Influence of Military Service on Tetanus Antibody Titer in Korean Adults

Shin, Jong Whan; Kim, Jin Joo; Jeong, Joong Sik; Song, Kyoung Jun; Cho, Jin Seong

Abstract

PURPOSE
Most Korean veterans receive a tetanus immunization as part of military service. Both tetanus toxoid and immunoglobulin are given to injured patients that present to the emergency department, regardless of their tetanus antibody titer and history of military service. The goal of this study was to determine the tetanus antibody titer and history of military service among patients presenting to the emergency room.
METHODS
Seven hundred and seventy patients visited the emergency department after an injury from April 2008 to June 2009. The samples obtained were tested using a Tetanus Immunoglobulin G ELISA (enzyme-linked immunosorbent assay) method. The tetanus antibody titer was analyzed according to time, five years after entrance into military service and also between veterans and nonveterans.
RESULTS
Subjects that had safe antibody titers that were protective against tetanus up to 20 years after entrance into military accounted for 60%. Those with a history of military service were more likely to have protective antibody levels (> or =0.1 IU/ml, odds ratio 2.41, 95% CI 1.613-3.596) and mean antibody titers (p<0.001). In the subjects between 20 and 45 years of age those with a history of military service were more likely to have statistically significant antibody titers. In addition, male veterans were more likely to have significant antibody titers compared to the males and females that were not veterans (p=0.015 and p<0.001); however, there were no significant differences between the males and females that were not veterans.
CONCLUSION
The results of this study showed that until about 20 years after entrance into military service, 60% of the subjects had protective tetanus antibody titers. The history of military service influenced tetanus antibody titers until about 45 years of age.