SARS-CoV-2 exposures of healthcare workers from primary care, long-term care facilities and hospitals: a nationwide matched case-control study

Belan, Martin; Charmet, Tiffany; Schaeffer, Laura; Tubiana, Sarah; Duval, Xavier; Lucet, Jean‐Christophe; Fontanet, Arnaud; Birgand, Gabriel; Kernéis, Solen

doi:10.1016/j.cmi.2022.05.038

Cited by 17 publications

(18 citation statements)

References 26 publications

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“…While describing demographic features of those infected, and supporting the need for improved infection control measures, these early studies did little to identify modifiable workplace factors other than direct patient contact 4–6 . Later studies that included HCWs beyond the first wave of infection had to consider also the impact of vaccination and previous infection on risk 7–10 . From studies to date, the main risk factor identified for workplace transmission is contact with patients with Covid‐19, identified in multiple studies, with the use of respiratory protection 11–15 and vaccination 16,17 mitigating that risk 18 .…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] Later studies that included HCWs beyond the first wave of infection had to consider also the impact of vaccination and previous infection on risk. [7][8][9][10] From studies to date, the main risk factor identified for workplace transmission is contact with patients with Covid-19, identified in multiple studies, with the use of respiratory protection [11][12][13][14][15] and vaccination 16,17 mitigating that risk. 18 The excess Covid-19 mortality seen in HCWs in the United Kingdom in the period to September 2020 was no longer evident in later time periods, presumably reflecting rapid access to vaccinations and improved infection controls at the workplace.…”

Section: Introductionmentioning

confidence: 99%

“…[PCR] tests) and controls (with negative tests) were interviewed retrospectively. 10,13,22 The current study uses a C-R design nested within a prospective HCW cohort study. The aim was to carry out exposure interviews of cases and referents, immediately a case was reported, concentrating on the identification of modifiable risk factors.…”

Section: Introductionmentioning

confidence: 99%

“…The alternative, with a retrospective collection of exposure data post confirmation of infection, carries a risk of reporting bias, with cases recollecting exposures more readily, and perhaps less objectively, than referents. Some research groups have attempted to collect temporarily relevant data using a cross‐sectional design over a brief period, analyzed as a case‐referent (C‐R) study 12,21 or through a C‐R design, in which cases (with positive polymerase chain reaction [PCR] tests) and controls (with negative tests) were interviewed retrospectively 10,13,22 . The current study uses a C‐R design nested within a prospective HCW cohort study.…”

Section: Introductionmentioning

confidence: 99%

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The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

Cherry

Mhonde

Adisesh

et al. 2023

American J Industrial Med

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Background During the early months of the Covid‐19 pandemic, studies demonstrated that healthcare workers (HCWs) were at increased risk of infection. Few modifiable risks were identified. It is largely unknown how these evolved over time. Methods A prospective case‐referent study was established and nested within a cohort study of Canadian HCWs. Cases of Covid‐19, confirmed by polymerase chain reaction, were matched with up to four referents on job, province, gender, and date of first vaccination. Cases and referents completed a questionnaire reporting exposures and experiences in the 21 days before case date. Participants were recruited from October 2020 to March 2022. Workplace factors were examined by mixed‐effects logistic regression allowing for competing exposures. A sensitivity analysis was limited to those for whom family/community transmission seemed unlikely. Results 533 cases were matched with 1697 referents. Among unvaccinated HCWs, the risk of infection was increased if they worked hands‐on with patients with Covid‐19, on a ward designated for care of infected patients, or handled objects used by infected patients. Sensitivity analysis identified work in residential institutions and geriatric wards as high risk for unvaccinated HCWs. Later, with almost universal HCW vaccination, risk from working with infected patients was much reduced but cases were more likely than referents to report being unable to access an N95 mask or that decontaminated N95 masks were reused. Conclusions These results suggest that, after a rocky start, the risks of Covid‐19 infection from work in health care are now largely contained in Canada but with need for continued vigilance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

Cherry

Mhonde

Adisesh

et al. 2023

American J Industrial Med

View full text Add to dashboard Cite

show abstract

“…Observational studies have found a weak association between contact precautions for the care of patients with COVID-19 with lower risk of contracting the disease. 5…”

Section: What Does the Evidence Say?mentioning

confidence: 99%