significant correlation between the seroprevalences of H. pylori and hepatitis A antibodies suggests fecal-oral transmission of H. pylori.