Professional practice for COVID-19 risk reduction among health care workers: A cross-sectional study with matched case-control comparison

Abstract

Background Health care workers (HCWs) are particularly exposed to COVID-19 and therefore it is important to study preventive measures in this population. Aim To investigate socio-demographic factors and professional practice associated with the risk of COVID-19 among HCWs in health establishments in Normandy, France. Methods A cross-sectional and 3 case-control studies using bootstrap methods were conducted in order to explore the possible risk factors that lead to SARS-CoV2 transmission within HCWs. Case-control studies focused on risk factors associated with (a) care of COVID-19 patients, (b) care of non COVID-19 patients and (c) contacts between colleagues. Participants 2,058 respondents, respectively 1,363 (66.2%) and 695 (33.8%) in medical and medico-social establishments, including HCW with and without contact with patients. Results 301 participants (14.6%) reported having been infected by SARS-CoV2. When caring for COVID-19 patients, HCWs who declared wearing respirators, either for all patient care (ORa 0.39; 95% CI: 0.29–0.51) or only when exposed to aerosol-generating procedures (ORa 0.56; 95% CI: 0.43–0.70), had a lower risk of infection compared with HCWs who declared wearing mainly surgical masks. During care of non COVID-19 patients, wearing mainly a respirator was associated with a higher risk of infection (ORa 1.84; 95% CI: 1.06–3.37). An increased risk was also found for HCWs who changed uniform in workplace changing rooms (ORa 1.93; 95% CI: 1.63–2.29). Conclusion Correct use of PPE adapted to the situation and risk level is essential in protecting HCWs against infection.

Effectiveness of face masks for reducing transmission of SARS-CoV-2: a rapid systematic review

“…Table 2 summarizes the number of studies addressing each type of comparison studied and the direction of their conclusions. There were 35 studies set in the community (three RCTs (14-16), 32 observational studies [15][16][17][18][19]48] and 40 studies situated in healthcare settings including hospitals and long-term care facilities (LTCFs) (one RCT [72], 39 observational studies [73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88]).…”

“…Of the 14 observational studies comparing different types of masks in healthcare settings, seven found that respirators were associated with a decreased risk of transmission compared with other masks and five found that there was no statistically significant difference between the two types. One study [88] compared respirator versus surgical mask use during AGPs for COVID-19 versus non-COVID-19 patients and found that while respirators were associated with lower infection rates than surgical masks in HCWs performing AGPs and non-AGPs for COVID-19 patients, the opposite was true for those caring for non-COVID-19 patients, for whom wearing a respirator was associated with a higher risk of infection than a surgical mask. A subset of six studies in healthcare settings (one RCT, five observational) reported the number of SARS-CoV-2 infection events in those who wore respirators versus surgical masks.…”

Efficacy and safety of sonographer discretion to terminate a venous duplex ultrasound for diagnosis of deep vein thrombosis in coronavirus disease 2019 patients

“…We recognize that there are significant ramifications of DVTs in COVID-19 patients, but we should also note the occupational hazards that may accompany the mode of diagnosis. Previous studies have demonstrated workplace exposure to be a risk for COVID-19 transmission among healthcare workers and patients 22 , 23 , 24 , 25 , 26 . While there are no specific prior articles evaluating the risks of COVID-19 exposure in sonographers, it has been demonstrated that there is an increased risk for transmission for nurses, staff working on COVID units, and those who have high risk exposures 27 .…”

“…Previous studies have demonstrated workplace exposure to be a risk for COVID-19 transmission among healthcare workers and patients [22][23][24][25][26] . While there are no specific prior articles evaluating the risks of COVID-19 exposure in sonographers, it has been demonstrated that there is an increased risk for transmission for nurses, staff working on COVID units, and those who have high risk exposures 27 .…”

Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case–control study in Québec, Canada

“…33,34 In our observational study, HCWs who wore an N95 during non-AGMP contacts with COVID-19–infected patients had an estimated 30% lower risk compared to those who used surgical masks. Wilson et al 36 reported higher protection for French HCWs mainly wearing respirators when caring for COVID-19 patients during AGMPs (OR, 0.6; 95% CI, 0.4–0.7) or during any (AGMP or non-AGMP) contact (OR, 0.4; 95% CI, 0.3–0.5). Lentz et al 35 conducted an international online survey among 1,130 HCWs and described a risk reduction only when respirators were used for all types of contact with COVID-19 patients (OR, 0.4; 95% CI, 0.2–0.8).…”