Prevalence of hepatitis A, B and C in the Flemish population.

Viral hepatitis is a serious health problem throughout the world. No recent prevalence data on hepatitis A, B and C were available for the population in Flanders, Belgium. For this reason, a sero-epidemiological study was undertaken in 1993-1994 in a sample of the general population. The purpose of this study was to obtain a clear picture of the prevalence of hepatitis A, B and C. Between April 1993 and February 1994, 4,058 blood samples were drawn and collected in 10 hospitals in Flanders. The study group was representative for the Flemish population. For hepatitis A a seroprevalence of 55.1% was found. In the non-Belgian residents the HAV prevalence was significantly higher than in Belgians (62% versus 52%; chi2 = 8.05; p = 0.005). For hepatitis B. 9.9% of the study group showed serological evidence of hepatitis B markers: 6.9% of the participants was positive for anti-HBs/anti-HBc, 0.7% appeared to be HBsAg positive and 3.5% was solely anti-HBs positive. The prevalence of HBV markers in Belgians was 6.9%, significantly lower compared to the 13.4% among non-Belgians (chi 2 = 14.05; p = 0.00018). 4055 serum samples were analysed for hepatitis C serology by second generation anti-HCV tests. Anti-HCV was detected in 0.87% of the serum samples. No statistically significant difference was found in HCV prevalnece between Belgians and non-Belgians. Results of this study should help policy makers in their decisions on the most appropriate hepatitis A and B vaccination strategy and on the most effective prevention strategy for hepatitis C.

Transfer of cadmium from a sandy acidic soil to man: a population study.

This population study included 230 subjects (age range 20-83 years) who consumed vegetables grown in kitchen gardens on a sandy acidic soil (mean pH approximately 6.3). The study investigated the association between the Cd (cadmium) levels in blood and urine and the Cd concentration in the soil (range 0.2-44 ppm). Seventy-six subjects were current smokers and 122 participants lived in a district with known Cd pollution. Urinary Cd in the 230 subjects averaged 8.7 nmole/24 hr, (range 1.3 to 47 nmole/24 hr) after age adjustment positively correlated with the Cd level in the soil; a twofold increase of the Cd concentration in the soil was accompanied by a 7% rise in urinary Cd in men (R2 = 0.05; P = 0.04) and by a 4% rise in women (R2 = 0.02; P = 0.05). Blood Cd averaged 11.5 nmole/liter (range 1.8-41 nmole/liter) and was negatively associated with the Cd level in the soil. After adjustment for significant covariates (smoking and serum gamma-glutamyl transpeptidase in both sexes, and age and serum ferritin in women), a twofold increase in the Cd concentration in the soil was accompanied by a 6% decrease in blood Cd in men (R2 = 0.03; P = 0.09) and by a 10% decrease in women (R2 = 0.06; P less than 0.01). In conclusion, in a rural population, consuming vegetables grown on a sandy acidic soil, 2 to 4% of the variance of urinary Cd was directly related to the Cd level in the soil. The negative correlation with blood Cd, a measure of more recent exposure, was biased by the implementation of preventive measures in the polluted district.

National study on the utilization of prophylactic antibiotics in surgery, Belgium, 1986.

During the last week of May 1986, a 1-week prospective study on antibiotic utilization in surgical patients was held in 104 (42%) of the 247 Belgian acute care hospitals. All surgical patients with a post-operative stay of at least 3 days were studied, involving 3112 patients. Each patient was observed for 7 days, starting from the day before surgery. Antibiotics were administered to 71.9% of all patients; 21.9% received therapeutic antibiotics and 52.9% prophylactic antibiotics; 2.9% received both. Of the 1285 patients undergoing a surgical procedure with no indication for antimicrobial prophylaxis, 50.7% nevertheless received prophylaxis; 92.8% of patients with a generally recognized indication for prophylaxis received antibiotic prophylaxis. Less than one fifth (17.1%) of all prophylactic courses were stopped on the day of the intervention whilst 26.3% were continued up to the fifth post-operative day or beyond. The most frequently prescribed drugs for this indication included first and second generation cephalosporins and nitroimidazoles. The number of different generic drugs utilized per hospital ranged from 1 to 18 (mean: 7.7).