許清曉(Clement C.S.Hsu, MD): Infectious Disease Risks Associated With Occupational Exposure

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Infectious Disease Risks Associated With
Occupational Exposure

A Systematic Review of the Literature

Juanita A Haagsma; Luqman Tariq; Dick J Heederik; Arie H
Havelaar

Posted: 01/22/2012; Occup Environ Med. 2012;69(2):140-146. ©
2012 BMJ Publishing Group

Table 1. Work-related pathogens by specific job title or broader
occupational groups

Occupation	ISCO code	Pathogen
Abattoir workers	751	(Methicillin resistant) Staphylococcus aureus, (swine) influenza virus, Brucella spp., Campylobacter spp., Coxiella burnettii, Escherichia coli, hepatitis B virus, hepatitis E virus, Leptospira hardjo, Leptospira pomona, Streptococcus pyogenes, Toxocara canis
Airline personnel	511	Hepatitis E virus
Animal carers	516	Bartonella hensalae, Borrelia burgdorferi, Capillaria hepatica, Chlamydophila psittaci, hantavirus, influenza virus, Leptospira spp., simian foamy virus, simian parvovirus, simian type D retrovirus, Toxocara canis, Toxoplasma gondii
Archaeologists	211	Coccidioides immites
Armed forces	01	Leishmania spp.
Childcare providers	531	Cryptosporidium parvum, Cytomegalovirus, Giardia lamblia, hepatitis A virus, parvovirus, varicella zoster virus
Cleaners	515	Hepatitis A virus, hepatitis B virus, Mycobacterium tuberculosis
Dental care workers (dentist 266, dentist assistant 325)	226, 325	Hepatitis B virus, hepatitis C virus, HIV, etc
Divers	754	Campylobacter jejuni, enteroviruses, Pseudomonas aeruginosa
Farm labourers (animal handlers)	921	(Methicillin resistant) Staphylococcus aureus, (swine and avian) influenza virus, Borrelia burgdorferi, Brucella spp., Campylobacter spp., Chlamydophilia psittaci, Clostridium tetani, Coxiella burnettii, Escherichia coli, Helicobacter pylori, hepatitis E virus, Leptospira icterohaemorrhagiae, Mycobacterium bovis, Strongyloides stercoralis, Toxocara canis, Toxoplasma gondii, West Nile virus
Farm workers, animals	612	(Methicillin resistant) Staphylococcus aureus, (swine and avian) influenza virus, Borrelia bergdorferi, Brucella spp., Campylobacter spp., Chlamydophilia psittaci, Clostridium tetani, Coxiella burnettii, Helicobacter pylori, hepatitis E virus, Leptospiro icterohaemorrhagiae, Mycobacterium bovis, Streptococcus suis, Strongyloides stercoralis, Toxocara canis, Toxoplasma gondii, West Nile virus
Farm workers, crops	611	Borrelia bergdorferi, Clostridium tetani, Coxiella burnettii, Escherichia coli, Leishmania spp., Strongyloides stercoralis, Toxocara canis
Fishermen	622	Anasakis simplex
Fishmonger	751	Anasakis simplex
Forestry workers	621	Anaplasma phagocytophilum, Borrelia burgdorferi, Coxiella burnetii, hantavirus, Rickettsia conorii, Ricketssia helvetica, tick-borne encephalitis virus, Toxoplasma gondii
Funeral service workers	516	Mycobacterium tuberculosis
Gardeners	611	Francisella tularensis
Healthcare assistants	532	Helicobacter pylori
Healthcare workers (nurses and midwives 222, nurse or midwife assistant 322)	222, 322	(Methicillin resistant) Staphylococcus aureus, Bordetella pertussis, cytomegalovirus, Helicobacter pylori, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis E virus, human herpes virus, HIV, human parvovirus, influenza virus, measles virus, monkey pox virus, mumps virus, Mycobacterium bovis, Mycobacterium tuberculosis, rubella virus, Salmonella spp., SARS coronavirus, Streptococcus pyogenes, vancomycin-resistant enterococci, varicella zoster virus
Hospital dietary workers	941	Coxiella burnettii, hepatitis A virus
Hunter, trapper	622	Borrelia burgdorferi, Brucella spp., Echinococcus granulosis, Echinococcus multilocularis, Ehrlichia chaffeensis, Francisella tularensis, hantavirus, Leptospira icterohaemorrhagia, Leptospira interrogans, Toxocara canis
Laboratory workers	321	(Methicillin resistant) Staphylococcus aureus, Bartonella hanselae, Brucella spp., Clostridium difficile, Coxiella burnettii, Giardia lamblia, HIV, influenza virus, Mycobacterium tuberculosis, Neisseria meningitidis, Pasteurella multocida, rhinovirus, Salmonella spp., Shigella spp., simian foamy virus
Medical doctors	221	Hepatitis B virus, hepatitis C virus, HIV, Mycobacterium tuberculosis, SARS coronavirus
Microbiologists	213	Neisseria meningitidis
Plant and machine operators and assemblers	81	Histoplasma capsulatum, Legionella pneumophila, Mycobacterium chelonae
Prison guards	541	Mycobacterium tuberculosis
Sex workers (also adult movie actors)	516	Chlamydia trachomatis, hepatitis B virus, hepatitis C virus, herpes virus, HIV, human papilloma virus, human T-lymphotrophic virus, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis
Teachers, primary	234	Cytomegalovirus, Neisseria
Veterinarian assistants	324	(Methicillin resistant) Staphylococcus aureus, (swine) influenza virus, Brucella spp., Bartonella hanselae, Campylobacter spp., Chlamyodphila psitacci, Clostridium tetani, Coxiella burnettii, Pasteurella multocida, Salmonella spp., Toxoplasma gondii
Veterinarians	225	(Methicillin resistant) Staphylococcus aureus, (swine) influenza virus, Bartonella hanselae, Brucella spp., Campylobacter spp., Chlamyodphila psittaci, Clostridium tetani, Coxiella burnettii, hepatitis E virus, monkey pox virus, Pasteurella multocida, Salmonella spp., Toxocara canis, Toxoplasma gondii
Waste collectors	961	Brucella spp., Helicobacter pylori, hepatitis A virus, hepatitis B virus, hepatitis C virus, Toxoplasma gondii

ISCO, International Standard Classification of Occupation.

All pathogens identified in the literature search were
classified in a matrix according to site of entry into the human body (skin,
uro-genital tract, respiratory tract and gastro-intestinal tract^[9]) and source of
exposure (human-to-human, animal-to-human and environment-to-human) (Table 2).
Where necessary, pathogen groups were further subdivided to reflect specific
exposure scenarios. Thus, infections of the skin and mucous membranes due to
human–human transmission were subdivided in two groups relating to needle-stick
injuries or other rupture of the normal skin barrier and infections of the skin
and mucous membranes. Likewise, infections of the skin and mucous membranes due
to animal–human transmission were subdivided in those resulting from bites or direct
animal contact, and those from bites by vectors (mosquitoes and ticks).
Environmental sources were subdivided to reflect the main reservoirs of the
pathogens (human, animal or inanimate). This classification results in groups
of pathogens with similar transmission pathways.

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Table 2. Work-related pathogens by proximate sources of exposure
and site of entry in the human body

Site of entry	Proximate sources of exposure
Site of entry	Human*	Animal*	Environment†
Skin and mucous membranes‡	Needle-stick injuries Hepatitis B virus Hepatitis C virus HIV Human herpes virus 8 Cutaneous infections (Methicillin-resistant) Staphylococcus aureus Streptococcus pyogenes Streptococcus suis Cytomegalovirus	Mammals (bites or direct contact) Brucella spp. Hantavirus Rabies virus Leptospira hardjo Francisella tularensis Bartonella henselae Pasteurella multocida (Methicillin-resistant) Staphylococcus aureus Simian foamy virus Simian type D retrovirus Monkey pox virus Mosquito bites Leishmania spp. West Nile virus Tick bites Anaplasma phagocytophilum Borrelia burgdorferi Ehrlichia chaffeensis Tick-borne encephalitis virus Rickettsia spp.	Human reservoirs Strongyloides stercoralis Animal reservoirs Clostridium tetani Leptospira icterohaemorrhagia Inanimate reservoirs Pseudomonas aeruginosa
Uro-genital tract	Human papilloma virus Neisseria gonorrhoeae Chlamydia trachomatis HIV Human T-lymphotrophic virus Treponema pallidum Hepatitis B virus Trichomonas vaginalis Herpes virus
Respiratory tract	Bordetella pertussis Streptococcus pyogenes Neisseria meningitides Varicella zoster virus Influenza virus SARS coronavirus Rubella virus Mumps virus Measles virus Mycobacterium tuberculosis Parvovirus Rhinovirus Monkey pox virus	Avian influenza virus Simian parvovirus Influenza virus Mycobacterium tuberculosis	Animal reservoirs Coxiella burnettii Francisella tularensis Histoplasma capsulatum Hantaviruses Chlamydophilia psittaci Inanimate reservoirs Coccidioides immites Enterobacteriaceae (eg, Klebsiella spp., Enterobacter spp.) Legionella pneumophila Mycobacterium chelonae
Gastro-intestinal tract	Helicobacter pylori Giardia lamblia Cryptosporidium parvum	Cryptosporidium spp. Salmonella spp. Campylobacter spp. Escherichia coli	Human reservoirs Hepatitis A virus Hepatitis E virus Clostridium difficile Animal reservoirs Shiga-toxin producing Escherichia coli Brucella spp. Hepatitis E virus Salmonella spp. (non-typhoidal) Campylobacter spp. Toxocara canis/Toxocara cati Shigella spp. Cryptosporidium parvum Echinococcosis multilocularis Echinococcus granulosis Anasakis simplex Toxoplasma gondii Capillaria hepatica Mycobacterium bovis

* Including indoor environment.

†Food, water, soil and air.

‡Including eyes and ears.

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2012年1月31日 星期二

Infectious Disease Risks Associated With Occupational Exposure

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2012年1月31日星期二