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[Epidemiology of occupational infectious diseases in health care workers].

BACKGROUND
Despite continuous progress in medicine and improvement of quality of work, occupational diseases are still a serious problem. During the last few years, 5000 to 12,000 cases of occupational diseases were annually registered in Poland. Among them, infectious diseases still occupy the third place. The aim of the study was to carry out an epidemiological analysis of occupational infectious diseases identified in health care workers of the Wrocław region in 1990-2002.


MATERIALS AND METHODS
Information included in occupational disease identification cards was used as a basis for the study group selection. The form provided data on workplaces with exposure to agents responsible for generation of occupational diseases. Decisions on identification of occupational diseases in workers employed in EKD sections (code 85) were also taken into account.


RESULTS
During last years, 136-300 cases of occupational diseases in health care workers were annually diagnosed in the Wrocław region, and infectious diseases made 10-30% of this number. In this group of diseases, viral hepatitis and tuberculosis were most frequent (45-82%). In 1990-2000, viral hepatitis was identified as an occupational disease in 323 health care workers; nurses formed the major group (195) followed by doctors (39) and lab workers (30). Recently, epidemiological situation of occupational infectious diseases has improved. From 1989, the incidence of occupational viral hepatitis in health care workers is on the systematic decrease (only 17 cases in 1994). Undoubtedly, the introduction of obligatory vaccination against HBV among health care workers has greatly contributed to this improvement.


CONCLUSIONS
It is found that hepatitis B virus (HBV) is the major factor responsible for infections in professional health care workers. The decrease in HBV infections correlates with a growing proportion of the vaccinated personnel. It should be stressed that infections with HCV are on the increase in this occupational group.