TY - JOUR
T1 - Sources of healthcare workers' COVID‑19 infections and related safety guidelines
AU - Oksanen, Lotta Maria A.H.
AU - Sanmark, Enni
AU - Oksanen, Sampo A.
AU - Anttila, Veli Jukka
AU - Paterno, Jussi J.
AU - Lappalainen, Maija
AU - Lehtonen, Lasse
AU - Geneid, Ahmed
N1 - Funding Information:
This work was supported by the Helsinki University Hospital (research grant No. Y1014KN025, grant manager: Leena-Maija Aaltonen). Received: October 4, 2020. Accepted: January 28, 2021. Corresponding author: Lotta-Maria Adele Helena Oksanen, Helsinki University Hospital Department of Otorhinolaryngology and Phoniatrics – Head and Neck Surgery, Maistraatinportti 2, PO Box 250, 00029 Helsinki, Finland (e-mail: [email protected]).
Publisher Copyright:
© 2021 Nofer Institute of Occupational Medicine. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objectives: To evaluate the effectiveness of safety guidelines in the workplace, the authors analyzed the work-related exposure to SARS-CoV-2 and the source of COVID-19 infections among healthcare workers (HCWs), together with the use of personal protective equipment (PPE). Material and Methods: A cross-sectional prospective study was conducted in tertiary hospitals in the Uusimaa region, Finland, with 1072 volunteers being enrolled in the study from among the HCWs at the Helsinki University Hospital. Overall, 866 (80.8%) HCWs (including 588 nurses, 170 doctors, and 108 laboratory and medical imaging nurses) completed the questionnaire by July 15, 2020, with 52% of the participants taking care of COVID-19 patients. The participants answered a structured questionnaire regarding their use of PPE, the ability to follow safety guidelines, exposure to COVID-19, and the source of potential COVID-19 infections. The participants with COVID-19 symptoms were tested with the SARS-CoV-2 real-time polymerase chain reaction method. All infected participants were contacted, and their answers were confirmed regarding COVID-19 exposure. Results: In total, 41 (4.7%) participants tested positive for SARS-CoV-2, with 22 (53.6%) of infections being confirmed or likely occupational, and 12 (29.3%) originating from colleagues. In 14 cases (63.6%), occupational infections occurred while using a surgical mask, and all infections originating from patients occurred while using a surgical mask or no mask at all. No occupational infections were found while using an FFP2/3 respirator and following aerosol precautions. The combined odds ratio for working at an intensive care unit, an emergency department, or a ward was 3.4 (95% CI: 1.2-9.2, p = 0.016). Conclusions: A high infection rate was found among HCWs despite safety guidelines. Based on these findings, the authors recommend the use of FFP2/3 respirators in all patient contacts with confirmed or suspected COVID-19, along with the use of universal masking, also in personnel rooms.
AB - Objectives: To evaluate the effectiveness of safety guidelines in the workplace, the authors analyzed the work-related exposure to SARS-CoV-2 and the source of COVID-19 infections among healthcare workers (HCWs), together with the use of personal protective equipment (PPE). Material and Methods: A cross-sectional prospective study was conducted in tertiary hospitals in the Uusimaa region, Finland, with 1072 volunteers being enrolled in the study from among the HCWs at the Helsinki University Hospital. Overall, 866 (80.8%) HCWs (including 588 nurses, 170 doctors, and 108 laboratory and medical imaging nurses) completed the questionnaire by July 15, 2020, with 52% of the participants taking care of COVID-19 patients. The participants answered a structured questionnaire regarding their use of PPE, the ability to follow safety guidelines, exposure to COVID-19, and the source of potential COVID-19 infections. The participants with COVID-19 symptoms were tested with the SARS-CoV-2 real-time polymerase chain reaction method. All infected participants were contacted, and their answers were confirmed regarding COVID-19 exposure. Results: In total, 41 (4.7%) participants tested positive for SARS-CoV-2, with 22 (53.6%) of infections being confirmed or likely occupational, and 12 (29.3%) originating from colleagues. In 14 cases (63.6%), occupational infections occurred while using a surgical mask, and all infections originating from patients occurred while using a surgical mask or no mask at all. No occupational infections were found while using an FFP2/3 respirator and following aerosol precautions. The combined odds ratio for working at an intensive care unit, an emergency department, or a ward was 3.4 (95% CI: 1.2-9.2, p = 0.016). Conclusions: A high infection rate was found among HCWs despite safety guidelines. Based on these findings, the authors recommend the use of FFP2/3 respirators in all patient contacts with confirmed or suspected COVID-19, along with the use of universal masking, also in personnel rooms.
KW - COVID-19
KW - Health personnel
KW - Infectious disease transmission
KW - Masks
KW - N95 respirators
KW - Occupational exposure
UR - http://www.scopus.com/inward/record.url?scp=85107710983&partnerID=8YFLogxK
U2 - 10.13075/IJOMEH.1896.01741
DO - 10.13075/IJOMEH.1896.01741
M3 - Article
C2 - 33847307
AN - SCOPUS:85107710983
SN - 1232-1087
VL - 34
SP - 239
EP - 249
JO - INTERNATIONAL JOURNAL OF OCCUPATIONAL MEDICINE AND ENVIRONMENTAL HEALTH
JF - INTERNATIONAL JOURNAL OF OCCUPATIONAL MEDICINE AND ENVIRONMENTAL HEALTH
IS - 2
ER -
