Helicobacter pylori infection:: Epidemiology and occupational risk for health care workers

Introduction: Helicobacter pylori has been recognised as a major cause of gastroduodenal diseases, including gastric and duodenal ulcers with faeco-oral, oro-oral and gastro-oral transmission occurring. With the close personal contact inherent in patient care, health care workers may be at an increased risk of acquiring H. pylori and subsequent development of associated conditions. The objective of this review was to review the transmission and the occupational risk for health care workers. Methods: A literature search was performed using Pubmed (January 1990 to May 2001). Relevant key words were used and additional manual searches were made using the reference lists from the selected articles to retrieve other papers relevant to the topic. Results: Current knowledge implies various pathways of agent transmission, favouring person-to-person erode of transmission early in life. Faeco-oral, oro-oral and gastro-oral transmissions are proposed arid may be of different relevance among various populations. As for health care workers, after elimination of the methodological weak studies, the risk seems to be increased in gastroenterologists, endoscopy staff and intensive care nurses. Results in other groups are conflicting. Conclusions: H. pylori infection is an occupational risk in some groups of health care workers. Studies are needed to elucidate the risk in other occupational groups.