Susceptibility to Hepatitis A, Hepatitis B, and Tetanus in Solid Waste Workers in Attica, Greece

Background: The study aimed to estimate susceptibility rates to hepatitis A, hepatitis B, and tetanus among solid waste workers in Greece. Methods: The study was conducted from June 2024 to January 2025 at a company that is responsible for the management of solid waste in Attica. Hepatitis A, hepatitis B, and tetanus vaccination were self-reported. Serum samples were tested for HBsAg, anti-HBs, anti-HBc, and antibodies against the hepatitis A virus (anti-HAV). Results: A total of 219 workers were studied (response rate: 67%). Compared with workers nonexposed to solid waste, exposed workers reported higher vaccination rates against all 3 diseases ( P value <0.001 for all). There were 2 HBsAg-positive cases among exposed workers. Overall, 53.6% of exposed workers had serologic proof of hepatitis B vaccination compared with 43.4% among nonexposed workers ( P value=0.625). Susceptibility rates to hepatitis A were 51.8% and 67.1% in exposed and nonexposed workers, respectively ( P value=0.04). Susceptibility rates to hepatitis B were 42% in exposed and 51.4% in nonexposed workers ( P value=0.142). Susceptibility to tetanus was 25.9% and 57% among exposed and nonexposed workers ( P value <0.001). The overall susceptibility rates were 57.2% for hepatitis A, 46.9% for hepatitis B, and 37.4% for tetanus. Conclusions: A negligible HBsAg seroprevalence rate was found, which is attributed to the improvement of solid waste management and the use of protective equipment in the past decade. Nevertheless, 57.2% of participating workers were susceptible to hepatitis A, 46.9% to hepatitis B, and 37.4% to tetanus. There is a need for catch-up vaccinations to promote the health of solid waste workers.