A University Hospital Healthcare Workers' High-Risk Contact with Patients Diagnosed with Coronavirus Disease (COVID-19): a Cross-Sectional Evaluation

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.

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Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052434 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2434

Author(s):

Yoshito Nishimura ◽

Tomoko Miyoshi ◽

Hideharu Hagiya ◽

Yoshinori Kosaki ◽

Fumio Otsuka

Keyword(s):

Healthcare Workers ◽

Healthcare Professionals ◽

Healthcare Delivery ◽

General Medicine ◽

Maslach Burnout Inventory ◽

University Hospital ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

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SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094540 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4540

Author(s):

Johannes Korth ◽

Benjamin Wilde ◽

Sebastian Dolff ◽

Jasmin Frisch ◽

Michael Jahn ◽

...

Keyword(s):

High Risk ◽

Healthcare Workers ◽

Risk Group ◽

Close Contact ◽

Virus Transmission ◽

High Risk Group ◽

Low Risk ◽

University Hospital ◽

Intermediate Risk ◽

Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

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Latent Tuberculosis Infection among Healthcare Workers in Duhok Province: From Screening to Prophylactic Treatment

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4020085 ◽

2019 ◽

Vol 4 (2) ◽

pp. 85 ◽

Cited By ~ 2

Author(s):

Hind Bahzad Almufty ◽

Ibtesam Salih Abdulrahman ◽

Muayad Aghali Merza

Keyword(s):

High Risk ◽

Healthcare Workers ◽

Prophylactic Treatment ◽

Univariate Analysis ◽

Health Care Facilities ◽

P Value ◽

Smear Microscopy ◽

Medical Doctors ◽

Cross Sectional ◽

Increased Risk

Healthcare workers (HCWs) are at increased risk of infection with Mycobacterium tuberculosis (Mtb) and, hence, of developing tuberculosis (TB) disease. The aims of this study are to identify the prevalence and determinants of latent TB infection (LTBI) among HCWs in Duhok Province. This is a cross-sectional prospective study conducted during April–July 2018 in different health care facilities of Duhok province. HCWs at multiple levels were selected by a non-systematic random sampling method. Information on demographic and associated risk factors of LTBI were collected by using a standardized questionnaire. Thereafter, all HCWs underwent QuantiFERON Gold Plus (QFT-Plus) assay. HCWs with indeterminate QFT-Plus underwent a Tuberculin Skin Test. HCWs with positive results were further evaluated by smear microscopy investigation and chest X-ray examination. Three hundred ninety-five HCWs were enrolled; 49 (12%) tested positive for LTBI. The mean age of the HCWs was 33.4 ± 9.25 with a female predominance (51.1%). According to the univariate analysis, LTBI was significantly higher among HCWs with the following: age groups ≥ 30 years, alcohol intake, ≥ 11 years of employment, high risk stratification workplaces, and medical doctors. In the multivariate analysis, the age group of 30–39 years (OR = 0.288, 95% CI: 0.105–0.794, p value = 0.016) was the only risk factor associated with LTBI. Further medical investigations did not reveal active TB cases among HCWs with LTBI. With regards to prophylactic treatment, 31 (63.3%) LTBI HCWs accepted the treatment, whereas 18 (36.7%) declined the chemoprophylaxis. Of these 31 HCWs on chemoprophylaxis, 12 (38.7%) received isoniazid (INH) for six months, 17 (54.8%) received INH in combination with rifampicin (RMP) for three months, and two (6.5%) received alternative therapy because of anti-TB drug intolerance. In conclusions, although Iraq is a relatively high TB burden country, the prevalence of LTBI among Duhok HCWs is relatively low. It is important to screen HCWs in Duhok for LTBI, particularly medical doctors, young adults, alcoholics, and those whom had a long duration of employment in high-risk workplaces. The acceptance rate of HCWs with LTBI to chemoprophylaxis was low. Therefore, ensuring medical efforts to educate the healthcare staff particularly, non-professionals are a priority to encourage chemoprophylaxis acceptance.

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Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10916 ◽

2019 ◽

Vol 13 (08) ◽

pp. 744-747 ◽

Cited By ~ 1

Author(s):

Uluhan Sili ◽

Pinar Ay ◽

Huseyin Bilgin ◽

Seyhan Hidiroglu ◽

Volkan Korten

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

University Hospital ◽

World Health ◽

Training Methods ◽

Cross Sectional

Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for “before clean/aseptic procedure” indication and highest compliance was 68.6% for “after touching a patient” indication. Although > 90% healthcare workers correctly identified the World Health Organization’s five indications for HH, 82 – 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.

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Screening for Tuberculosis Infection in Spanish Healthcare Workers Comparison of the QuantiFERON-TB Gold In-Tube Test with the Tuberculin Skin Test

Infection Control and Hospital Epidemiology ◽

10.1086/598519 ◽

2009 ◽

Vol 30 (9) ◽

pp. 876-883 ◽

Cited By ~ 22

Author(s):

Eva Elisa Àlvarez-León ◽

Elizabeth Espinosa-Vega ◽

Évora Santana-Rodríguez ◽

Jesús M. Molina-Cabrillana ◽

Jose Luis Pérez-Arellano ◽

...

Keyword(s):

Positive Result ◽

Tuberculin Skin Test ◽

Skin Test ◽

Healthcare Workers ◽

Latent Tuberculosis ◽

Cross Sectional Study ◽

University Hospital ◽

Enzyme Linked Immunosorbent Assay ◽

Cross Sectional ◽

Negative Results

Objective.The risk of latent tuberculosis (LTBI) in healthcare workers (HCWs) is high. Until recently, the tuberculin skin test (TST) was the only diagnostic test available for Mycobacterium tuberculosis infection. A new enzyme-linked immunosorbent assay test, the QuantiFERON-TB Gold (QFT-G) test, was recommended by the US Centers for Disease Control and Prevention as an alternative test for the diagnosis of LTBI in HCWs. The purpose of our study was to compare the TST and the QFT-G test in Spanish HCWs in order to improve procedures for the detection of LTBI.Methods.A cross-sectional study with blinded comparison of TST and QFT-G test results was carried out among 134 HCWs at an 800-bed Spanish university hospital. The level of interferon-7 production stimulated by the QFT-G test was measured. A concentration of at least 0.35 IU/mL was considered a positive result. An induration of at least 5 mm in non-BCG-vaccinated or at least 15 mm in BCG-vaccinated HCWs for the TST was considered positive.Results.Of the 134 HCWs included (mean age, 33.4 years; 101 [75.4%] women; 47 [35.1%] BCG vaccinated), the LTBI prevalence diagnosed with any test was 11.2% (95% confidence interval, 6.6%-18.1%), with the TST was 8.96%, and with the QFT-G test was 5.97% (nonsignificant differences). The QFT-G test value was higher in subjects with TST induration of at least 15 mm than in subjects with TST induration of less than 15 mm (P < .001). Overall agreement between the results of the two tests was found in 94% of HCWs (K = 0.56), but agreement was only 59% in HCWs who had a positive result for both tests. Disagreement was present in the results found for 5% of HCWs.Conclusions.Few studies have compared both tests in populations with high M. tuberculosis exposure but low BCG vaccination prevalence. Agreement between both tests is high, especially among negative Results. Studies are needed to clarify the reasons for disagreement and to establish the best TST and QFT-G test cutoff point.

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Tuberculosis and Tuberculin Quality: Best Intentions, Misleading Results

Infection Control and Hospital Epidemiology ◽

10.1086/501937 ◽

2001 ◽

Vol 22 (08) ◽

pp. 481-484 ◽

Cited By ~ 12

Author(s):

M. Sigfrido Rangel-Frausto ◽

Samuel Ponce-de-León-Rosales ◽

Claudia Martinez-Abaroa ◽

Kaare Hasløv

Keyword(s):

Medical Students ◽

High Risk ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Healthcare Workers ◽

Low Risk ◽

University Hospital ◽

High Risk Population ◽

Risk Population

Abstract Objective: To compare the performance of three purified protein derivative (PPD) formulations: Tubersol (Connaught); RT23, Statens Serum Institut (SSI); and RT23, Mexico, tested in Mexican populations at low and high risk for tuberculosis (TB). Design: A double-blinded clinical trial. Setting: A university hospital in Mexico City. Participants: The low-risk population was first or second-year medical students with no patient contact; the high-risk population was healthcare workers at a university hospital. Methods: Each of the study subjects received the three different PPD preparations. Risk factors for TB, including age, gender, occupation, bacille Calmette-Guerin (BCG) status, and TB exposure, were recorded. A 0.1-mL aliquot of each preparation was injected in the left and right forearms of volunteers using the Mantoux technique. Blind readings were done 48 to 72 hours later. Sensitivity and specificity were calculated at 10 mm of induration using Tubersol as the reference standard. The SSI tested the potency of the different PPD preparations in previously sensitized guinea pigs. Results: The low-risk population had a prevalence of positive PPD of 26%. In the low-risk population, RT23 prepared in Mexico, compared to the 5 TU of Tubersol, had a sensitivity of 51%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 86%. The RT23 prepared at the SSI had a sensitivity of 69%, a specificity of 99%, a positive predictive value of 95%, and a negative predictive value of 90%. In the high-risk population, the prevalence of positive PPD was 57%. The RT23 prepared in Mexico had a sensitivity of 33%, a specificity of 100%, and a positive predictive value of 53%; the RT23 prepared at the SSI had a sensitivity of 91%, a specificity of 98%, a positive predictive value of 98%, and a negative predictive value of 89%. RT23 used in Mexico had a potency of only 23% of that of the control. There was no statistical association among those with a positive PPD, irrespective of previous BCG vaccination (relative risk, 0.97; 95% confidence interval, 0.76-1.3; P=.78). Conclusions: Healthcare workers had twice the prevalence of positive PPD compared to medical students. RT23 prepared in Mexico had a low sensitivity in both populations compared to 5 TU of Tubersol and RT23 prepared at the SSI. Previous BCG vaccination did not correlate with a positive PPD. Low potency of the RT23 preparation in Mexico was confirmed in guinea pigs. Best intentions in a TB program are not enough if they are not followed by high-quality control.

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Psychological Distress, Fear of COVID-19, and Resilient Coping Abilities among Healthcare Workers in a Tertiary First-Line Hospital during the Coronavirus Pandemic

Journal of Clinical Medicine ◽

10.3390/jcm10071465 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1465

Author(s):

Enrico Collantoni ◽

Anna Maria Saieva ◽

Valentina Meregalli ◽

Cristian Girotto ◽

Giovanni Carretta ◽

...

Keyword(s):

Psychological Distress ◽

Healthcare Workers ◽

Social Stigma ◽

The Elderly ◽

University Hospital ◽

Psychological Consequences ◽

Psychological Outcome ◽

Cross Sectional ◽

Heavy Burden ◽

Traumatic Distress

The COVID-19 pandemic is causing a heavy burden in hospital healthcare workers (HCW) in terms of increased work, organizational changes, risk exposure, and social stigma. The present study aims at evaluating the psychological outcome among HCWs at the final stages of the first wave of the COVID-19 pandemic. This cross-sectional and survey-based study was conducted during June 2020 among 996 HCWs of the University Hospital of Padova. All the subjects completed questionnaires investigating the perception of risk of infecting or being infected by COVID-19, psychopathological variables, and coping abilities. Compared to physicians and healthcare assistants, nurses showed higher levels of depression (p = 0.002), insomnia (p < 0.001), and generalized anxiety (p = 0.001). Females reported increased concerns about the possibility of infecting others (p = 0.046), greater anxiety (p < 0.001), COVID-19 related fears (p < 0.001), depression (p < 0.001), and post-traumatic distress (p < 0.001) than males. Being employed in a COVID-19 unit, being transferred to other units, and living with children and the elderly were factors associated with higher levels of psychological distress. Greater coping abilities were detected in physicians, and in those HCWs employed in COVID units. Our findings evidenced that the psychological consequences of the pandemic were non-homogeneously distributed across HCWs categories and pointed out the presence of specific in-hospital and out-of-hospital risk factors.

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COVID-19 Pandemic in University Hospital: Is There an Effect on The Medical Interns?

10.1101/2020.10.01.20205112 ◽

2020 ◽

Author(s):

WeiHonn Lim ◽

Li Ying Teoh ◽

Kanesh Kumaran A/L Seevalingam ◽

Shanggar Kuppusamy

Keyword(s):

Support Group ◽

Healthcare Workers ◽

Well Being ◽

University Hospital ◽

Cross Sectional ◽

Peer Support Group ◽

Ordinal Logistic Regression Analysis ◽

Heavy Workload ◽

Medical Interns ◽

The Impact

AbstractIntroductionCoronavirus Disease 2019 (COVID-19) pandemic has disrupted the current healthcare system and carries a major impact to the healthcare workers (HCW). University Malaya Medical Centre (UMMC) has been selected as one of the centres in managing COVID-19 cases in Malaysia. Many HCW including the medical interns, are directly or indirectly involved in the management.MethodsThis is a cross-sectional, pilot study to determine the impact of the pandemic on UMMC medical interns. A survey which comprises 37-items was used. Data are analysed by Ordinal Logistic Regression Analysis.ResultsOur study shows that medical interns are tired (p = 0.014), starving (p = 0.004), have inadequate exercises (p = 0.004) and burdened with heavy workload (p=0.023) during pandemic period. Many are depressed (p = 0.043), scared to work (p = 0.03), and worried of getting infected (p < 0.05). Some quarrel with their colleagues (p < 0.05), losing contact with friends (p = 0.022) and feel that it will be beneficial to have a peer support group (p = 0.027).ConclusionIn summary, the impact of COVID-19 amongst medical interns is significant and their overall well-being should be protected without jeopardising their training.

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