Epidemiological model of COVID-19 in healthcare workers: occupational vs. environmental disease

Abstract This study aims to estimate the occupational etiology of COVID-19 in the healthcare sector and obtain a risk matrix for the burden of disease across occupations and specific activities. The study population included 4515 cases and 133077 controls. We have used an epidemiological model that included data collected over one year from employed persons with confirmed SARS-CoV-2 infection, age group 20-64, and residing in Sibiu County. We measured the incidence rate (IR), relative risk (RR), and risk of COVID-19 attributable to the occupational exposure (AR), respectively, statistical analysis based on frequency distribution and the portion of cases to compute the risk levels in social- and healthcare workers. According to this model, approximately 70.5% of COVID-19 risk could be attributable to occupational exposure. The workplace is a strong predictor of infection risk (RR 3.4), particularly in residential long-term care facilities, hospitals, and ambulance services. The highest-risk job functions are nurse, nursing assistant, ambulance worker, and dentist. In conclusion, we believe in having demonstrated that epidemiological modeling may be helpful for risk management and notification of COVID-19 as an occupational disease in frontline staff and essential healthcare personnel.

Download Full-text

Italy: nationalist anti-migrant policies and emigration of Italian health professions

European Journal of Public Health ◽

10.1093/eurpub/ckz185.566 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Pavolini

Keyword(s):

Healthcare Workers ◽

Qualitative Interviews ◽

National Level ◽

Health Sector ◽

Healthcare Personnel ◽

Strong Increase ◽

Skilled Workers ◽

Term Care ◽

Care Workers

Abstract Background Traditionally Italy has been characterised by a limited investment in healthcare personnel, apart from physicians. The outcome has been a low health worker to population density; especially nurses and long-term care personnel face shortages. The outcome has been, at least until 2010 an increasing presence of migrant care workers. However, the situation has changed for several reasons. On one hand, since austerity policies have been implemented, the whole healthcare system has registered a freeze in new healthcare personnel hiring. One the other hand, in more recent years policies have started to be implemented, especially by the latest government (where one of the two governing parties is a radical right one) to make it more difficult for migrants to access the country. Methods The study draws on an analysis of administrative data and previous researches in the field, matched by qualitative interviews with key informants at the national level. Results Shortage of skilled workers in the health sector is likely to increase in future. It is becoming more difficult for foreigners to get access to work in this sector, while Italian healthcare workers are leaving the country. In recent years there has been a strong increase in healthcare professionals’ emigration toward North America and other EU countries. Conclusions Italy needs both a new effective strategy of health workforce governance and a more migrant-friendly policy to manage incoming and outgoing flows of health professionals.

Download Full-text

European Recommendations for the Management of Healthcare Workers Occupationally Exposed to Hepatitis

European Journal of Medicine and Natural Sciences ◽

10.26417/ejmn.v2i1.p49-49 ◽

2018 ◽

Vol 2 (1) ◽

pp. 49

Author(s):

Enis Uruci

Keyword(s):

Occupational Exposure ◽

Hepatitis B ◽

Healthcare Workers ◽

Antiviral Treatment ◽

World Health ◽

Antibody Concentration ◽

Post Exposure Prophylaxis ◽

Transferase Activity ◽

Mediterranean Countries

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, .or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs .or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs .or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) (1). In the general population, HCV prevalence varies geographically from about 0.5% in northern countries to 2% in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3% to 3%. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average.

Download Full-text

SARS-CoV-2 Ig G among Healthcare Workers and the General Population

Pathogens ◽

10.3390/pathogens10040465 ◽

2021 ◽

Vol 10 (4) ◽

pp. 465

Author(s):

Gregorio P. Milani ◽

Mario G. Bianchetti ◽

Giuseppe Togni ◽

Andreas W. Schoenenberger ◽

Franco Muggli

Keyword(s):

General Population ◽

Healthcare Workers ◽

Geographical Area ◽

Healthcare Personnel ◽

Protein Subunit ◽

Positive Serology ◽

Seroprevalence Data ◽

And Gender ◽

Few Data ◽

Ig G

It is assumed that healthcare workers are at the highest risk to be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few data from healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection support this assumption. We investigated the prevalence of immunoglobulin G (Ig G) against SARS-CoV-2 among healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection and the general population in a well-defined geographical area. The first part of the study was conducted in May 2020 in Val Mesolcina (Southern Switzerland), a valley with ~8000 inhabitants. All healthcare workers were invited. All participants (n = 488) of the Swiss Longitudinal Cohort Study (SWICOS), a cohort representative of the general population, were also invited. Circulating Ig G against spike protein subunit 1 of SARS-CoV-2 were tested in each subject. Subjects with positive Ig G were tested again after 6 months. The condition of being a healthcare worker, rather than a part of the general population, was tested as a predictor of seroprevalence positivity by both simple and multiple (adjusted for age and sex) logistic regression. Eleven (2.6%) of the 423 SWICOS participants and 46 (16%) out of 289 healthcare workers were positive for antibodies against SARS-CoV-2. The seroprevalence OR was 7.01 (95% CI: 3.53–15.47) for healthcare workers as compared to SWICOS participants. After adjusting for age and gender, the seroprevalence OR was 5.13 (95% CI: 2.54–10.40). About three quarters of the subjects in the SWICOS (73%) and in healthcare (79%) group with a previous positive serology still presented positive Ig G against the SARS-CoV-2 after 6 months. The present seroprevalence data point out that the SARS-CoV-2 infection is seven times higher among healthcare workers than in the general population of Val Mesolcina. Efforts to effectively protect all the healthcare personnel are needed.

Download Full-text

The Healthcare Sector Employer’s Duty of Care: Implications for Worker Well-Being

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116015 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6015

Author(s):

Melissa McDiarmid ◽

Marian Condon ◽

Joanna Gaitens

Keyword(s):

Middle East ◽

Healthcare Workers ◽

Care Program ◽

Well Being ◽

Middle East Respiratory Syndrome ◽

Worker Safety ◽

Healthcare Sector ◽

Duty Of Care ◽

Protective Equipment ◽

Extreme Risk

Pandemic diseases of this century have differentially targeted healthcare workers globally. These infections include Severe Acute Respiratory Syndrome SARS, the Middle East respiratory syndrome coronavirus Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola. The COVID-19 pandemic has continued this pattern, putting healthcare workers at extreme risk. Just as healthcare workers have historically been committed to the service of their patients, providing needed care, termed their “duty of care”, so too do healthcare employers have a similar ethical duty to provide care toward their employees arising from historical common law requirements. This paper reports on results of a narrative review performed to assess COVID-19 exposure and disease development in healthcare workers as a function of employer duty of care program elements adopted in the workplace. Significant duty of care deficiencies reported early in the pandemic most commonly involved lack of personal protective equipment (PPE) availability. Beyond worker safety, we also provide evidence that an additional benefit of employer duty of care actions is a greater sense of employee well-being, thus aiding in the prevention of healthcare worker burnout.

Download Full-text

Characterization and evolution of infection control practices among SARS-CoV-2 infected healthcare workers of acute care hospitals and long-term care facilities in Quebec, Canada, Spring 2020

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.160 ◽

2021 ◽

pp. 1-37

Author(s):

Sara Carazo ◽

Denis Laliberté ◽

Jasmin Villeneuve ◽

Richard Martin ◽

Pierre Deshaies ◽

...

Keyword(s):

Acute Care ◽

Attack Rate ◽

Healthcare Workers ◽

Long Term Care ◽

Acute Care Hospitals ◽

Exposure Period ◽

Infection Prevention And Control ◽

Term Care ◽

Care Facilities

ABSTRACT Objectives: To estimate the SARS-CoV-2 infection rate and the secondary attack rate among healthcare workers (HCWs) in Quebec, the most affected province of Canada during the first wave; to describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and to compare the exposures and practices between acute care hospitals (ACHs) and long-term care facilities (LTCFs). Design: Survey of cases Participants: Quebec HCWs from private and public institutions with laboratory-confirmed COVID-19 diagnosed between 1st March and 14th June 2020. HCWs ≥18 years old, having worked during the exposure period and survived their illness were eligible for the survey. Methods: After obtaining consent, 4542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. Results: HCWs represented 25% (13,726/54,005) of all reported COVID-19 cases in Quebec and had an 11-times greater rate than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants, working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs of LTCFs had less training, higher staff mobility between working sites, similar PPE use but better self-reported compliance with at-work physical distancing. Sub-optimal IPC practices declined over time but were still present at the end of the first wave. Conclusion: Quebec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.

Download Full-text

Interventions to reduce sickness absence among healthcare workers: a systematic review

International Journal of Emergency Services ◽

10.1108/ijes-05-2018-0028 ◽

2019 ◽

Vol 8 (2) ◽

pp. 147-162

Author(s):

Laura Simmons ◽

Arwel W. Jones ◽

Niro Siriwardena ◽

Christopher Bridle

Keyword(s):

Systematic Review ◽

Influenza Vaccination ◽

Sickness Absence ◽

Healthcare Workers ◽

Healthcare Services ◽

Primary Outcome Measure ◽

Healthcare Sector ◽

Intervention Programme ◽

Content Type ◽

Multicomponent Intervention

Purpose Sickness absence is a major concern for healthcare services and their employees with healthcare workers having higher sickness absence rates compared to the general population. The purpose of this paper is to systematically review randomised control trials (RCTs) that aimed to reduce sickness absence among healthcare workers. Design/methodology/approach A systematic review was conducted that aimed to include RCTs with study participants who were employed in any part of the healthcare sector. This review included any type of intervention with the primary outcome measure being sickness absence. Findings Seven studies were included in the review and consisted of one exercise-only intervention, three multicomponent intervention programmes, two influenza vaccination interventions and one process consultation. Three studies (exercise-only, one multicomponent intervention programme and one influenza vaccination intervention) were able to demonstrate a reduction in sickness absence compared to control. Research limitations/implications Due to the lack of high-quality evidence, this review identified that there are currently no interventions that healthcare organisations are able to use to effectively reduce sickness absence among their employees. This review also highlights the importance of a standardised measure of sickness absence for healthcare staff, such as shifts. Originality/value To the authors’ knowledge, this is the first systematic review to synthesise such evidence among healthcare workers.

Download Full-text