Hepatitis E virus infection: an emerging occupational risk?

BACKGROUND: Hepatitis E virus (HEV) infection is endemic in many developing countries, causing substantial morbidity. Transmission is primarily faeco-oral and is associated with both sporadic infections and epidemics in areas where poor sanitation and weak public health infrastructures exist. Recently, it has become clear that HEV is also an endemic disease in industrialized countries. Moreover, a porcine reservoir and growing evidence of zoonotic transmission have been reported in these countries, suggesting the possibility of occupational transmission to man. AIMS: To summarize the current knowledge on the epidemiology and prevention of transmission of HEV infection in occupational settings. METHODS: The following key words were used to explore PubMed: hepatitis E, disease, epidemiology, profession(al), occupation(al). RESULTS: After screening of the results, 107 publications were retained. In non-endemic regions, seroprevalence varied from a few per cent (2-7.8%) in Europe, Japan and South America to 18.2-20.6% in the USA, Russia, UK, southern France and Asia. A meta-analysis of 12 cross-sectional studies evaluating HEV immunoglobulin G (IgG) seroprevalence in individuals occupationally exposed to swine showed greater odds of seropositivity in the exposed group but also a high degree of heterogeneity. A funnel plot suggested publication bias. CONCLUSIONS: There was a significant association between occupational exposure to swine and HEV IgG seroprevalence, but the level of prevalence detected depended also on the type of HEV IgG kits used. Further research, including on mechanisms and risk factors for infection, as well as the development of better serological tests for identification of infection, is required.

[Diet as a key element of health promotion at the workplace in scientific research and practice. First results of the EU project FAHRE]. / La dieta come elemento cardine della promozione della salute ne luoghi di lavoro nella ricerca scientifica e nella pratica. Primi risultati del progetto EU FAHRE.

The globalization of markets have led to rapid changes in diet and lifestyle in the developed countries, where living standards have improved, and availability and variety of food has increased while physical activity decreases have led to an augment in chronic diseases (obesity and diabetes mellitus), cardiovascular diseases and some specific cancers. In this context there is a need to develop health promotion activities. Workers represent a very appropriate group for such activities because they are relatively homogeneous, easily reachable because they can be found together in the same place and time and the occupational physician has good knowledge of the of health status of individual worker. In this scenario, a renew interest must be posed to the relationship between diet and health. In this context our Group is participating at the FAHRE project (Food and Health Research in Europe). The project aims to establish the state of the art of research at the interface of nutrition and health in the European Union, identifying its strengths and weaknesses in order to propose strategies to increase coordination and improve its functioning as a European Research Area.

[Biological risk prevention in agriculture and animal breeding: immunization strategies]. / Strategie vaccinali per la prevenzione del rischio biologico in agricoltura e zootecnia.

Vaccine preventable diseases are, so far, a main focus of Public Health programmes all over the world since people still die in consequence of Dyphteria or Tetanus. Biological risk is widely represented in agriculture and animal breeding, due to environmental characteristics and to injury typology. Moreover, aged people and migrants represent a significant part of the workforce. These two groups are, for instance, more exposed to Clostridium tetani infection because not fully immunized. Among infectious diseases that can affect agricultural workers, just tetanus can be well controlled by immunization programmes. Teaching and training activities are the most important tools to get protection against Leptospira interrogans, Salmonella spp and hepatitis E Virus infection. As for every training activity, linguistic and cultural barriers have to be taken into account.