Viral hepatitis in health service workers in the Province of Wielkopolska.

Viral hepatitis is the most frequent occupational disease in the health service workers. On the ground of epidemiological data on certifications of occupational diseases, an analysis of morbidity of viral hepatitis was performed. Among viruses that can cause occupational hepatitis there are HAV, HBV and HCV. However, occupational HDV and HGV infections are also possible. In Poland, the number of hepatitis diagnosed as occupational diseases became more stable in the years 1996-1998, whereas morbidity of hepatitis C significantly increased. Such an epidemiological situation could be observed in the area of Wielkopolska and throughout the country. In the former province of Poznań and in the present province of Wielkopolska, occupational hepatitis occurred mostly in nurses. In the nineteen sixties and seventies, the most dramatic increase in the incidence of hepatitis B was noticed in the population of nurses and midwives at the age between 21 and 30 years. This can provide evidence of especially high exposure to infectious factors in this occupational group and of high HBV infectivity. Nowadays, an average age at the time of diagnosis of hepatitis C is somewhat higher. Hepatitis C is usually recognized at the age between 30 and 39 years. A relatively low infectivity of HCV and mostly asymptomatic course of the infection, which delays diagnosis, may provide some explanations of these phenomena. The geographical distribution of stated cases of hepatitis C is difficult to predict and may suggest that some non-medical factors also play a role. Since no specific measures to prevent the incidence of hepatitis C have been developed, a good recognition of HCV reservoir in the population of health service workers (particularly nurses) is one of possible methods to improve the epidemiological situation. It might also be necessary to discuss some limitations in work ability of infected persons. In addition, good training in occupational hygiene and how to handle infectious materials is essential for health service workers.