Healthcare institutions’ recommendation regarding the use of FFP-2 masks and SARS-CoV-2 seropositivity among healthcare workers: a multicenter longitudinal cohort study

Background Health care workers (HCW) are heavily exposed to SARS-CoV-2 from the beginning of the pandemic. We aimed to analyze risk factors for SARS-CoV-2 seroconversion among HCW with a special emphasis on the respective healthcare institutions’ recommendation regarding the use of FFP-2 masks. Methods We recruited HCW from 13 health care institutions (HCI) with different mask policies (type IIR surgical face masks vs. FFP-2 masks) in Southeastern Switzerland (canton of Grisons). Sera of participants were analyzed for the presence of SARS-CoV-2 antibodies 6 months apart, after the first and during the second pandemic wave using an electro-chemiluminescence immunoassay (ECLIA, Roche Diagnostics). We captured risk factors for SARS-CoV-2 infection by using an online questionnaire at both time points. The effects of individual COVID-19 exposure, regional incidence and FFP-2 mask policy on the probability of seroconversion were evaluated with univariable and multivariable logistic regression. Results SARS-CoV-2 antibodies were detected in 99 of 2794 (3.5%) HCW at baseline and in 376 of 2315 (16.2%) participants 6 months later. In multivariable analyses the strongest association for seroconversion was exposure to a household member with known COVID-19 (aOR: 19.82, 95% CI 8.11–48.43, p < 0.001 at baseline and aOR: 8.68, 95% CI 6.13–12.29, p < 0.001 at follow-up). Significant occupational risk factors at baseline included exposure to COVID-19 patients (aOR: 2.79, 95% CI 1.28–6.09, p = 0.010) and to SARS-CoV-2 infected co-workers (aOR: 2.50, 95% CI 1.52–4.12, p < 0.001). At follow up 6 months later, non-occupational exposure to SARS-CoV-2 infected individuals (aOR: 2.54, 95% CI 1.66–3.89 p < 0.001) and the local COVID-19 incidence of the corresponding HCI (aOR: 1.98, 95% CI 1.30–3.02, p = 0.001) were associated with seroconversion. The healthcare institutions’ mask policy (surgical masks during usual exposure vs. general use of FFP-2 masks) did not affect seroconversion rates of HCW during the first and the second pandemic wave. Conclusion Contact with SARS-CoV-2 infected household members was the most important risk factor for seroconversion among HCW. The strongest occupational risk factor was exposure to COVID-19 patients. During this pandemic, with heavy non-occupational exposure to SARS-CoV-2, the mask policy of HCIs did not affect the seroconversion rate of HCWs.

Adherence to Personal Protective Equipment Against Infectious Diseases Among Healthcare Workers in Arak-Iran

Background: Occupational exposure to blood and body secretions poses a significant risk of COVID-19, HIV, HCV, and HBV among healthcare workers (HCWs). Assessment of this exposure is necessary for optimized planning and policy-making measures. This study aimed to assess the exposure to occupational risk factors among emergency HCWs. Methods: This cross-sectional study was performed on HCWs working in 3 educational hospitals affiliated with Arak University of Medical Sciences. The study sample included all HCWs working in emergency wards who met inclusion criteria. The data were collected using a valid and reliable researcher-made questionnaire and analyzed through analytical tests in SPSS software. Results: The 116 studied HCWs included 97 nurses and 19 physicians and medical specialties. The mean age was 31.06 with 4.7 years of work experience (207.8 hours per month) in working at the patient bedside. The results indicated that needlestick injuries have a significant positive and negative relationship with job history (p=0.001) and month-averaged working hours (p=0.012), respectively. 96.6% stated that wearing gloves is not necessary, 59.9% stated that they do not use protective glasses due to a decrease in their vision, while 50% did not use gowns due to the lack of gowns in the ward. 63.8%, 57.8%, 50%, 63.8%, 56% and 54.3% of the participants expressed shift work, a high number of hospitalized patients in the crowded ward, the need for high-speed working, high working load, an increase in working hours, and low working consent as the most important factors leading to an increment in blood transmitted diseases, respectively. Conclusion: It is necessary to design national surveillance systems to report exposed cases and develop measures and strategic plans considering the high effects of exposure to blood and body secretions.

Predictors of SARS-CoV-2 infection in a multi-ethnic cohort of United Kingdom healthcare workers: a prospective nationwide cohort study (UK-REACH)

Introduction Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. Methods We analysed data from the United Kingdom Research study into Ethnicity And COVID-19 Outcomes in Healthcare workers (UK-REACH) cohort study. We used logistic regression to examine associations of demographic, household and occupational predictor variables with SARS-CoV-2 infection (defined by PCR, serology or suspected COVID-19) in a diverse group of HCWs. Results 2,496 of the 10,772 HCWs (23.2%) who worked during the first UK national lockdown in March 2020 reported previous SARS-CoV-2 infection. In an adjusted model, demographic and household factors associated with increased odds of infection included younger age, living with other key workers and higher religiosity. Important occupational risk factors associated with increased odds of infection included attending to a higher number of COVID-19 positive patients (aOR 2.49, 95%CI 2.03—3.05 for ≥21 patients per week vs none), working in a nursing or midwifery role (1.35, 1.15—1.58, compared to doctors), reporting a lack of access to personal protective equipment (1.27, 1.15 — 1.41) and working in an ambulance (1.95, 1.52—2.50) or hospital inpatient setting (1.54, 1.37 — 1.74). Those who worked in Intensive Care Units were less likely to have been infected (0.76, 0.63—0.90) than those who did not. Black HCWs were more likely to have been infected than their White colleagues, an effect which attenuated after adjustment for other known predictors. Conclusions We identified key sociodemographic and occupational risk factors associated with SARS-CoV-2 infection amongst UK HCWs, and have determined factors that might contribute to a disproportionate odds of infection in HCWs from Black ethnic groups. These findings demonstrate the importance of social and occupational factors in driving ethnic disparities in COVID-19 outcomes, and should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting HCWs in future waves of the COVID-19 pandemic. Trial registration: ISRCTN 11811602

Occupational risk factors for meniscal lesions: a systematic review and meta-analysis

Background Meniscal lesions are common and are associated with the development of knee osteoarthritis. Knee-straining activities at work such as kneeling or squatting cause high biomechanical stresses on the knee joints that can lead to acute or chronic injuries. The objective of this systematic review is to update the evidence on the potential relationship between occupational risk factors and meniscal lesions. Methods We searched the Medline, Embase and Web of Science databases until August 2021 to identify epidemiological observational studies on the association between occupational risk factors and meniscal lesions. Study selection, data extraction and risk of bias assessment were performed independently by two reviewers. Effect measures were extracted from individual studies and pooled with random effects meta-analysis. Heterogeneity analyses were conducted. We used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the overall quality of evidence. Results The database search resulted in 11,006 references, and 46 additional studies were identified through hand search. Twenty-two studies (represented in 25 publications) met the predefined eligibility criteria and nine records were included in the meta-analysis. There was only one study with an overall low risk of bias. Significant associations between occupational risk factors and the development of meniscal lesions were found for kneeling (effect size (ES) 2.15, 95% CI 1.67–2.76), squatting (ES 2.01, 95% CI 1.34–3.03), climbing stairs (ES 2.28, 95% CI 1.58–3.30), lifting and carrying weights ≥ 10 kg (ES 1.63, 95% CI 1.35–1.96), lifting and carrying weights ≥ 25 kg (ES 1.56, 95% CI 1.08–2.24), playing football on a professional level (ES 5.22, 95% CI 3.24–8.41), working as a hard coal miner (ES 5.23, 95% CI 2.16–12.69) and floor layers (ES 1.99, 95% CI 1.43–2.78). The overall quality of evidence according GRADE was moderate to low. Conclusion We found consistent evidence of an increased risk of meniscal lesions by occupational knee-straining exposures. Our findings are important for the development of preventive strategies to reduce work-related knee disorders and work absence. Trial registration PROSPERO (registration no. CRD42020196279).

Analysis of occupational risk factors causing diseases of the circulatory system in medical workers: Literature review

The review focuses on analysis of domestic and foreign literature sources concentrating on influence exerted by occupa-tional factors and factors related to labor process on prevalence of diseases of the circulatory system (CSD) among medical workers. At present, specific features typical for occupational activities performed by medical workers are proven to be among major causes of high CSD prevalence among them. Experts have established most common occupational factors and labor-related factors that are able to induce and stimulate development of cardiovascular pathology. Labor intensity associated with neuro-emotional loads, high responsibility, round-the-clock working regime and night shifts (hazard category 3.2–3.3) is estab-lished to have a leading role among adverse labor-related factors for medical workers. Other significant contributions are made by adverse chemicals and biological agents, noise and ultrasound, laser exposure and ionizing radiation. Some authors showed that CSD prevalence was considerably higher among medical workers than among people employed in other industries. The highest CSD prevalence was detected among medical workers with the most adverse working conditions (hazard category 3.2–3.3). A high degree of occupational conditionality for CSD is typical for surgeons, therapists, and phthisiatricians. Emergency doctors run the highest risk of CSD (RR = 3.1; EF = 67.7 %). Assessment cardiovascular risks according to the SCORE system revealed that approximately 15 % medical workers older than 40 ran moderate cardiovascular risks; medical workers older than 50, high (20.0–22.0 %) or extremely high (10.0–12.5 %) total risks of death due to CSD.

Population-Based Study on Cancer Incidence in Pharmacist: A Cohort Study in Taiwan

Cancer is increasing in rate globally and is leading cause of death among no communicable chronic diseases (NCDs) after cardiovascular disease (CVD). Most of the research focuses on the risk of occupational injury, job stress, mental illness, substance abuse and workplace safety in physicians and nurses. However, fewer studies have investigated the risk of cancer in pharmacists. We compared the matched general population to investigate the risk of cancer in pharmacists in Taiwan. Data were obtained from the Health and Welfare Data Science Center of the Ministry of Health and Welfare in Taiwan. We established a pharmacist group that included 11,568 pharmacists and selected a 4-fold comparison (n = 46,272) for the non-clinics comparison group, frequency being matched by age, gender and Charlson Comorbidity Index (CCI) score. The pharmacists had a lower but non-significant risk of all cancer (Adjusted hazard ratio [aHR] = 0.96; 95% confidence interval [CI] = 0.85–1.07) compared with the general population. Female pharmacists had a higher risk of cancer than male pharmacists ([aHR] = 1.23; 95% CI = 1.06–1.43). Pharmacists had higher risks of breast cancer in females (aHR = 1.68; 95% CI = 1.35–2.08) and of prostate cancer in males (aHR = 2.18; 95% CI = 1.35–2.08) when compared with the general population. Occupational risk factors could play a role, but they were not evaluated. These epidemiological findings require additional studies to clarify cancer risk mechanisms in pharmacists.

Older Male Construction Workers and Sustainability: Work-Related Risk Factors and Health Problems

This study aims to analyze the characteristics of working conditions, exposure to risk factors, and health-related problems of older male construction workers. In this study, 1519 male construction workers were the subjects of study, and the working conditions, exposure to occupational risk factors, and physical health-related problems were compared among workers under 50 years, in their 50s, and 60 or over. Older male construction workers have lower educational backgrounds and lower average salaries. The degree of exposure to risk factors was higher in workers aged 60 or over than other age groups, such as high temperature, awkward posture, manual material handling, standing posture, repetitive motion, fumes/dust, vapor, skin contact, and tobacco smoke. In addition, the complaint rate of hearing problems, overall fatigue, backache, upper limb pain, or lower limb pain was higher in older workers. In particular, the complaint rate of musculoskeletal pain was 56.6%, overall fatigue was 40.3%, and the rate of depression symptoms was 41.9%. This study shows a high prevalence of musculoskeletal disorders, overall fatigue, and depression symptoms of male elderly construction workers, suggesting that comprehensive support is needed to improve not only the working conditions of workers but also psychological health problems.