Risk of SARS-CoV-2 Acquisition in Health Care Workers According to Cumulative Patient Exposure and Preferred Mask Type

Dörr, Tamara; Haller, Sven; Müller, Maja; Friedl, Andrée; Vuichard, Danielle; Kahlert, Christian; Köhler, Philipp

doi:10.1001/jamanetworkopen.2022.26816

Cited by 15 publications

(9 citation statements)

References 6 publications

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“…This is in line with several previous studies 10 , 13 . Many authors reported a strong positive association between SARS-CoV-2 infection and being in contact with a COVID-19 case at home, including in Switzerland (aOR, 7.79; 95% CI, 5.98–10.15) 9 , in France (aOR 2.00; 95% CI 2.23–3.28) and in Belgium (aOR 3.15; 95% CI 2.33–4.25) 7 , 14 . In contrast to some studies conducted among hospital HCWs 7 , but consistent with others 10 , 11 , we did not find associations between the SARS-CoV-2 infection and workplace factors (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The same two hypotheses (true association in bivariate analyses but lack of power to show it in multivariate analyses, or biased association in bivariate analyses by confounding factor) may explain the significant association in bivariate analyses between the use of mask and the infection. It was reported in some studies with both occupational and non-occupational factors associated with SARS-CoV-2 infection, that the strongest predictor of contracting COVID-19 was exposure to an infected person outside work 9 , 14 . Our findings are in lines with the fact that for PHCWs, the risk of SARS-CoV-2 infection from community exposure may be more significant than the risk of occupational exposure.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies reported a higher risk (between two- and seven-fold) of infection among HCWs from hospital or other healthcare settings than in the general population 5 , while others have not found such differences 4 , 6 , 7 . While some authors reported a dose–response association between COVID-19-patient exposure and the risk of SARS-CoV-2 infection 8 , 9 , others showed that community exposure was associated with infection but workplace factors were not 10 – 12 . Several studies have also suggested that HCWs in primary care were at higher risk of infection than in hospital settings due to lower availability of PPE, in addition to a high flow of patients 13 , 14 .…”

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave

Pouquet,

Decarreaux,

Di Domenico

et al. 2024

Sci Rep

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Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5–36.0) for GPs, 28.7% (95% CI 24.4–33.0) for pediatricians, 25.2% (95% CI 20.6–31.0) for dentists, and 25.5% (95% CI 18.2–34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01–5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14–2.05), South-East (aPR = 1.57; CI 95% 1.19–2.08), North-East (aPR = 1.81; CI 95% 1.38–2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22–1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave

Pouquet,

Decarreaux,

Di Domenico

et al. 2024

Sci Rep

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“…Retrospective analysis showed that use of KN95/N95 respirators by both community members [47] and in healthcare settings [48] resulted in lower COVID infection rates as compared to cloth and surgical masks. Across a variety of manufacturers the average filtration efficiency of N95 at\ 0.3 μm particle size was found to be much higher at 98% and more consistent than 81% for KN95 (Table 2 of [49]).…”

Section: Introductionmentioning

confidence: 99%

The World Is Completely Unprepared For Detecting Emerging Viruses/Bacteria In The Air

Srikrishna

2022

Preprint

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N95 respirators are useful for reducing risk from a person infected with COVID-19 at both near-field (e.g. < 6 feet) and far-field exposures (e.g. > 6 feet). Although air filtration is not usually effective at near-field, emulating at least the far-field equivalent of N95 requires 95% relative reduction of particles (20x) from an airborne particulate source in each room. To mitigate COVID infection risk with air filtration, there is a wide range of air change per hour (ACH) recommendations from public health agencies (CDC, CDPH, etc.) ranging from 2 to 12 ACH. Tracking the removal of an inert airborne contaminant (e.g. salt water) as a function of time is often used to measure ACH but is cumbersome and generally not desirable in occupied rooms such as a classroom or home. Instead, we describe a procedure using an optical particle counter to track the decay of ambient aerosols (0.3 μm diameter) and fit it to an exponentially decaying curve to measure ACH from the exponential coefficient. Experiments were conducted both in a room (from surface deposition alone and with air filtration) and in a whole, multi-room house (with air filtration). First, the rate of surface deposition in an unventilated room without HVAC ventilation or air filtration enabled was measured to be 0.6 ACH. Second, ACH was measured (verified) with low-noise generating HEPA purifiers ($299-$999) and Do-It-Yourself (DIY) air purifiers ($55-$160, 1"-5", MERV 13-16) in each room. The ACH measured with these air purifiers ranged from 4 to 20. Using the measured ACH and volume of the room/house to estimate the clean air delivery rate (CADR) per $100, it varied by a factor of 3x from below 100 cfm for tested HEPA purifiers to above 300 cfm with tested DIY air purifiers. Using 0.6 ACH as a baseline for an unventilated room, at least 12 ACH is required to reduce exposures equivalent to protection of N95 respirators (95%) at far-field, which is verifiable in a room or building with ambient aerosols using either HEPA or DIY air filtration.

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“…Ironically, readers of the article may use the putative connection between respirators and complications of airway management as an argument not to wear respirators during patient care, which in our opinion, puts patients and clinicians at greater risk of infection with dangerous pandemic respiratory pathogens. Notably, a recently published study has provided evidence that respirators protect healthcare workers from infection [ 5 ].…”

mentioning

confidence: 99%

Respirators and complications of airway management

2022

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was associated with increased risk of complications of airway management, specifically desaturation and difficult facemask ventilation. We have been continuously wearing N95 filtering facepiece (FFP) or elastomeric respirators while providing patient care since the early phases of the COVID-19 pandemic in April 2020. We have also advocated for anaesthetists to wear respirators while providing patient care on a universal basis, whether or not patients are known or suspected of being infected with SARS-CoV-2 [2, 3]. Based on our personal experience and the literature describing the use of respirators in healthcare, we are sceptical of the results of the study by Potter et al., and we are unaware of any plausible explanation for an increase in complications of airway management depending on whether anaesthetists are wearing respirators or fluid-resistant surgical masks. The authors suggest that discomfort caused by wearing a respirator or difficulty in communication might be the explanation; in our personal experience, this seems very unlikely. Interestingly, a simulation study of the Australian Defence Force chemical, biological, radiological and nuclear air-purifying mask, which is a full-face elastomeric respirator, sometimes referred to colloquially as a 'gas mask', was

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Risk of SARS-CoV-2 Acquisition in Health Care Workers According to Cumulative Patient Exposure and Preferred Mask Type

Abstract: This cohort study compares the risk of infection with SARS-CoV-2 among health care workers by mask preference and level of patient exposure.

Cited by 15 publications

References 6 publications

SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave

SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave

The World Is Completely Unprepared For Detecting Emerging Viruses/Bacteria In The Air

Respirators and complications of airway management

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