Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T03:26:05.883Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of healthcare personnel exposures to patients with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) associated with personal protective equipment

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  12 May 2021

Vishal P. Shah Open the ORCID record for Vishal P. Shah [Opens in a new window] ,
Laura E. Breeher ,
Caitlin M. Hainy  and
Melanie D. Swift
Vishal P. Shah*
Affiliation:
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota
Laura E. Breeher
Affiliation:
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota Occupational Health Services, Mayo Clinic, Rochester, Minnesota
Caitlin M. Hainy
Affiliation:
Occupational Health Services, Mayo Clinic, Rochester, Minnesota
Melanie D. Swift
Affiliation:
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota Occupational Health Services, Mayo Clinic, Rochester, Minnesota
*
Author for correspondence: Vishal Shah, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Personal protective equipment (PPE) is a critical aspect of preventing the transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in healthcare settings. We aimed to identify factors related to lapses in PPE use that may influence transmission of SARS-CoV-2 from patients to healthcare personnel (HCP).

Design:

Retrospective cohort study.

Setting:

Tertiary-care medical center in Minnesota.

Participants:

In total, 345 HCP who sustained a significant occupational exposure to a patient with coronavirus disease 2019 (COVID-19) from May 13, 2020, through November 30, 2020, were evaluated.

Results:

Overall, 8 HCP (2.3%) were found to have SARS-CoV-2 infection during their 14-day postexposure quarantine. A lack of eye protection during the care of a patient with COVID-19 was associated with HCP testing positive for SARS-CoV-2 by reverse-transcriptase polymerase chain reaction (RT-PCR) during the postexposure quarantine (relative risk [RR], 10.25; 95% confidence interval [CI], 1.28–82.39; P = .009). Overall, the most common reason for a significant exposure was the use of a surgical face mask instead of a respirator during an aerosol-generating procedure (55.9%). However, this was not associated with HCP testing positive for SARS-CoV-2 during the postexposure quarantine (RR, 0.99; 95% CI, 0.96–1; P = 1). Notably, transmission primarily occurred in units that did not regularly care for patients with COVID-19.

Conclusions:

The use of universal eye protection is a critical aspect of PPE to prevent patient-to-HCP transmission of SARS-CoV-2.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 6 , June 2022 , pp. 770 - 774
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed. World Health Organization website. https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC-2020.4. Updated June 29, 2020. Accessed December 3, 2020.Google Scholar
Wang, J, Zhou, M, Liu, F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect 2020;105:100–101.CrossRefGoogle ScholarPubMed
Islam, MS, Rahman, KM, Sun, Y, et al. Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: a global analysis. Infect Control Hosp Epidemiol 2020;41:1196–1206.CrossRefGoogle ScholarPubMed
Heinzerling, A, Stuckey, MJ, Scheuer, T, et al. Transmission of COVID-19 to healthcare personnel during exposures to a hospitalized patient—Solano County, California, February 2020. Morb Mortal Wkly Rep 2020;69:472–476.CrossRefGoogle Scholar
Options to reduce quarantine for contacts of persons with SARS-CoV-2 infection using symptom monitoring and diagnostic testing. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-options-to-reduce-quarantine.html. Updated December 2, 2021. Accessed February 23, 2021.Google Scholar
Breeher, L, Boon, A, Hainy, C, Murad, MH, Wittich, C, Swift, M. A framework for sustainable contact tracing and exposure investigation for large health systems. Mayo Clin Proc 2020;95:1432–1444.CrossRefGoogle ScholarPubMed
Liu, M, Cheng, SZ, Xu, KW, et al. Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study. BMJ 2020;369:m2195.CrossRefGoogle Scholar
COVID-19 recommendations for healthcare workers. Minnesota Department of Health website. https://www.health.state.mn.us/diseases/coronavirus/hcp/hcwrecs.pdf. Updated December 18, 2020. Accessed January 13, 2021.Google Scholar
Park, YJ, Choe, YJ, Park, O, et al. Contact tracing during coronavirus disease outbreak, South Korea, 2020. Emerg Infect Dis 2020;26:2465–2468.CrossRefGoogle ScholarPubMed
Madewell, ZJ, Yang, Y, Longini, IM Jr, Halloran, ME, Dean, NE. Household transmission of SARS-CoV-2: a systematic review and meta-analysis. JAMA Netw Open 2020;3(12):e2031756.CrossRefGoogle ScholarPubMed
Zabarsky, TF, Bhullar, D, Silva, SY, et al. What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection? Am J Infect Control 2021;49:392–395.CrossRefGoogle ScholarPubMed
Burke, RM, Balter, S, Barnes, E, et al. Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States. PLoS One 2020;15(9):e0238342.CrossRefGoogle ScholarPubMed
Sun, CB, Wang, YY, Liu, GH, Liu, Z. Role of the eye in transmitting human coronavirus: what we know and what we do not know. Front Public Health 2020;8:155.CrossRefGoogle Scholar
Marra, AR, Edmond, MB, Popescu, SV, Perencevich, EN. Examining the need for eye protection for coronavirus disease 2019 (COVID-19) prevention in the community. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.314.Google Scholar
Chu, DK, Akl, EA, Duda, S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020;395:1973–1987.CrossRefGoogle ScholarPubMed
Hawkins, ES, Fertel, BS, Muir, MR, Meldon, SW, Delgado, FJ, Smalley, CM. Adding eye protection to universal masking reduces COVID-19 among frontline emergency clinicians to the level of community spread. Am J Emerg Med 2020. doi: 10.1016/j.ajem.2020.08.064.Google Scholar
Bhaskar, ME, Arun, S. SARS-CoV-2 Infection among community health workers in India before and after use of face shields. JAMA 2020;324:1348–1349.CrossRefGoogle ScholarPubMed
Zeng, W, Wang, X, Li, J, et al. Association of daily wear of eyeglasses with susceptibility to coronavirus disease 2019 infection. JAMA Ophthalmol 2020;138:1196–1199.CrossRefGoogle ScholarPubMed
Bundgaard, H, Bundgaard, JS, Raaschou-Pedersen, DET, et al. Effectiveness of adding a mask recommendation to other public health measures to prevent SARS-CoV-2 infection in Danish mask wearers: a randomized controlled trial. Ann Intern Med 2021;174:335–343.CrossRefGoogle ScholarPubMed
Coclite, D, Napoletano, A, Gianola, S, et al. Face mask use in the community for reducing the spread of COVID-19: a systematic review. Front Med (Lausanne) 2020;7:594269.CrossRefGoogle ScholarPubMed
Gandhi, M, Marr, LC. Uniting infectious disease and physical science principles on the importance of face masks for COVID-19. Med (NY) 2021;2:29–32.Google ScholarPubMed
Mack, CD, Wasserman, EB, Perrine, CG, et al. implementation and evolution of mitigation measures, testing, and contact tracing in the National Football League, August 9–November 21, 2020. Morb Mortal Wkly Rep 2021;70:130–135.CrossRefGoogle ScholarPubMed