Hepatitis B virus (HBV) infection is very common and contagious public health problem with serious pathological consequences (i.e. chronic liver failure, cirrhosis, hepatocellular carcinoma). Since HBV is frequently reported as an occupational disease factor, exposure risk is a concerning problem especially in health-care personnel. The aim of this study is to evaluate the time-dependent change of anti-HBs titer levels in various occupational groups. In the study, 2512 cases from 12 different occupational groups with HBV exposure risk who were applied to Ankara Occupational and Environmental Diseases Hospital Occupational Diseases Clinic for medical screening between October 2012 and November 2018 were examined and assessed. Protective titer levels of anti-HBs were determined in 64.8% people in the risky occupational group. HBV seropositivity rates were found as highest in dentists (94.5%) and lowest in kitchen workers (40.1%). The protective anti-HBs titer level in healthcare workers (i.e. dentist, x-ray technician, supporter healthcare personnel) was found to be 89.4%. Those with anti-HBs titer protective level (≥ 10 mIU / ml) were defined as Group-1 (n=1631), and those with Ab level (
1. Hepatitis B fact sheet. In: World Health Organization: media centre July 2016 update. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b accessed date 04.23.2020.
2. Global Hepatitis Report 2017, page 9.ISBN 978-92-4-156545- 5, Geneva: World Health Organization;2017. https://apps.who. int/iris/bitstream/handle/10665/255016/9789241565455-eng.pdf; jsessionid=BCDD1746BC15449CCA67A7DBAA1BA8A0?sequence=1 accessed date 04.22.2020.
3. Szeszenia-Dąbrowska N, & Wilczyńska U. Occupational diseases in Poland-An overview of current trends, Int J Occup Med Environ Health. 2013;26:457-70.
4. Hamborsky J, Kroger A, Wolfe S.13th edition. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 10: Hepatitis B, page:167, Washington D.C. Public Health Foundation, 2015. Available at: https://www.cdc.gov/vaccines/pubs/ pinkbook/index.html
5. Turkey Viral Hepatitis Prevention and Control Program, page 6, ISBN: 978-975-590-688-1 Ministry of Health Publication No 1102, 2018, Ankara. Available at: https://hsgm.saglik.gov.trdepo/birimler/Bulasici-hastaliklar-db/ duyurular/Turkiye_ Viral_Hepatit_Onleme_ve Kontrol_ Programi/ Turkiye_ Viral_Hepatit_ Onleme_ve_ Kontrol_Programi_TR.pdf
6. Weekly Epidemiological Record (WER), World Health Organization. October 2009; 84 (40): 405-20. Available at: https://www.who.int/wer/2009/ wer8440.pdf?ua=1
7. Leuridan E, Van Damme P. Hepatitis B and the need for a booster dose. Clin Inf Dis. 2011;53:68-75.
8. Averhoff F, Mahoney F, Coleman P, et al. Immunogenicity of hepatitis B Vaccines. Implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med. 1998;15:1-8.
9. Coppeta L, Pompei A, Balbi O, et al. Persistence of immunity for hepatitis B virus among heathcare workers and italian medical students 20 years after vaccination. Int J Environ Res Public Health. 2019;16:1515.
10. Schillie S, Vellozzi C, Reingold A, et al. Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. Recommendations and Reports /January12, 2018; 67(1):1-31. https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1. htm?scid=rr6701a1_w.
11. Schillie S, Murphy TV, Sawyer M, et al. CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR Recomm Rep 2013;62(No. RR-10):1– 19. Available at:https://www.cdc.gov/ mmwr/ preview/mmwrhtml/rr6210a1. htm
12. Regulation on the Prevention of Exposure Risks to Biological Factors, health surveillance, article16. Official Journal Date:15.06.2013/28678, Availableat:https://https://www.mevzuat.gov.tr/MetinAspx?MevzuatKod =7.5.18485&MevzuatIliski=0&sourceXmlSearch=B%C4%B0YOLOJ %C4% B0K%20ETKENLERE accessed date 04.23.2020.
13. Tozun N, Ozdogan O, Cakaloglu Y, at al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect. 2015;21:1020-6.
14. Williams WW, Lu P, O’Halloran A, et al. Surveillance of Vaccination Coverage among Adult Populations-United States, 2015. MMWR Surveill Summ. 2017;66:1-28.
15. Haviari S, Benet T, Saadathan-Elahi M, et al. Vaccination of healthcareworkers: A review. Hum Vaccin Immunother. 2015;11:2522-37.
16. Fortunato F, Tafuri S, Cozza, et al. Low vaccination coverage among Italian healthcare workers in 2013: contributing to the voluntary vs. mandatory vaccination debate. Hum Vaccin Immunother. 2015;11:133-9.
17. Ineli B.U, Akdeniz M & Kavukcu E. The Assessment of the Knowledge About Adult Vaccine, And Vaccination Coverage in Adults Aged 18 and Older In Turkey. International Journal of Scientific and Technological Research.2019;5:17-25.
18. Özgüler M, Saltik-Güngör L, Kaygusuz T, et al Hepatitis A, hepatitis B, measles, and rubella seroprevalence of healthcare workers at Elâzığ training and research hospital. Klimik J. 2016;29:10.
19. Stefanati A, Bolognesi N, Sandri F, et al. Long-term persistency of hepatitis B immunity: an observational cross-sectional study on medical students and resident doctors. J Prev Med Hyg. 2019;60:184-90.
20. Alavian SM, Mansouri S, Abouzari M, et al. Long-term efficacy of hepatitis B vaccination in healthcare workers of Oil Company Hospital, Tehran, Iran (1989-2005). Eur J Gastroenterol Hepatol. 2008;20:131-4.
21. McMahon BJ, Bruden DL, Petersen, et al. Antibody levels and protection after hepatitis B vaccination: results of a 15-year follow-up. Ann Intern Med 2005;142:333–41.
22. Simo Minana J, Gaztambide Ganuza M, Fernandez Millan P, et al. Hepatitis B vaccine immunoresponsiveness in adolescents: a revaccination proposal after primary vaccination. Vaccine. 1996;14:103–6.
23. Darvish Moghaddam S, Zahedi MJ, Yazdani R. Persistence of immune response after hepatitis B vaccination in medical students and residents. Arch Iranian Med. 2004;7:37–40.
24. Dienstag JL, Werner BG, Polk F, et al. Hepatitis B vaccine in health care personnel: safety, immunogenicity, and indicators of efficacy. Ann Intern Med. 1984;101:34–40.
25. Coursaget, P, Yvonnet B, Chiron J. P, et al Scheduling of revaccination against hepatitis B virus. Lancet. 1991;337:1180-3.
26. Zanetti AR, Mariano A, Romanò L, et al. Study Group. Long-term immunogenicity of hepatitis B vaccination and policy for booster: an Italian multicentre study. Lancet. 2005;366:1379-84.
27. Ryckman KK, Fielding K, Hill AV, et al. Host genetic factors and vaccineinduced immunity to HBV infection: haplotype analysis. PLoS One 2010;5:12273
28. Romanò L, Galli C, Tagliacarne C, et al. Study Group Persistence of immunity 18-19 years after vaccination against hepatitis B in 2 cohorts of vaccinees primed as infants or as adolescents in Italy. Hum Vaccin Immunother .2017;13:981-5.
29. World Health Organization .Hepatitis B vaccines: WHO position paper, July 2017- Recommendations. Vaccine. 2019;37:223-5.
30. Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2020 https://www.cdc.gov/vaccines/schedules/hcp/imz/adult. html accessed date 04.3.2020