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Increased Risk of Hepatitis E in Sewage Workers from India

Vaidya, Sunil R. MSc; Tilekar, Bipin N. BSc; Walimbe, Atul M. MSc; Arankalle, Vidya A. PhD

Journal of Occupational and Environmental Medicine: November 2003 - Volume 45 - Issue 11 - p 1167-1170
doi: 10.1097/01.jom.0000088874.43855.2f

Considering feco-oral transmission of hepatitis E virus (HEV), the risk of the infection was assessed among sewage workers. On the basis of the close contact with sewage, the participants (n = 147) were divided into sewage workers (n = 92) and others (n = 55); none used personal protective equipment (eg, coveralls, boots, gloves) Age-matched individuals from lower socioeconomic status and without any exposure to sewage were used as controls. IgG-anti-HEV positivity in enzyme-linked immunosorbent assay was significantly higher (P < 0.01) among staff members (83/147, 56.5%) than the controls (19%). A significant rise in anti-HEV positivity (P < 0.05) was recorded in sewage workers working for >5 years. Multivariate regression analysis identified contact with sewage as the independent variable associated with anti-HEV positivity. Strict adherence to good working practices must take top priority for protection of these workers from sewage pathogens.

From the National institute of Virology 20-A, Dr Ambedkar Road, Pune, India.

Address correspondence to: Dr V. A. Arankalle, Deputy Director and Head, Hepatitis Division, National institute of Virology 20-A, Dr Ambedkar Road, Pune, India-411001; E-mail address:

©2003The American College of Occupational and Environmental Medicine