Use of the hepatitis-B vaccine and infection with hepatitis B and C among orthopaedic surgeons

We used a questionnaire, with a guarantee of anonymity to the respondents, and conducted serological testing of 3411 attendees at the 1991 Annual Meeting of The American Academy of Orthopaedic Surgeons to evaluate the prevalences of infection with the hepatitis-B and C viruses and the use of the hepatitis-B vaccine among orthopaedic surgeons. There was evidence of infection with hepatitis B in 410 (13 per cent) of 3239 participants who had reported having no non-occupational risk factors; 2103 (65 per cent) reported that they had been immunized with the hepatitis-B vaccine. Of 3262 participants who reported having no non-occupational risk factors and who were evaluated for infection with hepatitis C, twenty-seven (less than 1 per cent) tested positive for the antibody to the hepatitis-C virus. The prevalence of previous infection with hepatitis B increased with increasing age; four (3 per cent) of 136 surgeons who were twenty to twenty-nine years old had evidence of infection, whereas ninety-six (27 per cent) of 360 surgeons who were sixty years old or more had evidence of infection. The prevalence of infection with hepatitis C also increased with increasing age; none of 135 surgeons who were twenty to twenty-nine years old had evidence of infection, and five (1 per cent) of 360 surgeons who were sixty years old or more had evidence of the virus. The prevalence of vaccination decreased steadily with age: 123 (90 per cent) of 136 surgeons who were twenty to twenty-nine years old reported that they had received the hepatitis-B vaccine, whereas 127 (35 per cent) of 360 surgeons who were sixty years old or more reported that they had received the vaccine. The prevalence of infection with hepatitis B or hepatitis C was not associated with the measured indices of exposure to the blood of patients (the number of cutaneous or mucosal contacts with blood that had occurred within the previous month or the number of percutaneous injuries that had occurred within the previous month or year, as recalled by the participants). In conclusion, the prevalence of immunization with the hepatitis-B vaccine was high among the orthopaedic surgeons studied. Although the prevalence of infection with the hepatitis-C virus was several times greater in the current investigation than has been reported in studies of blood donors in the United States, infection with this virus was not associated with the indices of occupational exposure to blood measured in this study.