Prevalence of antibody to hepatitis B surface antigen among staff in an Edinburgh hospital

Abstract

Antibody to hepatitis B surface antigen was detected by radioimmunoprecipitation in 74 (5-5%) of 1336 staff members in a large general hospital in Edinburgh, in 14 (2-9%) of 480 volunteer blood donors in the area, and in 12 (6-1%) of 197 pregnant women attending for the first time at the ante-natal clinic in the hospital. Rates of antibody prevalence rose with age in the sample of hospital staff and in that of the blood donors, particularly among males. On the other hand, in the ante-natal patients antibody prevalence declined with age. The rates in hospital staff were higher than those in blood donors of comparable age and sex, and high titres of antibody were more common in the staff group. However, no association was found between antibody prevalence and a history of clinical hepatitis, blood transfusion, or recognized contact with cases of hepatitis. Staff who had previously worked in an infectious disease hospital did not show increased antibody prevalence, indicating that simple isolation measures have been adequate to minimize exposure to hepatitis B. No particular prevalence of infection was seen in physicians and surgeons, in the nursing staff, or in workers in clinical diagnostic laboratories, hospital administration or other areas. One group clearly showing increased antibody prevalence was staff currently working, or who had worked, in the Haemodialysis Unit; this correlated with the outbreak of dialysis-associated hepatitis in 1969--70. However, no evidence suggested that significant dissemination of infection had occurred to other defined groups of hospital staff. Elevated rates were also observed in a small sample of kitchen and portering staff, and in obstetric medical and nursing staff; the latter observation indicate a need for further investigation to identify unsuspected exposure to hepatitis B virus.

Antibody to hepatitis B surface antigen in haemophiliacs on long-term therapy with Scottish factor VIII.

“…HBsAg-positive donations, which in different Scottish regions range from 0-2-1-25/1000 donations (R. Hopkins, personal communication) are excluded. On the other hand, anti-HBs-positive donations (29/1000 donations by radioimmunoprecipitation for the Edinburgh region (Burrell et al, 1977)) are not excluded. This situation has provided a unique opportunity to study hepatitis B seroconversion rates in patients coming into contact with fractions from large numbers of volunteer plasma donations, prepared within one centre, since the institution of universal HBsAg screening.…”

Hepatitis Bs antibody in alcoholic cirrhosis.

“…Anti-HBs generally increases with age and is more common in males, Negroes, and the lower social classes (Szmuness et at., 1973;Burrell et al, 1977). Our patients were matched for age, sex, and race with the control population, and social class has been demonstrated not to have influenced our results.…”

HBsAg Carriers in an Antenatal Clinic and their Management in Labour

“…Though the risk of getting an acute attack of clinical hepatitis is remote, nevertheless, staff may well acquire the antigen subcliniclly since a higher rate of HB s Ab (antibody) carriers were detected amongst the obstetrics, medical and nursing staff,[11] thereby emphasizing the fact that they, along with the laboratory staff, are being continuously exposed to this unknown hazard because their chances of contact with contaminated blood are much more than elsewhere in the hospital. That is why Burrell et al [11] commented on the latter observation by saying that “this indicates a need for further investigation to identify unsuspected exposure to hepatitis B virus”. Fortunately, during the period of study no caesarean section was performed, which probably prevented staff from coming in contact with massive amounts of patient's blood.…”