Occupational exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and risk of infection among healthcare personnel

Abstract

Objective: To assess the rate and factors associated with healthcare personnel (HCP) testing positive for SARS-CoV-2 after an occupational exposure Design: Retrospective cohort study Setting: Academic medical center with sites in Minnesota, Wisconsin, Arizona, and Florida Subjects: HCP with a high or medium risk occupational exposure to a patient or other HCP with SARS-CoV-2 Methods: We reviewed the records of HCP with significant occupational exposures from March 20th, 2020 through December 31st, 2020. We then performed regression analysis to assess the impact of demographic and occupational variables to assess their impact on the likelihood of testing positive for SARS-CoV-2 Results: A total of 2,253 confirmed occupational exposures occurred during the study period. Employees were the source for 57.1% of exposures. Overall, 101 (4.5%) HCP tested positive in the postexposure period. Of these, 80 had employee sources of exposure and 21 had patient sources of exposure. The post exposure infection rate was 6.2% when employees were the source, compared to 2.2% with patient sources. In a multivariate analysis, occupational exposure from an employee source had a higher risk of testing positive compared to a patient source (OR 3.22 95% CI (1.72-6.04)). Gender, age, high-risk exposure, and HCP role were not associated with increased risk of testing positive. Conclusions: The risk of acquiring COVID-19 following a significant occupational exposure is relatively low, even in the pre-vaccination era. Exposure to an infectious coworker carries a higher risk than exposure to a patient. Continued vigilance and precautions remain necessary in healthcare settings.

Occupational risk of COVID-19 related hospital admission in Denmark 2020–2021: a follow-up study

“…Ideally, research into risks of COVID-19 by occupation would be based on cases ascertained through systematic prospective follow-up of large cohorts of workers, with regular ascertainment of symptoms, clinical signs, and polymerase chain reaction (PCR) testing. As that has not been feasible, researchers have been forced to use proxy measures of incidence based on: PCR testing (4)(5)(6)(7)(8)(9)(10)(11), measurements of specific immunoglobulins against SARS-CoV-2 (12)(13)(14), symptoms and sickness absence (6), COVID-19 related hospital admission (7,15,16), or mortality from the disease (7,15,(17)(18)(19)(20)(21)(22). In most studies to date, with broad coverage of occupations, mortality from COVID-19 has been the outcome measure (7,15,(17)(18)(19)(20)(21)(22).…”

Occupational risk of SARS-CoV-2 infection: a nationwide register-based study of the Danish workforce during the COVID-19 pandemic, 2020–2021

“…At the bottom line, unresolved limitations inherently related to analysis of testing results call for cautious interpretation of risk for specific occupations which must be construed in the light of findings in earlier studies applying other methodological approaches2 3 10 33–36 and independent assessment of workplace risk factors, for instance, using job exposure matrices 6 37…”

COVID-19 clusters in a teaching hospital during the second wave of the SARS-CoV-2 pandemic in France: A descriptive study and lessons learned for waves to come

“… 6 Also, the literature has shown that HCW-to-HCW exposure gives rise to a higher risk of SARS-CoV-2 infection than exposure to a patient, and this might contribute to the triggering of clusters. 7 …”