日本人開業歯科医師のB型肝炎罹患に関する研究
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概要
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In order to clarify the epidemiological features of occupationally acquired hepatitis B virus infection in japanese private dental practitioners, the author carriedout a questionnaire survey (n=2, 356) and serological survey (n=209). HBs-Ag and HBe-Ag in saliva (whole and parotid) of hepatits B virus (HBV) carriers (n=36) were also investigated to study the saliva as a source of infection. HB-antigen and antibody were determined mainly by solid-phase-radioimmunoassay (RIA).<BR>The following conclusions were obtained:<BR>1) The incidence of hapatitis (including jaundice) in japanese private dental practitioners in the questionnaire survey was 16.8%, and a higher rate of incidence was seen in the higher age groups. The occurrence of hepatitis (including jaundice) was at the age of 36.4 years (mean). 44.7 % of the dentists who had been practicing more than 10 years had contracted hepatitis and the mean occurrence period was 8.9 years.<BR>2) The incidence HB infection in Japanese private dental practitioners in the serological survey was 48.4 % (positive to HB-antigen and antibody), which was significantly higher than the controls (p<0.05). A higher rate of positive antibody reaction was seen in the higher age groups. An acquired immunity against HB was obtained within 20 years of practice which may protect the dentists from the HB infection.<BR>3) HB infection in Japanese private dental practitioners tends to a lateral infection during the dental treatment of hepatitis patients. By the application of the prevalence theory of Reed-Flost, it was calculated that 35 to 40 HBs-Ag positive patients may be treated by a Japanese private dental practitioner per year.<BR>4) Considering the occult blood reaction in saliva, the HBs-Ag in saliva may originate mostly from the blood. Thus, pure saliva may not contain the HBs-Ag. However, since HBe-Ag originating from blood was identified, it is possible that the saliva is one cause of HB.<BR>From the consideration of the questionnaire and serological surveys, it seems reasonable to conclude that Japanese private dental practitioners have been infected with HB at a high rate. Therefore, anti-HBs serum or inactivated HB-antigen-vaccine might be required to prevent the disease.
- 有限責任中間法人 日本口腔衛生学会の論文