Older people have less response to recombinant hepatitis B vaccine
Clinical bottom line
Older people have a lower response to hepatitis B vaccine, even when the
definition of older is as young as 30 years.
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Reference
DN Fisman et al. The effect of age on immunologic response to recombinant
hepatitis B vaccine: a meta-analysis. Clinical Infectious Diseases 2002 35:
1368-1375.
Meta-analysis
The search of MEDLINE and the Cochrane Library looked for human studies
involving individuals aged 19 years or older and published in English.
Randomised trials and observational studies were eligible if they use
standard recombinant hepatitis B vaccines. Recipients could be healthy
individuals and individuals with comorbid illnesses, but studies with only
individuals (students, military recruits) less than 30 years of age were not
included. Studies additionally had to have examined age as a variable for
immulogical response.
The description of "older" was that used in each study. If stratified by
age, 40 years was used as a default definition.
Results
There were 24 studies with 11,000 subjects. The results for all studies and
higher quality studies are shown in Table 1.
Table 1: Relative risk of nonresponse
Analysis
Relative risk (95% CI)
All studies 1.8 (1.5 to 2.1)
Higher quality studies 1.6 (1.2 to 2.2)
Comment
This review does all sorts of things to do with heterogeneity and
publication bias, much of which is unnecessary. What they do not give are
the actual rates of nonresponse in younger or older people. This is a shame,
because a relative risk without this information is quite useless. What we
have are the results of the search, so that if necessary we could pull the
papers and find that information.
Greta Thornbory
Consultant, Occupational Health & Education
Consultant Editor, OH Journal
www.gtenterprises-uk.com
Tel: 01235 770156
Mob: 07778 518 027
----- Original Message -----
From: "Tracie McKelvie" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, October 21, 2004 1:33 PM
Subject: Re: Room Lighting for DSE Users
> Does anyone have any info re: Hep B vaccines not being effective in the
> over 30 yr olds??
>
> Rgds
>
> Tracie Mckelvie
> Occupational Health Nurse / Adviser
> Pembrokeshire College
> Merlins Bridge
> Haverfordwest
> Pembs.
> SA61 1SZ
>
> TEL: 01437 765247 Ext 393
> FAX: 01437 767279
> E-mail: [log in to unmask]
>
>
> >>> [log in to unmask] 10/21/04 09:18am >>>
> Those staff with 500 lux are they using CRT monitors or flat screens.
> For
> CRT monitors the recommended light level is 250-500 lux. For flat
> screens it
> can be anywhere between 300 - 1000 lux.
>
> What are the over head lights (CAT 3 or similar), are they highly
> reflective. If they are try changing the tubes or placing diffuser over
> the
> light fittings to give a diffused balanced light.
>
> Is there a need for different light levels, as some people may not be
> getting enough light!
>
> Out of interest there will be an article in EZ-1 ergonomics on lighting
> for
> visually impaired in the November or December issue.
>
> Duncan Abbott
> enricoSmog ergonomic practitioners
> www.enricosmog.com
>
>
>
>
>
>
> ----- Original Message -----
> From: "Kerry McNeil" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Thursday, October 21, 2004 7:53 AM
> Subject: Room Lighting for DSE Users
>
>
> > Dear All
> > Please could I ask if any of you have had experience of assessing
> overhead
> > lighting for DSE users? I am assessing a large office and some areas
> are
> > much brighter than others (Between 250-550 lux)
> >
> > From what I can see, 500 lux is considered suitable for DSE use but
> the
> > employees in the areas with this level of light are complaining that
> it is
> > too bright and that they are getting headaches.
> >
> > Does anyone have any suggestions as to what level of lighting they
> have
> > found to be comfortable?
> >
> > Thanks for anyone that can help
> > Best Wishes
> > Kerry McNeil
> >
> > ~~~~~~~~~~~~~~~
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> >
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> >
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> > http://uk.groups.yahoo.com/group/OHJobs/
> >
> >
>
> ~~~~~~~~~~~~~~~
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>
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