Epidemiology of hepatitis A in Valencia, Spain: public health implications.

Between July 1988 and July 1989, sera from 1223 persons resident in the Valencia area of Spain were tested for antibodies against the hepatitis A virus. Sixty-five per cent of serum samples were positive for anti-HAV (95% confidence interval = 62.4-67.6). The prevalence of anti-HAV increased significantly with age (odds ratio > 50 years = 69.8; 95% confidence interval = 26.5-183.4) and previous history of hepatitis A (odds ratio = 2.1; 95% confidence interval = 1.4-3.2). Prevalence decreased with higher educational level (odds ratio, university studies = 0.2; 95% confidence interval = 0.1-0.5). Overall, there has been a reduction of anti-HAV prevalence reflecting the decreasing exposure of the Spanish population to hepatitis A virus in recent years, particularly in the younger generations. The age of infection has increased, increasing the probability of future epidemics in groups previously protected by immunity acquired in early childhood. This new epidemiological pattern has strong public health implications, and universal childhood vaccination together with measures directed to improve sanitation may be the best public health strategy to protect the population.

[Respiratory pathology in occupational medicine: evaluation of 3 methods of data collection and research on risk factors]. / Pathologie respiratoire en médecine du travail: évaluation de trois modes de recueil des données et recherche des facteurs de risque.

Three methods of gathering data of respiratory symptoms (using a self questionnaire, a detailed interview and a shortened interview) were compared in 4.206 construction workers in different branches of their profession. There was non significant difference between the replies given, in either sex, to the self questionnaire and those given in the detailed interview by employees of the research bureau. The comparison between the long and the short interview, carried out on the painters, plumbers, carpenters and brick-layers did not show any difference for those questions asked in the same manner in the two documents. On the other hand the question relating to intrathoracic wheezing, which was more condensed in the shortened interview, did not have the same degree of affirmative replies. The replies concerning cough and expectoration obtained by the two methods enabled a comparison to be made between prevalance of chronic bronchitis in the different occupations. This pathology was most frequently seen amongst bricklayers and painters. Other factors (nationality, age, smoking habits) were also linked to chronic bronchitis. Taking all these factors into account has not weakened the link between chronic bronchitis and occupation.