Occupational management of healthcare workers exposed to COVID-19

Abstract

Background The year 2020 was marked by the new coronavirus pandemic, resulting in millions of cases and deaths, placing healthcare workers at high risk of infection. Aims The aim of this study was to describe the role of an occupational health service during coronavirus disease 2019 pandemic in an oncologic hospital and characterize the most likely sources of viral infection. Methods The information of all healthcare workers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from 11 March to 15 December 2020 was collected through an epidemiological survey conducted during contact tracing. The data extracted included gender, age, comorbidities, occupational group, source of infection, clinical presentation, duration of the disease, need for hospitalization and persistent or late symptoms after disease or upon returning to work. Results Out of a total of 2300 workers, 157 were infected, consisting of nurses (36%), nurse assistants (33%) and diagnostic and therapeutic professionals (10%). Physicians and administrative staff accounted for 8% each. The most frequently reported source of infection was occupational (43%), owing to worker-to-worker transmission (45%) and patient-to-worker transmission (36%). The most frequent moments of infection perceived corresponded to the removal of protective equipment during meals and moments of rest in the staff and changing rooms. Conclusions The study revealed that occupational transmission from patients and colleagues might be an important source of SARS-CoV-2 infection in healthcare workers. Spread between colleagues accounted for 45% of the occupational source infections reported. Implementing physical distancing measures and limiting the number of people in changing and rest rooms could significantly reduce infection and related absenteeism.

COVID‐19 infection and the broader impacts of the pandemic on healthcare workers

“…These tiers include elimination, substitution, engineering controls, administrative controls and PPE, with decreasing levels of degree of protection and reliability. Combining the hierarchy of controls with the predominant host–agent–environment infectious disease model can help guide efforts to stop occupational transmission, 113 especially as HCWs may be both the target and the source of infection 115 . Outbreaks in hospitals, primary care, aged care, disability care, community and home care services draw attention to the risks of HCWs contracting COVID‐19 and also subsequently acting as vectors for transmission 116 …”

“…Combining the hierarchy of controls with the predominant host-agent-environment infectious disease model can help guide efforts to stop occupational transmission, 113 especially as HCWs may be both the target and the source of infection. 115 Outbreaks in hospitals, primary care, aged care, disability care, community and home care services draw attention to the risks of HCWs contracting COVID-19 and also subsequently acting as vectors for transmission. 116 Although PPE received considerable attention due to national shortages, process and system changes should be the primary tools to prevent unnecessary hazards to HCWs and to reduce PPE wastage.…”

Occupational Exposure to Infectious Diseases among Health Workers: Effects, Managements and Recommendations

“…The removal of protective gear during meals and rest periods in the staff and changing rooms were identified as the most frequent times of infection. The WHO's interim guidance of 2 February 2021 categorized mitigation strategies into four categories: Low risk, medium risk, high risk, and extremely high risk where HCWs are advised to: Stay at home if you're feeling under the weather; practice good hand-and respiratory hygiene; use PPE (a respirator N95 or FFP2 or FFP3, a gown, gloves, eye protection, and an apron) and follow basic safety procedures when caring for patients [18,19]. The simplest strategy to avoid the high expenses associated with managing workplace exposures to blood and other fluids is to prevent exposures.…”

Lessons learned from the COVID-19 pandemic—what Occupational Safety and Health can bring to Public Health

“…Because employees interact, cohabit, commute to work together, they are potential carriers, vectors, or targets of the virus. Effective workplace prevention can reduce excess occupational risk for workers, their families, community contacts, and patients in healthcare [8][9][10][11]. Workplaces also serve as settings for education about prevention and vaccination, knowledge that workers can transfer to their communities.…”