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Open Access Research article

Decrease in seroprevalence of Hepatitis A after the implementation of nationwide disposable tableware use in Taiwan

Shih-Bin Su12, Ching-Yih Lin3, Ming-Jen Sheu3, Wei-Chih Kan4, Hsien-Yi Wang4 and How-Ran Guo5678*

Author Affiliations

1 Department of Family Medicine, Chi-Mei Medical Center, Tainan, Taiwan

2 Institute of Biomedical Engineering, Southern Taiwan University, Tainan, Taiwan

3 Department of Gastroenterology, Chi-Mei Medical Center, Tainan, Taiwan

4 Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan

5 Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

6 Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan

7 Sustainable Environment Research Center, National Cheng Kung University, Tainan, Taiwan

8 Center for Occupational and Environmental Health and Preventive Medicine, National Cheng Kung University, Tainan, Taiwan

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BMC Public Health 2010, 10:719  doi:10.1186/1471-2458-10-719

Published: 23 November 2010



Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use.


We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies.


The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from pervious studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982.


Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A.