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RESULTS. Seventy-five percent of case patients with hepatitis B and 26% of control subjects had never used the exchange; similar proportions were found for the hepatitis C case and control groups. After adjustment for demographic characteristics and duration of injecting drugs, nonuse of the exchange was associated with a sixfold greater risk of hepatitis B (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 1.5, 20.4) and a sevenfold greater risk of hepatitis C (OR = 7.3; 95% CI = 1.6, 32.8). CONCLUSIONS. The results suggest that use of the exchange led to a significant reduction in hepatitis B and hepatitis C in the county and may have also prevented a substantial proportion of human immunodeficiency virus infections in injection drug users. <\/jats:p>","DOI":"10.2105\/ajph.85.11.1531","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T08:18:52Z","timestamp":1227946732000},"page":"1531-1537","source":"Crossref","is-referenced-by-count":177,"title":["Reduced risk of hepatitis B and hepatitis C among injection drug users in the Tacoma syringe exchange program."],"prefix":"10.2105","volume":"85","author":[{"given":"H","family":"Hagan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D C","family":"Jarlais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S R","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Purchase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J","family":"Alter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040427"},{"key":"p_2","first-page":"155","volume":"2","author":"Alter MJ","year":"1994","journal-title":"InfectAgents Dis."},{"key":"p_3","unstructured":"DeCock KM, Jones B, Govindarajan S, Redeker AG. 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