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Potential risk factors associated with COVID-19 in health care workers
V Spilchuk1,2, V H Arrandale3,4, J Armstrong2
1Division of Occupational Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Insights
Health care workers (HCWs) face COVID-19 risks, with 31% of infections being work-related, often from colleagues. Prevention measures in non-clinical areas are crucial for reducing occupational COVID-19 transmission.
Area of Science:
- Occupational Health
- Infectious Disease Epidemiology
- Public Health
Background:
- Health care workers (HCWs) are at increased risk for COVID-19.
- Factors contributing to HCW COVID-19 risk require further elucidation.
- Understanding occupational transmission is vital for healthcare settings.
Purpose of the Study:
- To describe COVID-19 infections among hospital employees in Ontario, Canada.
- To identify potential risk factors for COVID-19 acquisition in HCWs.
- To analyze trends in HCW COVID-19 cases from March to July 2020.
Main Methods:
- Analysis of COVID-19 positive tests and high-risk exposures among hospital staff.
- Comparison of HCWs who developed COVID-19 after exposure versus those who did not.
- Examination of temporal trends in HCW infections and exposures.
Main Results:
- 193 staff (2%) tested positive for COVID-19; 31% of cases were occupationally acquired.
- Staff-to-staff transmission accounted for 59% of occupational infections.
- Of 204 high-risk exposures, 13% led to COVID-19, with 42% from staff-to-staff contact.
Conclusions:
- HCWs are susceptible to work-related COVID-19.
- Staff-to-staff transmission is a significant contributor to occupational infections.
- Enhanced prevention strategies in non-clinical areas may reduce COVID-19 transmission among HCWs.
Background:
Health care workers (HCWs) have been recognized as being at higher risk for coronavirus disease 2019 (COVID-19) infection; however, relevant factors and magnitude have not been clearly elucidated.
Aim:
This study was aimed to describe COVID-19 infections among hospital employees at a large tertiary care hospital located in Ontario, Canada from March to July 2020, towards better understanding potential risk factors.
Methods:
Data on all HCWs with either a positive COVID test or a high-risk exposure from March to July 2020 were analyzed. HCWs with positive COVID test results and high-risk exposures were described. Those who developed COVID-19 following high-risk exposure were compared to those who did not. Data were also analyzed to determine trends over time.
Results:
Over the period of observation, 193 staff (2% of total working staff) had a positive COVID-19 test. Incidence of HCW infections closely followed community incidence. Overall, 31% of COVID-19 cases were deemed occupationally acquired. Of these, 41% were acquired from a patient, with the remainder (59%) from fellow staff. Over the same period, 204 staff were identified as having a high-risk exposure. The majority of exposures (55%) were patient-associated, with the remaining (45%) resulting from staff-to-staff contact. Overall, 13% went on to develop COVID-19. Of these cases, 58% were patient-associated and 42% were a result of staff-to-staff transmission.
Conclusions:
HCWs are at risk for work-related COVID-19. Given the number of infections attributed to staff-staff transmission, greater attention could be paid to implementing prevention measures in non-clinical areas.
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