Are endoscopy nurses at risk of infection with Helicobacter pylori from their work?

BACKGROUND: In response to studies suggesting risk of occupational transmission of Helicobacter pylori (HP) to endoscopy staff, this cross-sectional study of seroprevalence to HP in gastroscopy nurses working in West of Scotland hospitals (an area of high endemicity of HP infection) was performed to determine if they were at excess risk relative to peers working in surgical specialities but without gastroscopy exposure. The study aimed to fulfil employer's duties to carry out a suitable risk assessment required by health and safety legislation. METHOD: This cross-sectional study compares the seroprevalence of HP in gastroscopy nurses and comparators drawn from orthopaedic and trauma units in 10 hospitals during 1998. A directly administered questionnaire collated exposure information on occupational and non-occupational risk factors for infection. Venepuncture was performed for latex agglutination test for IgG to HP. Confounding by socio-economic factors was controlled for by multivariate analysis. RESULTS: Of the 222 participants, 74 were endoscopy staff (84% response) and 148 (59%) were comparators. Of these, 32.4% of gastroscopy and 33% of comparators were seropositive for HP (OR 0.97, P > 0.9, 95% CI 0.5-1.8). No association was found between gastroscopy exposure variables (frequency, years) or exposure to all endoscopy procedures and HP. Significant associations were found for age, childhood deprivation and greater number of siblings. CONCLUSION: No excess HP infection was found in gastroscopy nurses. Duties imposed by the health and safety legislation appear discharged by normal infection control procedures. Socio-economic factors are key determinants of HP status.

People who travel to be treated for HIV infection: keeping track for care management.

An HIV information exchange was established to provide district health authorities (DHAs) with current demographic and epidemiological data on residents infected with HIV. Reporters in each DHA in the Thames regions were asked to collect information about all HIV infected individuals treated within their districts during 1993. The information was collated at the PHLS AIDS Centre and summary tables were distributed to the DHAs involved describing their residents. We received reports of 7760 people infected with HIV and who were treated in the Thames regions in 1993. Thirty-five per cent were treated outside the region where they lived, 22% were treated within their region but outside their district of residence, and 43% were treated in the DHA where they lived. For 30 of the 38 DHAs the number of resident patients exceeded the number treated within the district. This exchange of information between DHA of treatment and DHA of residence showed that it is possible to provide summaries of current HIV case loads based on place of residence without compromising confidentiality. It also confirmed that many patients choose to be treated away from their area of residence.