Potential risk factors associated with COVID-19 in health care workers.
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ABSTRACT: Background
Health care workers (HCWs) have been recognized as being at higher risk for coronavirus disease 2019 (COVID-19) infection; however, relevant factors and magnitude have not been clearly elucidated.Aim
This study was aimed to describe COVID-19 infections among hospital employees at a large tertiary care hospital located in Ontario, Canada from March to July 2020, towards better understanding potential risk factors.Methods
Data on all HCWs with either a positive COVID test or a high-risk exposure from March to July 2020 were analyzed. HCWs with positive COVID test results and high-risk exposures were described. Those who developed COVID-19 following high-risk exposure were compared to those who did not. Data were also analyzed to determine trends over time.Results
Over the period of observation, 193 staff (2% of total working staff) had a positive COVID-19 test. Incidence of HCW infections closely followed community incidence. Overall, 31% of COVID-19 cases were deemed occupationally acquired. Of these, 41% were acquired from a patient, with the remainder (59%) from fellow staff. Over the same period, 204 staff were identified as having a high-risk exposure. The majority of exposures (55%) were patient-associated, with the remaining (45%) resulting from staff-to-staff contact. Overall, 13% went on to develop COVID-19. Of these cases, 58% were patient-associated and 42% were a result of staff-to-staff transmission.Conclusions
HCWs are at risk for work-related COVID-19. Given the number of infections attributed to staff-staff transmission, greater attention could be paid to implementing prevention measures in non-clinical areas.
SUBMITTER: Spilchuk V
PROVIDER: S-EPMC8689909 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Potential risk factors associated with COVID-19 in health care workers.
Spilchuk V V Arrandale V H VH Armstrong J J
Occupational medicine (Oxford, England) 20220101 1
<h4>Background</h4>Health care workers (HCWs) have been recognized as being at higher risk for coronavirus disease 2019 (COVID-19) infection; however, relevant factors and magnitude have not been clearly elucidated.<h4>Aim</h4>This study was aimed to describe COVID-19 infections among hospital employees at a large tertiary care hospital located in Ontario, Canada from March to July 2020, towards better understanding potential risk factors.<h4>Methods</h4>Data on all HCWs with either a positive C ...[more]
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Project description:IntroductionHealth care workers (HCWs) are crucial to the fight against COVID-19 and are at risk of being infected. We sought to determine the risk factors and associations of COVID-19 among HCWs in Ghana during the period of the pandemic.Materials and methodsA case-control study was conducted using the WHO COVID-19 HCWs exposure risk assessment tool. A HCW was categorized as "high risk" for COVID-19 if s/he did not respond "always, as recommended" to adherence to Infection Prevention and Control (IPC) measures during a healthcare interaction. A HCW was categorized as "low risk" if s/he responded "always, as recommended" to adherence to IPC measures. We used univariate and multiple logistic regression models to determine associated risk factors. Statistical significance was set at 5%.ResultsA total of 2402 HCWs were recruited and the mean age was 33.2±7.1 years. Almost 87% (1525/1745) of HCWs had high risk for COVID-19 infection. Risk factors identified were profession (doctor- aOR: 2.13, 95%CI: 1.54-2.94; radiographer-aOR: 1.16, 95% CI: 0.44-3.09)), presence of comorbidity (aOR: 1.89, 95%CI: 1.29-2.78), community exposure to virus (aOR: 1.26, 95% CI: 1.03-1.55), not performing hand hygiene before and after aseptic procedures performed (aOR: 1.6, 95% CI: 1.05-2.45); not frequently decontaminating high-touch surfaces always as recommended (aOR: 2.31, 95%CI: 1.65-3.22; p = 0.001) and contact with a confirmed COVID-19 patient (aOR: 1.39, 95% CI: 1.15-1.67). Among those who came into any form of contact with confirmed COVID-19 patient, providing direct care (aOR: 2.0, 95%CI: 1.36-2.94), face-to-face contact (aOR: 2.23, 95%CI: 1.41-3.51), contact with environment/materials used by COVID-19 patient (aOR: 2.25, 95%CI: 1.45-3.49) and presence during conduct of aerosol generating procedures (aOR: 2.73, 95%CI: 1.74-4.28) were associated with COVID-19 infection.ConclusionNon-adherence to IPC guidelines puts HCWs at increased risk of COVID-19 infection thus ensuring IPC adherence is key to reducing this risk.
| S-EPMC10325113 | biostudies-literature
Project description:IntroductionHealthcare workers (HCW) are most vulnerable to contracting COVID-19 infection. Understanding the extent of human-to-human transmission of the COVID-19 infection among HCWs is critical in managing this infection and for policy making. We did this study to estimate new infection by seroconversion among HCWs in recent contact with COVID-19 and predict the risk factors for infection.MethodsA cohort study was conducted at a tertiary care COVID-19 hospital in New Delhi during the first and second waves of the COVID-19 pandemic. All HCWs working in the hospital during the study period who came in recent contact with the patients were our study population. The data was collected by a detailed face-to-face interview, serological assessment for anti- COVID-19 antibodies at baseline and end line, and daily symptoms. Potential risk factors for seroprevalence and seroconversion were analyzed by logistic regression keeping the significance at p<0.05.ResultsA total of 192 HCWs were recruited in this study, out of which 119 (62.0%) were seropositive. Almost all were wearing Personal protective equipment (PPE) and following Infection prevention and control (IPC) measures during their recent contact with a COVID-19 patient. Seroconversion was observed among 36.7% of HCWs, while 64.0% had a serial rise in the titer of antibodies during the follow-up period. Seropositivity was negatively associated with being a doctor (odds ratio [OR] 0.35, 95% Confidence Interval [CI] 0.18-0.71), having COVID-19 symptoms (OR 0.21, 95% CI 0.05-0.82), having comorbidities (OR 0.14, 95% CI 0.03-0.67), and received IPC training (OR 0.25, 95% CI 0.07-0.86), while positively associated with partial (OR 3.30, 95% CI 1.26-8.69), as well as complete vaccination for COVID-19 (OR 2.43, 95% CI 1.12-5.27). Seroconversion was positively associated with doctor as a profession (OR 13.04, 95% CI 3.39-50.25) and with partially (OR 4.35, 95% CI 1.07-17.65), as well as fully vaccinated for COVID-19 (OR 6.08, 95% CI 1.73-21.4). No significant association was observed between adherence to any IPC measures and PPE adopted by the HCW during the recent contact with COVID-19 patients and seroconversion.ConclusionAlmost all the HCW practiced IPC measures in these settings. High seropositivity and seroconversion are most likely due to concurrent vaccination against COVID-19 rather than recent exposure to COVID-19 patients. Further studies using anti-N antibodies serology may help us find the reason for the seropositivity and seroconversion among HCWs.
| S-EPMC9858779 | biostudies-literature
Project description:Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemic.
| S-EPMC7502606 | biostudies-literature
Project description:IntroductionHealth care workers are the most affected part of the world population due to the COVID-19 pandemic. Countries prioritize vaccinating health workers against COVID-19 because of their susceptibility to the virus. However, the acceptability of the vaccine varies across populations. Thus, this study aimed to determine the health care worker's intentions to accept the COVID-19 vaccine and its associated factors in southwestern Ethiopia, 2021.MethodsA facility-based cross-sectional study was conducted among health care workers in public hospitals in southwestern Ethiopia from March 15 to 28, 2021. A simple random sampling method was used to select 405 participants from each hospital. Data were collected using self-administered questionnaires. Descriptive statistics, such as frequency and percentage, were calculated. Multivariable logistic regression was also performed to identify factors associated with health care worker's intention to accept the COVID-19 vaccine. Statistically significant variables were selected based on p-values (<0.05) and the adjusted odds ratio was used to describe the strength of association with 95% confidence intervals.ResultAmong the respondents, 48.4% [95% CI: 38.6, 58.2] of health care workers intended to accept COVID-19. Intention to accept COVID-19 vaccination was significantly associated with physicians (AOR = 9.27, 95% CI: 1.27-27.32), professionals with a history of chronic illness (AOR = 4.07, 95% CI: 2.02-8.21), perceived degree of risk of COVID-19 infection (AOR = 4.63, 95% CI: 1.26-16.98), positive attitude toward COVID-19 prevention (AOR = 6.08, 95% CI: 3.39-10.91) and good preventive practices (AOR = 2.83, 95% CI: 1.58-5.08).ConclusionIn this study, the intention of health care workers to accept the COVID-19 vaccine was low. Professional types, history of chronic illness, perceived degree of risk to COVID-19 infection, attitude toward COVID-19 and preventive practices were found to be factors for intention to accept COVID-19 vaccine in professionals. It is important to consider professional types, history of chronic illness, perceived degree of risk to COVID-19, attitude of professionals and preventive behaviors to improve the intention of professionals' vaccine acceptance.
| S-EPMC8415602 | biostudies-literature
Project description:ImportanceIdentifying health care settings and professionals at increased risk of SARS-CoV-2 infection is crucial to defining appropriate strategies, resource allocation, and protocols to protect health care workers (HCWs) and patients. Moreover, such information is crucial to decrease the risk that HCWs and health care facilities become amplifiers for SARS-CoV-2 transmission in the community.ObjectiveTo assess the association of different health care professional categories and operational units, including in-hospital wards, outpatient facilities, and territorial care departments, with seroprevalence and odds of SARS-CoV-2 infection.Design, setting, and participantsThis cross-sectional study was conducted using IgG serological tests collected from April 1 through May 26, 2020, in the Lombardy region in Italy. Voluntary serological screening was offered to all clinical and nonclinical staff providing any health care services or support to health care services in the region. Data were analyzed from June 2020 through April 2021.ExposuresEmployment in the health care sector.Main outcomes and measuresSeroprevalence of positive IgG antibody tests for SARS-CoV-2 was collected, and odds ratios of experiencing infection were calculated.ResultsA total of 140 782 professionals employed in the health sector were invited to participate in IgG serological screening, among whom 82 961 individuals (59.0% response rate) were tested for SARS-CoV-2 antibodies, with median (interquartile range [IQR]; range) age, 50 (40-56; 19-83) years and 59 839 (72.1%) women. Among these individuals, 10 115 HCWs (12.2%; 95% CI, 12.0%-12.4%) had positive results (median [IQR; range] age, 50 [39-55; 20-80] years; 7298 [72.2%] women). Statistically significantly higher odds of infection were found among health assistants (adjusted odds ratio [aOR], 1.48; 95% CI, 1.33-1.65) and nurses (aOR, 1.28; 95% CI, 1.17-1.41) compared with administrative staff and among workers employed in internal medicine (aOR, 2.24; 95% CI, 1.87-2.68), palliative care (aOR, 1.84; 95% CI, 1.38-2.44), rehabilitation (aOR, 1.59; 95% CI, 1.33-1.91), and emergency departments (aOR, 1.56; 95% CI, 1.29-1.89) compared with those working as telephone operators. Statistically significantly lower odds of infection were found among individuals working in forensic medicine (aOR, 0.40; 95% CI, 0.19-0.88), histology and anatomical pathology (aOR, 0.71; 95% CI, 0.52-0.97), and medical device sterilization (aOR, 0.54; 95% CI, 0.35-0.84) compared with those working as telephone operators. The odds of infection for physicians and laboratory personnel were not statistically significantly different from those found among administrative staff. The odds of infection for workers employed in intensive care units and infectious disease wards were not statistically significantly different from those of telephone operators.Conclusions and relevanceThese findings suggest that professionals partially accustomed to managing infectious diseases had higher odds of SARS-CoV-2 infection. The findings further suggest that adequate organization of clinical wards and personnel, appropriate personal protective equipment supply, and training of all workers directly and repeatedly exposed to patients with clinical or subclinical COVID-19 should be prioritized to decrease the risk of infection in health care settings.
| S-EPMC8261609 | biostudies-literature
Project description:BackgroundVaccination of healthcare workers (HCWs) is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their patients, as well as to encourage their patients to get immunized. The present study aimed to investigate the psychological outcomes and associated factors among vaccinated and unvaccinated HCWs against COVID-19 infection in Bangladesh.MethodsFrom March to August 2021, an online nationwide survey was conducted with a total of 2,038 Bangladeshi HCWs. The frequency of symptoms of general health problems, depression, anxiety, stress, post-traumatic stress disorder, insomnia, and loneliness was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and UCLA-LS scales, respectively.ResultsCompared with unvaccinated HCWs (n = 1,058), vaccinated HCWs (n = 980) had a statistically significant lower prevalence of general health problems (16.7 vs. 59.1%), depression (15.6 vs. 31.9%), post-traumatic stress disorder (22.3 vs. 30.8%), insomnia (23.8 vs. 64.9%), and loneliness symptoms (13.9 vs. 21.8%). Among vaccinated HCWs, females were significantly associated with a higher risk of symptoms of general health problems (AOR, 2.71; 95% CI, 0.97-7.60), anxiety (AOR, 2.17; 95% CI, 1.14-4.13), and loneliness (AOR, 2.52; 95% CI, 1.11-5.73). Except for anxiety and post-traumatic stress disorder symptoms, participants living in urban areas had a significantly lower risk of all psychological outcomes (e.g., depression: AOR, 0.43; 95% CI, 0.27-0.67; stress: AOR, 0.64; 95% CI, 0.47-0.88). Respondents who were married were significantly less likely to experience symptoms of general health problems (AOR, 0.10; 95% CI, 0.02-0.39), depression (AOR, 0.31; 95% CI, 0.22-0.82), insomnia (AOR, 0.46; 95% CI, 0.20-1.03), and loneliness (AOR, 0.31; 95% CI, 0.10-0.92). Participants who worked as doctors were significantly less chance of experiencing symptoms of general health problems (AOR, 0.18; 95% CI, 0.08-0.37), depression (AOR, 0.51; 95% CI, 0.30-0.87), and anxiety (AOR, 0.54; 95% CI, 0.37-0.78). On the other hand, unvaccinated HCWs who were 18-29 years old and had <5 years of work experience were significantly associated with a higher risk of all psychological outcomes except anxiety and insomnia symptoms (e.g., depression among 18-29 years old: AOR, 1.83; 95% CI, 0.27-2.60; stress among those with <5 years of work experience: AOR, 2.37; 95% CI, 0.93-6.07). Participants who worked as nurses were significantly more likely to suffer from depression (AOR, 1.44; 95% CI, 0.84-2.46), anxiety (AOR, 1.42; 95% CI, 0.24-1.73), and stress (AOR, 1.55; 95% CI, 0.31-0.89) symptoms. Except for anxiety and stress symptoms, respondents who worked as frontline workers and provided direct care to infected patients were the significantly higher chance of experiencing all psychological outcomes (e.g., depression among who worked as frontline workers: AOR, 2.41; 95% CI, 0.23-3.73; insomnia among those who provide direct care to infected patients: AOR, 2.60; 95% CI, 0.34-3.06). Participants who were infected with COVID-19 had a significantly less chance of experiencing symptoms of general health problems (AOR, 0.89; 95% CI, 0.65-1.22), depression (AOR, 0.66; 95% CI, 0.48-0.92), and anxiety (AOR, 0.63; 95% CI, 0.46-0.87).ConclusionsTo control the infection and improve psychological outcomes, this study suggests emphasizing the vaccinated to unvaccinated HCWs as soon as possible. They also required special attention, health-related education, and psychological support.
| S-EPMC8988188 | biostudies-literature
Project description: Not available
| S-BSST563 | biostudies-other
Project description:BackgroundHealth care workers (HCWs) in Canada have endured difficult conditions during the COVID-19 pandemic. Many worked long hours while attending to patients in a contagious environment. This introduced an additional burden that may have contributed to worsened mental health conditions.ObjectiveIn this study, we examine the factors associated with worsened mental health conditions of HCWs as compared to before the start of the pandemic.MethodsWe use data from a survey of HCWs by Statistics Canada. A regression model is used to estimate the odds ratios (ORs) of worsened mental health after the start of the pandemic. The estimated odds ratio (OR) is associated with different independent variables that include demographics (age, sex, immigration status, and geographic area), occupational factors (work status, occupational group, and exposure category), and different access levels to personal protective equipment (PPE).ResultsOf 18,139 eligible participants surveyed, 13,990 (77.1%) provided valid responses. We found that HCWs younger than 35 years old were more likely (OR 1.14, 95% CI 1.03-1.27; P=.01) to exhibit worsened mental health as compared to the reference group (35-44 years old). As for sex, male HCWs were less likely (OR 0.76, 95% CI 0.67-0.86; P<.001) to exhibit worsened mental health as compared to female HCWs. Immigrant HCWs were also less likely (OR 0.57, 95% CI 0.51-0.64; P<.001) to exhibit worsened mental health as compared to nonimmigrant HCWs. Further, HCWs working in Alberta had the highest likelihood of exhibiting worsened mental health as compared to HCWs working elsewhere (Atlantic provinces, Quebec, Manitoba, Saskatchewan, Ontario, British Columbia, and Northern Territories). Frontline workers were more likely (OR 1.26, 95% CI 1.16-1.38; P<.001) to exhibit worsened mental health than nonfrontline HCWs. Part-time HCWs were less likely (OR 0.85, 95% CI 0.76-0.93; P<.001) to exhibit worsened mental health than full-time HCWs. HCWs who reported encountering COVID-19 cases were more likely (OR 1.55, 95% CI 1.41-1.70; P<.001) to exhibit worsened mental health as compared to HCWs who reported no contact with the disease. As for PPE, HCWs who never had access to respirators, eye protection, and face shields are more likely to exhibit worsened mental health by 1.31 (95% CI 1.07-1.62; P<.001), 1.51 (95% CI 1.17-1.96; P<.001), and 1.41 (95% CI 1.05-1.92; P=.02) than those who always had access to the same PPE, respectively.ConclusionsDifferent HCW groups experienced the pandemic differently based on their demographic and occupational backgrounds as well as access to PPE. Such findings are important to stakeholders involved in the planning of personalized support programs and aid mental health mitigation in future crises. Certain groups require more attention.
| S-EPMC10905361 | biostudies-literature
Project description:BackgroundPrimary health-care workers (PHWs) managed increased workloads and pressure during the COVID-19 pandemic. This study conducted a national survey examining burnout among PHWs at the end of the COVID-19 pandemic, and identifies related factors. By doing so, it addresses the gap in understanding the burnout situation among PHWs at a national level, taking into account urban-rural disparities.MethodsWe conducted a nationwide cross-sectional survey of PHWs in China from May to October 2022, covering 31 provinces. The MBI-HSS was used to measure overall burnout and emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). We used multivariable logistic regression to identify risk factors, and subgroup analyses to identify differences between rural and urban areas.Results3769 PHWs from 44 primary health-care institutions completed the survey. Overall, 16.6% reported overall burnout, and the prevalence of EE, DP, and reduced PA was 29.7%, 28.0%, and 62.9%, respectively. The prevalence of overall burnout (17.6% vs. 13.7%, P = 0.004) and EE (31.5% vs. 24.8%, P < 0.001) was higher in urban than rural areas (AOR = 1.285; 95%CI, 1.021-1.617). Job satisfaction was a protective factor against burnout in both settings. The protective factors of overall burnout, EE and DP vary between urban and rural areas.ConclusionsThe Mental Health Status Questionnaire-Short Form (MSQ-SF) score functioned as a protective factor against burnout across both rural and urban locales, highlighting the intrinsic link between job satisfaction and burnout. Other influencing factors differed between urban and rural areas, so interventions should be tailored to local conditions. Rural married PHWs experienced the lower prevalence of burnout indicates the support structure may play a significant role. In urban settings, it is recommended to strategically pre-emptively stock essential supplies like PPE.
| S-EPMC11406954 | biostudies-literature
Project description:In December 2019, coronavirus disease 2019 (COVID-19) appeared in Wuhan (Hubei, China) and subsequently swept the globe. In addition to the risk of infection, there is a strong possibility that post-traumatic stress disorder (PTSD) may be a secondary effect of the pandemic. Health care workers (HCWs) participating in the pandemic are highly exposed to and may bear the brunt out of stressful or traumatic events. In this cross-sectional study, we assessed the morbidity and risk factors of PTSD symptoms among Chinese HCWs. A total of 457 HCWs were recruited from March 15, 2020, to Mach 22, 2020, including HCWs in Wuhan and Hubei Province (excluding Wuhan), the areas first and most seriously impacted by COVID-19. The morbidity of PTSD symptoms was assessed by the Event Scale-Revised (IES-R). The risk factors for PTSD symptoms were explored by means of logistic regression analysis. Over 40% of the respondents experienced PTSD symptoms more than one month after the COVID-19 outbreak, and this proportion increased to 57.7% in Wuhan HCWs, especially females and HCWs on the frontline. Thus, rapid mental health assessment and effective psychological interventions need to be developed for frontline HCWs to prevent long-term PTSD-related disabilities. Moreover, Negative coping style and neuroticism personality may be regarded as high risk factors for PTSD symptoms. Improving individual coping strategies to enhance resilience should be the focus of further preventive intervention strategies.
| S-EPMC9998286 | biostudies-literature