Are Daycare Workers at a Higher Risk of Parvovirus B19 Infection? A Systematic Review and Meta-Analysis

Abstract

Objective: In this systematic review, we aimed to summarize the evidence on the association between being a daycare educator working with children and the possible increased risk of parvovirus B19 infection compared to the general population. Methods: The Medline and Embase databases were searched using a defined search to find studies published since 2000. Two reviewers evaluated the search hits using predefined inclusion and exclusion criteria. The resulting studies were extracted and were assessed in eight domains of bias. A pooled relative risk (RR) of parvovirus infection for daycare workers compared to the general population was calculated. Results: After evaluating the 7781 search hits and manual search, four methodologically-adequate studies were identified: three cross-sectional studies and one retrospective cohort study. Of the three studies investigating the risk of infection, one evaluated parvovirus B19 seroconversion rates for daycare workers. There was an indication for an increased risk for daycare workers compared to the unexposed population (RR = 1.12, 95% CI 0.98–1.27) using prevalence estimators. Furthermore, daycare workers had a higher seroconversion rate compared to the unexposed population (RR = 2.63, 95% 1.27–5.45) in the low risk of bias study. Conclusions: Our findings suggest a higher risk of parvovirus B19 infection for daycare workers compared to an unexposed comparison population, which necessitate preventative efforts. Considering the underestimation of the occupational seroconversion risk by prevalence-based estimators, parvovirus B19 infections among daycare workers might mostly be occupationally acquired.

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“…and S.F.) assessed the risk of bias as high, low, or unclear against eight domains of bias, using a tool previously used for other occupational health reviews [ 20 , 21 , 22 , 23 ]. The hybrid tool uses SIGN (Scottish Intercollegiate Guidelines Network 2004) and CASP (Critical Appraisal Skills Program 2004/2006) assessment tools and contains several domains for risk of bias.…”

“…The hybrid tool uses SIGN (Scottish Intercollegiate Guidelines Network 2004) and CASP (Critical Appraisal Skills Program 2004/2006) assessment tools and contains several domains for risk of bias. Examples of reviews using this tool have been published previously [ 20 , 21 , 24 ], and the Risk of Bias tool can be found in the Supplementary Materials .…”

“…To assess the quality of the total body of evidence, we used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach [ 33 ], following the example of Hulshof and colleagues [ 34 ], with some modifications [ 20 , 21 , 24 ]. We used three levels of quality: high, moderate, and low.…”

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

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Occupational Risk for Post-Traumatic Stress Disorder and Trauma-Related Depression: A Systematic Review with Meta-Analysis

“…We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach for grading the quality of the total body of evidence [ 22 ], following the example of Hulshof et al, 2019 [ 23 ], with modifications (Romero Starke et al, 2019 [ 24 , 25 ]). We used the following levels of quality: high, moderate, and low.…”