Background It is recognized that healthcare workers (HCWs) are at high risk of contracting Covid-19. It is incumbent on occupational health staff to recognize potential symptoms of Covid-19 among HCWs. Aims The aims of the study were to describe the presenting symptoms of HCWs who developed Covid-19 in Ireland, and to estimate the odds of specific symptoms being associated with a positive Covid-19 polymerase chain reaction (PCR) result. Methods A retrospective chart review of all symptomatic HCWs who self-presented for Covid-19 testing in Cork from March to May 2020 was conducted. A sex-matched case–control study was carried out to compare presenting features among those who tested positive compared to those who tested negative. Univariate and multivariable-adjusted conditional logistic regression models were run using Stata 15.0 to identify the symptoms associated with positive Covid-19 swab results. Results Three hundred and six HCWs were included in the study; 102 cases and 204 controls. Common presenting features among cases were fever/chills (55%), cough (44%) and headache (35%). The symptoms which were significantly associated with a positive Covid-19 swab result were loss of taste/smell (adjusted odds ratio [aOR] 12.15, 95% confidence interval [CI] 1.36–108.79), myalgia (aOR 2.36, 95% 1.27–4.38), fatigue (aOR 2.31, 95% CI 1.12–4.74), headache (aOR 2.11, 95% CI 1.19–3.74) and fever/chills (aOR 1.88, 95% CI 1.12–3.15). Conclusions Fever, fatigue, myalgia, loss of taste/smell and headache were associated with increased odds of a Covid-19 diagnosis among symptomatic self-referred HCWs compared with those had negative swab results. Testing criteria for HCWs should reflect the broad range of possible symptoms of Covid-19.

IntroductionAudiometry plays a vital role in both a preventative and screening aspect in Occupational Medicine. It serves to quickly triage and identify those individuals at risk for progressive hearing loss in noisy environments and adherence to requirements in specific professions. To facilitate appropriate referral pathways, a system of categorisation HSE/HSA has been developed ranging from 1 (acceptable hearing) to 3 (Poor hearing) based on comparisons for age and gender – this allows for trained professionals who are not specialist per se to be involved in testing.This paper examines series of audiograms performed for the purpose of pre-employment to establish whether the expected distribution of 80th, 20th, 5th percentile of the normal population respectively for category 1 to 3, is in keeping with the actual values of the tested populations and, if at all there is a ‘Healthy worker effect ‘ which refers to the working population having a favourable morbidity profile.MethodsSequential Analysis of 1000 Pre-employment Audiograms and their computer generated HSE CategorizationResultThe results are compared to the population sample used for standardisation of the HSE categorization.DiscussionThe question arises of whether there is a need to update current age- gender adjusted reference values of the categorization tables, taking in to account the increased sound exposure to both environmental and Personal devices resultant of Modernization.

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