Modeling fomite-mediated SARS-CoV-2 exposure through personal protective equipment doffing in a hospital environment.
COVID-19
PPE
SARS CoV-2
hospital infection model
quantitative microbial risk assessment
surface-contact transmission
Journal
Indoor air
ISSN: 1600-0668
Titre abrégé: Indoor Air
Pays: England
ID NLM: 9423515
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
20
08
2021
received:
06
04
2021
accepted:
18
09
2021
pubmed:
26
10
2021
medline:
8
2
2022
entrez:
25
10
2021
Statut:
ppublish
Résumé
Self-contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS-CoV-2-positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete-time Markov chain for: IV-drip care, blood pressure monitoring, and doctors' rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID-19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID-19 positive wards, although this is where the highest self-inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0-0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.
Identifiants
pubmed: 34693567
doi: 10.1111/ina.12938
pmc: PMC8653260
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12938Subventions
Organisme : Medical Research Council
ID : MR/N014855/1
Pays : United Kingdom
Organisme : Engineering and Physical Sciences Research Council
Organisme : Medical Research Council
Pays : United Kingdom
Organisme : EPSRC Centre for Doctoral Training in Fluid
Informations de copyright
© 2021 The Authors. Indoor Air published by John Wiley & Sons Ltd.
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