Emergency department personnel patient care-related COVID-19 risk.

Details

• Personal Author:
  Harland KK ; Hesse E ; Krishnadasan A ; Kutty PK ; McDonald LC ; Mohr NM ; Montoy JCC ; Mower WR ; Santibanez S ; Schrading WA ; Slev P ; Talan DA ; Ten Eyck P ; Weissman, David N.
• Corporate Authors:
  Project COVERED Emergency Department Network
• Description:
  Objectives: Emergency department (ED) health care personnel (HCP) are at risk of exposure to SARS-CoV-2. The objective of this study was to determine the attributable risk of SARS-CoV-2 infection from providing ED care, describe personal protective equipment use, and identify modifiable ED risk factors. We hypothesized that providing ED patient care increases the probability of acquiring SARS-CoV-2 infection. Methods: We conducted a multicenter prospective cohort study of 1,673 ED physicians, advanced practice providers (APPs), nurses, and nonclinical staff at 20 U.S. centers over 20 weeks (May to December 2020; before vaccine availability) to detect a four-percentage point increased SARS-CoV-2 incidence among HCP related to direct patient care. Participants provided monthly nasal and serology specimens and weekly exposure and procedure information. We used multivariable regression and recursive partitioning to identify risk factors. Results: Over 29,825 person-weeks, 75 participants (4.5%) acquired SARS-CoV-2 infection (31 were asymptomatic). Physicians/APPs (aOR 1.07; 95% CI 0.56-2.03) did not have higher risk of becoming infected compared to nonclinical staff, but nurses had a marginally increased risk (aOR 1.91; 95% CI 0.99-3.68). Over 99% of participants used CDC-recommended personal protective equipment (PPE), but PPE lapses occurred in 22.1% of person-weeks and 32.1% of SARS-CoV-2-infected patient intubations. The following factors were associated with infection: household SARS-CoV-2 exposure; hospital and community SARS-CoV-2 burden; community exposure; and mask non-use in public. SARS-CoV-2 intubation was not associated with infection (attributable risk fraction 13.8%; 95% CI -2.0- 38.2%), and nor were PPE lapses. Conclusions: Among unvaccinated U.S. ED HCP during the height of the pandemic, the risk of SARS-CoV-2 infection was similar in nonclinical staff and HCP engaged in direct patient care. Many identified risk factors were related to community exposures. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Communicable Diseases Emergency Responders Environmental Exposure Health Care Facilities Workforce And Services Health Personnel Nose Occupational Health Personal Protective Equipment Respiratory Protective Devices Risk Assessment Risk Factors Safety Sense Organs

  More +
• Keywords:
  Emergency care; Emergency medical services workers; EMS; Medical facilities; COVID-19; Health care personnel; Health care facilities; Exposure levels; Risk factors; SARS-CoV-2; Personal protective equipment; PPE; Cohort studies; Physicians; Nurses; Nasal cavity; Serology; Statistical analysis; Face masks
• ISSN:
  1932-6203
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Alabama ; California ; Georgia ; Iowa ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 7 ; OSHA Region 8 ; OSHA Region 9 ; Utah ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  17
• Issue:
  7
• NIOSHTIC Number:
  nn:20065763
• Citation:
  PLoS One 2022 Jul; 17(7):e0271597
• Contact Point Address:
  N.M Mohr, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
• Email:
  nicholas-mohr@uiowa.edu
• Federal Fiscal Year:
  2022
• Peer Reviewed:
  True
• Source Full Name:
  PLoS One
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c5461c6a34a5c38b311bbd725ce4c8242924b8149fdcf160920bb32058d2634977acbff63daed8ac42a95ba41c143b73abd96104f755131168e25403dc79fca2
• Download URL:
  https://stacks.cdc.gov/view/cdc/249540/cdc_249540_DS1.pdf
• File Type:
  [PDF - 924.08 KB ]