Infection prevention and control risk factors for SARS-CoV-2 infection in health workers: a global, multicentre case-control study.
COVID-19
SARS-CoV-2
adherence
health workers
infection prevention and control
occupational risk factors
personal protective equipment
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
20 Sep 2024
20 Sep 2024
Historique:
received:
13
08
2023
revised:
17
03
2024
accepted:
02
04
2024
medline:
23
9
2024
pubmed:
23
9
2024
entrez:
22
9
2024
Statut:
aheadofprint
Résumé
Health workers were at higher risk for SARS-CoV-2 infection during the COVID-19 pandemic due to occupational risk factors. As part of the WHO Unity Studies initiative, we aimed to characterise these risk factors. This global, multicentre, nested, case-control study was conducted in 121 healthcare facilities in 21 countries. Cases were health workers who tested positive for SARS-CoV-2 infection with a documented occupational exposure to COVID-19 patients in the 14 days pre-enrolment. Controls were enrolled from the same facility with a similar exposure but negative serology. Case and control status was confirmed with serological testing at baseline and after 3-4 weeks. Demographic and infection risk factor data were collected using structured questionnaires. Between June 2020 and December 2021, data were obtained for 1213 cases and 1844 controls. SARS-CoV-2 infection risk was associated with non-adherence to personal protective equipment (PPE) guidelines (aOR 1·67 [95% CI 1·32-2·12]) and not consistently performing hand hygiene after patient contact (aOR 2·52 [1·72-3·68]). Direct close contact with COVID-19 patients was also associated with an increased risk, particularly during prolonged contact (>15 min.). Items associated with a lower risk were respirators during aerosol-generating procedures and gloves, gowns or coveralls during contact with contaminated materials/surfaces. No difference was observed among health workers using respirators versus surgical masks for routine care. Appropriate implementation of infection prevention and control measures and PPE use remain a priority to protect health workers from SARS-CoV-2 infection.
Sections du résumé
BACKGROUND
BACKGROUND
Health workers were at higher risk for SARS-CoV-2 infection during the COVID-19 pandemic due to occupational risk factors. As part of the WHO Unity Studies initiative, we aimed to characterise these risk factors.
METHODS
METHODS
This global, multicentre, nested, case-control study was conducted in 121 healthcare facilities in 21 countries. Cases were health workers who tested positive for SARS-CoV-2 infection with a documented occupational exposure to COVID-19 patients in the 14 days pre-enrolment. Controls were enrolled from the same facility with a similar exposure but negative serology. Case and control status was confirmed with serological testing at baseline and after 3-4 weeks. Demographic and infection risk factor data were collected using structured questionnaires.
FINDINGS
RESULTS
Between June 2020 and December 2021, data were obtained for 1213 cases and 1844 controls. SARS-CoV-2 infection risk was associated with non-adherence to personal protective equipment (PPE) guidelines (aOR 1·67 [95% CI 1·32-2·12]) and not consistently performing hand hygiene after patient contact (aOR 2·52 [1·72-3·68]). Direct close contact with COVID-19 patients was also associated with an increased risk, particularly during prolonged contact (>15 min.). Items associated with a lower risk were respirators during aerosol-generating procedures and gloves, gowns or coveralls during contact with contaminated materials/surfaces. No difference was observed among health workers using respirators versus surgical masks for routine care.
CONCLUSION
CONCLUSIONS
Appropriate implementation of infection prevention and control measures and PPE use remain a priority to protect health workers from SARS-CoV-2 infection.
Identifiants
pubmed: 39307426
pii: S0195-6701(24)00311-6
doi: 10.1016/j.jhin.2024.04.031
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Aleksandra Pejic
(A)
Anar Turmukhambetova
(A)
Bauyrzhan Omarkulov
(B)
Biljana Carevic
(B)
Bawinile Mdziniso
(B)
Faiqa Kassim Ebrahim
(FK)
Shambel Habebe
(S)
John Conly
(J)
Stephen Tsekrekos
(S)
Biagio Pinchera
(B)
Ivan Gentile
(I)
Paolo Villari
(P)
Roberto Poscia
(R)
Lorenza Lia
(L)
Giuseppe Falasconi
(G)
Giuseppe La Torre
(G)
Francesca Larese Filon
(FL)
Stefano Porru
(S)
Gianluca Spiteri
(G)
Rossitza Vatcheva-Dobrevska
(R)
Petya Stefanowa
(P)
Violeta Dicheva
(V)
Ljiljana Markovic-Denic
(L)
Lyudmila Akhmaltdinova
(L)
Marta Luisa Ciofi Degli Atti
(ML)
Vuk Marusic
(V)
Vladimir Nikolic
(V)
Vesna Mioljevic
(V)
Tochi Okwor
(T)
Tosin Akande
(T)
Esohe Olivia Ogboghodo
(EO)
Jerzy Tyszkiewicz
(J)
Grzegorz Placha
(G)
Ali Alrstom
(A)
Raed Abouharb
(R)
None Hasan Alzuhaily
Ala Bin Tarif
(AB)
Saverio Bellizzi
(S)
Mohannad Ramadan
(M)
David Tsereteli
(D)
Giorgi Chakhunashvili
(G)
Mariam Pashalishvili
(M)
Lul Raka
(L)
Aron Aregey
(A)
Bohdan Verovchuk
(B)
Vitalii Stetsyk
(V)
Tetiana Novak
(T)
Ferdous Hakim
(F)
Zaman Mostafa
(Z)
Tahmina Shirin
(T)
Balkrishna Bandu Adsul
(BB)
Mohammed Ahmad
(M)
Suman Bhansali
(S)
Anil Bilimale
(A)
Pritimoy Das
(P)
Mahbubur Rahman
(M)
Vaibhav G Garat
(VG)
Ravneet Kaur
(R)
Shashi Kant
(S)
Meenakshi Khapre
(M)
Leyanna Susan George
(LS)
Uday Narlawar
(U)
Pragati Rathod
(P)
Shyam Rathod
(S)
Charutha Retnakumar
(C)
Prakash B Patel
(PB)
Sarita Sharma
(S)
Vartika Saxena
(V)
Chitra Tomy
(C)
Sarita Wadhava
(S)
Regina P Berba
(RP)
Ma Patricia Therese G Virata
(MP)
Joanne Carmela M Sandejas
(JCM)
Informations de copyright
Copyright © 2024. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors have no conflicts of interests to declare.