Background and Objectives Helicobacter pylori was discovered in 1984, but its transmission is not yet clear. Direct person-to-person transmission is most likely and could be relevant to occupational transmission particularly in healthcare workers (HCWs) in institutions for elderly people (IEP). Prevalence of H.pylori increases with age, and studies have shown a prevalence up to 85% in people living in IEP.

Methods We compared the occupational risk for H. pylori in HCWs working in IEP (n = 198) to non-exposed controls (n = 250) in a cross-sectional study using serology. We calculated crude and age-adjusted prevalence; in bivariate analysis we compared both groups for a number of established general life-style and occupational risk factors. We applied logistic regression, Poisson regression with robust variance estimator and binomial regression, using established risk factors as covariates.

Results The crude prevalence of seropositivity was 14.6% (95% CI 9.7–19.6) in HCWs en 13.6% (95%CI 9.4–17.8) in controls. Age-standardised prevalence was 14.2% versus 14.9% (difference not significant) respectively. Univariate analysis of seropositivity showed no significant associations with frequency of faecal contact, washing and feeding of elderly persons, contact with vomit, handling nasogastric tubes or washing linen. Using logistic regression, OR was 0.9 (95% CI 0.5 - 1.6) in HCWs compared to non-exposed controls after adjusting for other risk factors; only age (OR 3.2 -95% CI 1.6–6.3) and travel to developing countries (OR 2.0 -CI 1.1–3.9) predicted seropositivity to H. pylori. In Poisson and log binomial regression, prevalence ratio (PR) was 0.9 (95%CI 0.6–1.5) and 0.9 (95%CI 0.6–1.4); only age and travel contributed significantly to H.pylori seropositivity in both models.

Conclusions In our study, using 3 multivariate methods (logistic regression, Poisson regression and binomial regression), the prevalence of H.pylori seropositivity was not significantly higher in HCWs compared to non-exposed controls. No significant associations between H.pylori seropositive status and occupational exposures were shown.