Diagnosing occupational COVID-19 in Croatian healthcare workers

Abstract

Coronavirus disease 2019 (COVID-19) can be diagnosed as occupational disease by an occupational health physician (OHP), if supported by relevant work-related and medical documentation. The aim of this study was to analyse such documentation submitted by Croatian healthcare workers (HCWs) and discuss its relevance in view of European and Croatian guidelines. The study included 100 Croatian HCWs who were SARS-CoV-2-positive and requested that their infection be diagnosed as occupational disease by their OHPs from 1 May 2020 to 10 March 2021. As participants they were asked to fill out our online Occupational COVID-19 in Healthcare Workers Questionnaire. For the purpose of this study we analysed answers about the type of close contact at the workplace, COVID-19 symptoms, and enclosed work-related (job description, employer statement about exposure to SARS-CoV-2) and medical documentation (positive SARS-CoV-2 polymerase chain reaction test and patient history confirming the diagnosis of COVID-19). Most participants were working in hospitals (N=95), mostly nurses (N=75), who became infected by a patient (N=68) or colleague (N=31), and had at least one COVID-19 symptom (N=87). Eighty participants did not enclose obligatory documents, 41 of whom failed to submit job description and 31 both job description and employer statement. These findings confirm that the major risk of occupational COVID-19 in HCWs is close contact with patients and colleagues, and points out the need for better cooperation between OHPs, occupational safety experts, employers, and diseased workers.

Factors That Play Roles in COVID-19 Transmission Among Healthworkers

“…9 Among 68% of healthcare workers who were infected from the COVID-19 patients they were taking care of, 86% of those used proper or recommended PPE while the rest either did not have it or did not comprehend the proper or recommended PPE. 3 At the beginning of the emerging pandemic, healthcare workers were vulnerable due to inadequate personal protective equipment (PPE) and defective handwashing, yet the improvement of PPE plays an enormous role in reducing the transmission risk. 7,9,10 Further evidence mentioned of all healthcare workers sent to Wuhan rolling shift in Intensive Care Unit at least performing aerosol-generating procedure equipped with appropriate PPE tested negative for COVID-19 even before vaccine available.…”

“…These issues require mitigation to reduce the risk of poor health outcomes which include: (1) enhanced administrative and engineering preventive controls, (2) warranting access to workers' compensation benefits, (3) increasing sick leave benefits, (4) delivering occupational and general health insurance coverage. 2,3 To prevent occupational exposure to COVID-19 among healthcare workers, several national and international associations have presented guidance ;…”

“…2 Most healthcare workers with COVID-19 tested positive from the patients they were taking care of. 3 Not only infected but health workers also face the threat of death. Globally, WHO records the death of health workers due to COVID-19 around 80,000 -180,000 in the period from January 2020 to May 2021.…”