Risk of hepatitis B in hospital personnel.

Between Jan 1, 1981, and Aug 31, 1983, 1,323 Ohio State University Hospital employees were screened for hepatitis B. There were 105 employees (cases) with present or past evidence of hepatitis B virus infection, and 210 randomly selected employees (controls) with no evidence of hepatitis B virus infection. Using logistic regression analyses to develop a risk index, the best predictive model indicated that nonwhites, males, discontinuity of employment, and frequency of contact with blood products constituted the most important risk factors in acquiring hepatitis B virus infections. Those with no blood product contact were at higher risk than those exposed to blood products. Thus, although there was a gradient of risk among those exposed to blood products, the findings suggest other factors may contribute more substantially to the risk than the exposure variables tested.

Municipal sewage sludge application on Ohio farms: health effects.

A 3-year prospective epidemiologic study was conducted on 47 farms receiving annual applications of treated sludge (average of 2-10 dry metric tons/ha/year) and 46 control farms in three geographic areas of Ohio. On the sludge-receiving farms 164 persons (78 families) and on the control farms 130 persons (53 families) participated by cooperating with monthly questionnaires concerning their health and their animals' health, annual tuberculin testing, and quarterly blood sampling for serological testing. The estimated risks of respiratory illness, digestive illness, or general symptoms were not significantly different between sludge farm and control farm residents. Similarly, there were no observed differences between disease occurrence in domestic animals on sludge and on control farms. No conversions from negative to positive tine test results occurred after sludge had been applied to the farms. The frequency of serological conversions (fourfold or greater rise in antibody) to a series of 23 test viruses and the frequency of associated illnesses were similar among persons on sludge and control farms. The absence of observed human or animal health effects resulting from sludge application in this study of Ohio farms was associated with low sludge application rates which were in accordance with Ohio and U.S. Environmental Protection Agency guidelines. Caution should be exercised in using these data to predict health risks associated with sludges containing higher levels of disease agents and with higher sludge application rates and larger acreages treated per farm than used in this study.

Tuberculosis surveillance of hospital personnel.

Tuberculosis continues to present a problem of exposure for both patients and personnel in the general hospital. While not frequent, it is not uncommon and often is initially unsuspected, resulting in significant delay in diagnosis and the possibility of many potential contacts. We have reviewed our experience with tuberculosis surveillance at the Ohio State University Hospitals with the following conclusions:(1) Skin testing is a cost-effective means of surveillance of personnel, but requires proper interpretation. (2)Apparently high conversion rates may result from an undocumented history of tuberculin status or the booster effect of repeated testing. (3) Annual chest roentgenograms are expensive, have limited value, and entail some radiation exposure. (4) Isoniazid prophylaxis has been shown to be effective in reducing later reactivation of primary tuberculosis. (5) Based on our experience and other available data, it appears appropriate to eliminate routine periodic chest films on tuberculin-positive individuals who have undergone isoniazid therapy unless additional risk factors are present.