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Increased Bloodborne Pathogen Exposure Hotline Utilization During the COVID-19 Pandemic: An Unexpected Phenomenon
Matthew Kiok1,2, Sandeep Guntur1,2, Paul D Blanc1,2
1San Francisco Veterans Affairs HealthCare System.
Insights
During the COVID-19 pandemic, healthcare workers experienced a rise in bloodborne pathogen exposure (BBPE) incidents, contrary to expectations. Increased workplace demands during infectious disease outbreaks may contribute to higher BBPE risks.
Area of Science:
- Occupational Health
- Infectious Disease Epidemiology
- Healthcare Worker Safety
Background:
- Mitigating bloodborne pathogen exposure (BBPE) is crucial for hospital occupational health.
- The COVID-19 pandemic strained healthcare services, but its effect on BBPE incidence was unknown.
- This study investigates BBPE trends during the pandemic.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on bloodborne pathogen exposure incidence among healthcare workers.
- To compare BBPE rates before and after the pandemic's onset in two affiliated health centers.
- To identify factors influencing BBPE risk during public health crises.
Main Methods:
- A 24-month study examined BBPE case incidence, comparing the 12 months before and after the COVID-19 pandemic onset.
- Quality improvement methods were used, analyzing data from two affiliated health centers.
- Statistical analysis compared observed BBPE incidence to predicted rates based on a referent facility.
Main Results:
- BBPE incidence at Health Center One (HC1) increased by 19% from Year 1 to Year 2 (46 to 55 cases).
- The referent facility (HC2) saw a 24% decrease in BBPE cases (664 to 503).
- The observed incidence at HC1 was significantly higher than the predicted rate (ratio 1.6, p < .05).
Conclusions:
- Healthcare worker BBPE incidence paradoxically increased at one center during the COVID-19 pandemic.
- This contrasts with the decrease observed at the referent facility.
- Increased demands on healthcare delivery during infectious disease outbreaks may elevate BBPE risks.
Abstract:
Background: Mitigating bloodborne pathogen exposure (BBPE) risk among healthcare workers is a major focus of hospital-based occupational health programs. The COVID-19 pandemic has placed added demands on occupational health services for healthcare workers. Its impact on BBPE incidence is unreported. Methods: As part of quality improvement efforts, we examined BBPE case incidence at two affiliated health centers during a 24-month period, 12 months preceding and following the COVID-19 pandemic onset. We used Year 1 to Year 2 change in incidence at the larger health center as the referent value to generate predicted incidence rates at the study health center. We tested the ratio of observed to predicted values at the study health center as a Poisson variable to its expectation. We defined a BBPE consistent with the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. Results: The BBPE case incidence at Health Center One (HC1), totaled 46 cases in Year 1, increasing 19% to 55 cases in Year 2. The cumulative incidence at Health Center Two (HC2), the referent facility, was 664 cases in Year 1, declining 24% to 503 in Year 2. The ratio of 55 events at HC1 to the expected incidence of 35, based on the experience at HC2, was 1.6 (p < .05). Discussion/Applications to Practice: The incidence of BBPE events at HC1 paradoxically increased during the COVID-19 pandemic, contrasting to the expected decrease that we observed at HC2. These data suggest that during times of increased stress to employee healthcare delivery from an infectious disease outbreak, the burden of ongoing practice demands may increase.
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