Risk Behaviors, Occupational Risk and Seroprevalence of Hepatitis B and A Infections among Public Cleansing Workers of Bangkok Metropolis

Background and Aims: Public cleansing workers, especially public garbage collectors are probably at risk for hepatitis B virus (HBV) and/or hepatitis A virus (HAV) infections. This study was designed to assess risky behaviors, occupational risk and seroprevalence of HBV and HAV infections in this group.
Methods: 354 public cleansing workers of Bangkok Metropolis (185 cleaners and 169 garbage collectors) were randomly selected by multi-stage sampling. The subjects were interviewed and their blood pecimens were collected to investigate HBV seromarkers (HBsAg, anti-HBs and anti-HBc) and anti-HAV by voluntary participation.
Results: Out of 354 workers, 22.6% had tattoos, 15.8% had a history of regular alcohol consumption, and 6.8% had a history of extramarital sex without using condoms in a previous year. Public garbage collectors had relatively higher percentage than public cleaners. Also, public garbage collectors had significantly higher percentage of occupational risks including a history of contact with blood, a history of contact with used condom, syringe or needle, and a history of needle stick or sharp puncture than public cleaners (P= 0.0018, 0.0067 & 0.0012, respectively). Results from blood screening revealed 49.4% of HBV seropositivity, 5.9% of HBsAg, 37.3% of anti-HBs, 6.2% of anti-HBc only, and 85% of anti-HAV antibody. Public garbage collectors had significantly higher HBV seropositivity than public cleaners (P=0.0058), while there was no statistical significance in anti-HAV positivity between groups. Risk factors for HBV seropositiveness after multivariate analysis were occupation (adjusted OR=1.76, P=0.0027), a history of contact with used condom, syringe or needle (adjusted OR=3.02, P<0.0001), and a history of needle stick or sharp puncture (adjusted OR=4.21, P<0.0001).
Conclusions: This study supported public cleansing workers; especially public garbage collectors were at risk for HBV and/or HAV infections. The risk reduction programs including a 100% condom use, life skills education, hygienic practice, use of safer equipment for collecting garbage, and HBV vaccination should be provided for this group.