American Journal of Epidemiology Vol. 139, No. 5: 504-512
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Longitudinal Study of Borrelia burgdorferi Infection in New Jersey Outdoor Workers, 1988–1991
1Departments of Environmental Health Sciences and Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD
2Department of Medicine, School of Medicine, The Johns Hopkins University Baltimore, MD
3Center for Occupational Medicine, New Jersey Department of Environmental Protection and Energy Trenton, NJ
4Department of Immunology and Infectious Diseases, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD
5Division of Viral and Rickettsial Diseases, Viral and Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention Atlanta, GA
Reprint requests to Dr. Brian Schwartz, The Johns Hopkins University School of Hygiene and Public Health, Division of Occupational Health, Room 7041, 615 N. Wolfe Street, Baltimore, MD 21205.
From 1988 to 1991, annual questionnaires and serosurveys were performed in a cohort of outdoor workers in New Jersey at high risk for Lyme disease to 1) evaluate temporal trends in seroprevalence and seroconversion of antibody to Borrelia burgdorferi; 2) identify risk factors for B.burgdorferi seroconversion during these years; and 3) examine associations between such seroconversion in 1989–1990 and anti-tick saliva antibody (ATSA, a biologic marker of tick exposure) seropositivity in 1990. A total of 1,519 workers participated in at least 1 year of the study. Lyme disease seroprevalence and seroconversion increased from 1988 to 1990 and then decreased in 1991. Years at residence, rural residence, and a history of medical problems were observed to be risk factors for seroconversion from 1988 to 1991. An interaction between pet ownership and rural residence was observed in that rural residents were only at an elevated risk if they owned pets. B. burgdorferi seroconversion from 1989 to 1990 was associated with ATSA seropositivity in 1990; in subjects reporting low tick exposure, the odds ratio was 8.2 (95% confidence interval 1.5–44.7). Associations between ATSA and B. burgdorferi serologic status suggested that educational programs may have contributed to the decline in Lyme seroprevalence and seroconversion in 1991.
biological markers; Borrelia; incidence; Lyme disease; prevalence; risk factors; seroepidemiologic methods; ticks
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