Indoor Air Quality Improvements to Reduce Global Catastrophic Biological Risk

The importance of indoor air quality (IAQ) to reduce infectious disease transmission has become clear during the COVID-19 pandemic. In addition to SARS-CoV-2, other diseases, including RSV and influenza, are spread by airborne transmission, and often indoors-where most people spend over 90% of their lives. Given the importance of indoor environments in the spread of infectious disease, ventilation and filtration to improve IAQ should play a major role in preparing for a global catastrophic biological risk event (GCBR). This study involves performing a review of peer-reviewed literature and reports about improving indoor air quality in public spaces and interviewing technical experts in the fields of indoor air, building ownership, IAQ policy, and disease transmission control. The goal of the study is to identify and develop near and long-term policy actions for improving IAQ aimed to reduce GCBRs and other infectious diseases at various levels, including local and national. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

The interplay between psychological stressors and biological hazards among healthcare workers during the COVID-19 pandemic

Despite the advent of modern technologies, biological risks still cause concern in workplaces. Healthcare workers (HCWs) are exposed to a wide range of occupational risks including biological and psychosocial ones. During the COVID-19 pandemic, HCWs experienced unprecedented levels of distress, especially due to the risk of SARS-CoV-2 contagion and the fear of spreading the virus in the work and social community. This emotional overload led to an increase in mental health disorders (e.g., anxiety, depression, and burnout) that can hinder patients' safety and the quality of care. After outlining the international safety regulation on biological risks, we discussed the interplay between biohazard and psychosocial risk, focusing on how to prevent occupational infections in healthcare using comprehensive action strategies that aim to ensure a healthy work environment to improve, protect, and promote the health and safety of all workers. Take-home message: Occupational infections, particularly those caused by emerging agents and/or responsible for epidemics, still cause concern in health care workers globally and require prompt action to implement health and safety programs. © 2022 by the authors.

The Impact of Biosecurity on Biological and Psychosocial Risks for Health Workers of COVID Hospitals in Guadalajara, Jalisco, Mexico.

BACKGROUND: Some data support that health care workers (HCWs) must have sufficient and good quality personal protective equipment (PPE) and the necessary training to manage COVID patients to avoid contagion that can lead to death. The objective of this study was to determine the relationship between biosafety on the biological risks of SARS-CoV-2 and risks of fatigue, anxiety, or depression in health workers who care for patients in COVID hospitals, from September 2020 to August 2021. MATERIAL AND METHODS: The questionnaire used in this study (Q6S64I) consisted of 6 spheres: Sociodemographic aspects, working conditions; Personal Protection Equipment; safety and health; training and knowledge about COVID-19, the form of transport, and personal health conditions. The answers were online. The Goldberg questionnaire (EADG) measures anxiety and depression, and the questionnaire measures fatigue (Barrientos-Gutiérrez et al.) (PSSF). RESULTS: In total, 76.5% of the HCWs were doctors, 25.2% worked in the emergency services, 79.3% received PPE from their institution, 82.9% cared for COVID-19 patients, and 27.9% tested positive for COVID-19. The PPE provided by the employer was 80%, but the quality was deficient, insufficient, and associated with a relative risk of 4.6. A total of 99% acquired better PPE on their own. The exposure to COVID-19 and the surgical mask provided by the institution had an associated relative risk of 2.8 for the HCWs. A total of 39% of the HCWs reported being calm. CONCLUSIONS: PPE, risk exposure, and safety at work were significantly associated with drowsiness and heaviness, difficulty concentrating, anxiety, and depression.

Biological risks, working conditions and psychological effects of COVID-19 in nursing personnel / Riesgos biológicos, condiciones de trabajo y efectos psicológicos del COVID-19 en personal de enfermería

Los profesionales de enfermería están relacionados con la atención directa del paciente con Covid- 19, dejándolos expuestos a riesgos biológicos y condiciones de trabajo modificadas que podrían causar efectos psisociales significativos. Como objetivo, se realizo una revisión bibliográfica para determinar las condiciones de trabajo y efectos psicológicos del COVID-19 en personal de enfermería durante el período 2020-2021. El estudio fue descriptivo, con una muestra de 39 articulos resultantes de la aplicación criterios de exclusión, las fuentes de datos utilizados fueron: EBSCO Host, Hinari, ProQuest, PubMed, Scopus, Web of Science, Wiley Online, Library, Redalyc, SciELO; se incluyó la búsqueda de palabras clave mediante los tesauros en DeCS y MeSH, las cuales se formularon ecuaciones con los operadores boléanos AND y OR con descriptores de búsqueda como: WorkingCondition/Labor condition, Covid-19/ SARS-CoV-2/ Coronavirus Infections, Nurse emotions/emotion/emotions/emotional/Feelings/Regrets, Nurse/nurses/nursing, y Method/ Methodology/ Model. Como resultado, a nivel de riesgo biológico, las condiciones inseguras repercutían en deficiencia y escases de equipos de protección personal, infraestructura y equipamiento, así mismo, las condiciones laborales a nivel organizacionales aludían a ausencia de políticas y directrices, bajos salarios, carga e inestabilidad laboral, además de esto, los efectos psicológicos del COVID-19 en personal de enfermería se pudieron evidenciar de manera positiva a través de decisión, motivación y orgullo y, negativa con ansiedad, depresión, estrés, inseguridad, molestia y temor. Como conclusión, es indispensable ofrecer infraestructura, condiciones y equipamiento al personal de enfermería, además de actividades de descanso para disminuir el estrés y la presión que generan agotamiento y efectos psicosociales(AU)

Nursing professionals are related to the direct care of patients with Covid-19, leaving them exposed to biological risks and modified working conditions that could cause significant psychosocial effects. As an objective, a bibliographic review was carried out to determine the working conditions and psychological effects of COVID-19 on nursing personnel during the 2020-2021 period. The study was descriptive, with a sample of 39 articles resulting from the application of exclusion criteria, the data sources used were: EBSCO Host, Hinari, ProQuest, PubMed, Scopus, Web of Science, Wiley Online, Library, Redalyc, SciELO; the search for keywords was included using the DeCS and MeSH thesauri, which were formulated with Boolean operators AND and OR with search descriptors such as: WorkingCondition/Labor condition, Covid-19/ SARS-CoV-2/ Coronavirus Infections , Nurse emotions/emotion/emotions/emotional/Feelings/Regrets, Nurse/nurses/nursing, and Method/ Methodology/ Model. As a result, at the level of biological risk, the unsafe conditions affected deficiency and scarcity of personal protective equipment, infrastructure and equipment, likewise, the working conditions at the organizational level alluded to the absence of policies and guidelines, low wages, workload and instability. In addition to this, the psychological effects of COVID-19 on nursing staff could be evidenced positively through decision, motivation and pride, and negatively with anxiety, depression, stress, insecurity, annoyance and fear. In conclusion, it is essential to offer infrastructure, conditions and equipment to nursing staff, as well as rest activities to reduce stress and pressure that generate exhaustion and psychosocial effects(AU)

Vaccination Offer during the Occupational Health Surveillance Program for Healthcare Workers and Suitability to Work: An Italian Retrospective Cohort Study.

The active immunization of health care workers (HCWs) is a crucial measure to avoid nosocomial infection; nevertheless, vaccine coverage (VC) among health personnel in Italy is unsatisfactory. To improve VC in the healthcare set, the Hygiene and Occupational Medicine departments of Bari Policlinico General University Hospital applied a specific program. The operative procedure demands that in the context of the occupational medical examination, all workers are evaluated for susceptibility to vaccine-preventable diseases (VDPs), with immunization prophylaxis offered to those determined to be susceptible. This study analyzed data from workers who attended the biological risk assessment protocol from December 2017 to October 2021 (n = 1477), who were evaluated for the immune status for measles, mumps, rubella, and varicella. Among the enrolled subjects, non-protective antibody titers were higher for measles and mumps (13%), followed by rubella (11%) and varicella (8%). Appropriate vaccinations were offered to all susceptible HCWs, and HCWs were re-tested one month after immunization. The seroconversion rate after the administration of one or more booster dose(s) was over 80%. Overall, 2.5% of the subjects refused the offered vaccine(s); the main determinant of immunization compliance was younger age (aOR = 0.86; 95%CI = 0.80-0.92). Especially during the COVID-19 pandemic, VPDs may still present a hazard in nosocomial environment. Our experience suggests that, despite hospital procedures and dedicated human assets, satisfactory VC cannot be reached without the provision of federal regulations. Nevertheless, public health policymakers have to improve the promotion of vaccine prophylaxis and education to reach higher VC.

SARS-CoV-2 Infection in Health Care Workers of Trieste (North-Eastern Italy), 1 October 2020-7 February 2022: Occupational Risk and the Impact of the Omicron Variant.

Vaccination coverage against COVID-19 among health care workers (HCWs) of the University Health Agency Giuliano-Isontina (ASUGI) of Trieste (North-eastern Italy) by 1 January 2022 was 90.4% with at least one vaccine dose, 84.9% with at least 2 doses, and 75.1% with 3 doses, 98.2% with Comirnaty (Pfizer BioNtech, New York, NY, USA) versus 1.8% with Spikevax (Moderna, Cambridge, MA, USA). From 1 October 2020 to 7 February 2022, 1652 SARS-CoV-2 infections were notified in HCWs of ASUGI Trieste. Although the overall risk of SARS-CoV-2 contagion increased over time, the rate of occupational infections progressively declined, from 42.5% during the second COVID-19 wave to 15.6% in the fifth. Between 1 January-7 February 2022 (a period dominated by the Omicron variant), albeit no COVID-19-associated hospitalizations were recorded in HCWs of ASUGI Trieste, 669 SARS-CoV-2 infections were counted against 367 cases observed from 1 October to 31 December 2020, the 3 months preceding the implementation of the vaccination campaign against COVID-19. Job tasks and health care settings turned out to be the most significant risk factors for SARS-CoV-2 infection. However, the effect of workplace prevailed over job task on the biological risk, with greater rates of SARS-CoV-2 infections observed among HCWs operating in areas with higher levels of circulation of the virus, particularly COVID-19 dedicated units.

Thoughts on future response to microbial risks in the new situation

China is in the critical period of building a moderately prosperous society in an all-round way. It is the period of rapid economic transformation and the decisive battle for deepening the reform. China's development is facing new opportunities and challenges. The risk of foreseeable and unforeseen is increasing. Combined with the new coronavirus, (coronavirus disease 2019 is a new type of pneumonia, also named Covid-19) one of the global biological risk events, this paper analyzes the challenges faced by China in the future in response to biological risk, and discusses how to deal with microbial risk in the future, makes in-depth thinking and puts forward suggestions. © 2022 Author(s).

“Re-engineering of a food oven for thermal sanitization of Personal Protective Equipment against Sars-CoV-2 virus”

One of the main issues addressed by the recent COVID-19 pandemic which affected the whole world is the availability of Personal Protective Equipment (PPE) (e.g., face masks, white coats, or disposable gloves). This issue impacts on sustainability from different perspectives, such as more generated waste or environmental pollution, both for manufacturing and disposal, or more inequalities deriving from who can afford and access PPE and who cannot, since many shortages were recorded during the pandemic as well as fluctuating unit prices. Moreover, quite often PPE intended for single use are improperly used more times, thus generating a biological risk of infection. In an attempt to propose an innovative solution to face this problem, in this paper the re-design of an oven originally intended for food purposes is presented, with the aim of operating a thermal sanitization of PPE. The machinery and its components are detailed, together with physical and microbiological tests performed on non-woven PPE to assess the effect of treatment on mechanical properties and viral load. The pilot machinery turned out to be effective in destroying a bovine coronavirus at 95°C and thus reducing contaminating risk in one hour without compromising the main properties of PPE, opening perspectives for the commercialization of the solution in the near future.

Comparison of Three Different Waves in Healthcare Workers during the COVID-19 Pandemic: A Retrospective Observational Study in an Italian University Hospital.

BACKGROUND: SARS-CoV-2 has infected many healthcare workers and (HCWs) worldwide. The aim of this study was to determine, analyze, and compare the frequency and characteristics of COVID-19 cases among HCWs of the University Hospital of Bari. METHODS: A retrospective observational study was conducted after preventive protocol implementation. The SARS-CoV-2 infection frequency was determined by real-time reverse transcription-polymerase chain reaction on nasopharyngeal samples. RESULTS: Overall, 519 HCWs (9%) tested positive among a total of 6030 HCWs during the three waves. The highest frequency of COVID-19 cases (n = 326; 63%) was observed during the 2nd wave, from September 2020 to December 2020, and the lowest (n = 34; 7%) was observed during the 1st wave, from March 2020 to August 2020 (p < 0.001). Working in a designated COVID-19 department was not a risk factor for infection. CONCLUSIONS: The correct use of personal protective equipment and the early identification of symptomatic workers are still essential factors to avoid nosocomial clusters, even in this current phase of vaccine availability.

Immune response to one dose of BNT162b2 mRNA Covid-19 vaccine followed by SARS-CoV-2 infection: An Italian prospective observational study.

INTRODUCTION: A mass vaccination campaign against SARS-CoV-2 was initiated in European countries on December 27, 2020. This study compared the antibody response in a sample of healthcare workers (HCWs) who, after the first dose of the BNT162b2 mRNA vaccine, were infected with SARS-CoV-2 (infection group) with the response in a control group of HCWs immunized with two doses (vaccine group). METHODS: This two-arm observational cohort study was carried out using routine health surveillance data obtained from HCWs at Bari Policlinico General Hospital (Italy). The antibody response was determined infection group and vaccine group. RESULTS: Among the 100 HCWs, 25 (25.0%) were in the infection group and 75 (75.0%) in the full-vaccine group. At the serological evaluation, all of the HCWs tested positive, with a geometric mean titer (GMT) of 7106.8 (95 %CI = 5628.5-8973.4) and a statistically significant difference (p < 0.0001) between the infection group (GMT = 2139.7; 95 %CI = 1310.4-3493.6) and the vaccine group (GMT = 10603.6; 95 %CI = 8698.0-12926.8). DISCUSSION: Our results shed light on the vaccine response of individuals in different risk categories. It also emphasizes the need for the continued use by HCWs of PPE and good practices during the window between the first and second anti-SARS-CoV-2 vaccinations.

Risk of Vaccine Breakthrough SARS-CoV-2 Infection and Associated Factors in Healthcare Workers of Trieste Teaching Hospitals (North-Eastern Italy).

Background: Healthcare workers (HCWs) are particularly exposed to biological risk, including SARS-CoV-2 infection. In order to contrast the current pandemic and alleviate the burden of the disease on the healthcare system, a mass vaccination campaign against COVID-19 has been launched worldwide. Aim To evaluate the impact of COVID-19 vaccination in HCWs exposed to SARS-CoV-2, to describe the clinical presentation of COVID-19 in infected HCWs, and to investigate clinical and occupational risk factors for breakthrough infection. Design: Retrospective cohort study. Methods: The cohort of HCWs of Trieste Hospitals were followed up from 1 March 2020, to 30 November 2021 (21 months). All HCWs were periodically screened for SARS-CoV-2 infection by real-time PCR (RT-PCR) analysis. Clinical data were obtained through routine medical surveillance records. Risk factors for SARS-CoV-2 infection were investigated by univariable as well as multivariable logistic regression analysis. Results: Among 4394 HCWs routinely screened for SARS-CoV-2 by PCR on nasopharyngeal swab, a total of 800 incident cases were identified during the entire study period (1 March 2020 to 30 November 2021). Five hundred and sixty-four cases occurred before, and 236 after the start of the vaccination campaign against COVID-19, of whom 155 received a complete vaccination scheme before SARS-CoV-2 infection. Breakthrough infection was featured by mild or no symptoms and was significantly associated with the male sex, BMI > 25, and diabetes mellitus. Some categories of HCWs (physicians and nurse aids/auxiliary personnel) were at a higher risk of breakthrough infection. Conclusions: Fully vaccinated HCWs were less likely to acquire symptomatic as well as asymptomatic SARS-CoV-2 infection. Risk factors for SARS-CoV-2 infection after a full COVID-19 vaccination scheme included the male gender, diabetes mellitus, and overweight. HCWs with higher exposure to COVID-19 patients were at higher risk of breakthrough infection.

Mapping Biological Risks Related to Necropsy Activities: Old Concerns and Novel Issues for the Safety of Health Professionals.

Nowadays only a few studies on biological and environmental risk among healthcare workers are available in literature. The present study aims to assess the health operator's risk of contact with microorganisms during necropsy activities, to evaluate the efficiency of current protections, to identify possible new sources of contact, and to point out possible preventive measures. In addition, considering the current pandemic scenario, the risk of transmission of SARS-CoV-2 infection in the dissection room is assessed. The objectives were pursued through two distinct monitoring campaigns carried out in different periods through sampling performed both on the corpses and at the environmental level.

Biological Risk in Italian Prisons: From the COVID-19 Management to the Development of a Standardized Model for Emergency Response.

Within the confinements of critical infrastructures, the COVID-19 pandemic is posing a series of challenges to Health Management. In the spotlight of highly contagious and quick spreading diseases within such enclosed facilities, whether it be a detention facility or otherwise, the health and safety of those living within its internment is paramount. This paper aims to highlight the specific challenges and the possible solutions to counteract this problem, starting from the lessons learnt from the Italian prison system case study. Following the general description of the available resources within the Italian prisons, the study aimed at specifically describing the first counteracting measures deployed by the Italian prison authorities during the first phase of the COVID-19 outbreak (February-July 2020). The aim was to propose an integrated plan capable of responding to a biological threat within the prisons. In particular, the study describes the actions and technical features that, in accordance with national and international legal frameworks and the relevant organisational bodies that run the Italian Prison Service, had been adopted in managing, right from the start, the COVID-19 pandemic until Summer 2020. Available information and data showed the ability of the prison administration to comply almost completely with WHO's technical and human rights recommendations and also, in successfully handling prison emergencies both in terms of the sick and the deceased in line with the epidemiological framework of the general population. In addition, the paper proposes a draft of guidelines that should involve the National Health Service and the Prison Service that are aimed at supporting the local prison facilities with drawing up their own biological incident contingency plans. An approved, legal, standardised plan could increase the awareness of prison managers. It could even increase their self-confidence, in particular, with regard to cases of dispute and their ability to respond to them. In fact, it is valuable and forward-thinking to be able to demonstrate that every endeavour has been taken and that 'certified' best practices have been put in place in accordance with the national standards.

In the Face of Potential Harm: The Predictive Validity of Neural Correlates of Performance Monitoring for Perceived Risk, Stress, and Internalizing Psychopathology During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic is a major life stressor posing serious threats not only to physical but also to mental health. To better understand mechanisms of vulnerability and identify individuals at risk for psychopathological symptoms in response to stressors is critical for prevention and intervention. The error-related negativity (ERN) has been discussed as a neural risk marker for psychopathology, and this study examined its predictive validity for perceived risk, stress, and psychopathological symptoms during the COVID-19 pandemic. METHODS: A total of 113 individuals who had participated as healthy control participants in previous electroencephalography studies (2014-2019) completed a follow-up online survey during the first COVID-19 wave in Germany. Associations of pre-pandemic ERN and correct-response negativity (CRN) with perceived risk regarding COVID-19 infection, stress, and internalizing symptoms during the pandemic were examined using mediation models. RESULTS: Pre-pandemic ERN and CRN were associated with increased perceived risk regarding a COVID-19 infection. Via this perceived risk, the ERN and CRN were associated with increased stress during the pandemic. Furthermore, risk perception and stress mediated indirect effects of ERN and CRN on internalizing psychopathology, including anxiety, depression, and obsessive-compulsive symptoms, while controlling for the effects of pre-pandemic symptom levels. CONCLUSIONS: In summary, heightened pre-pandemic performance monitoring showed indirect associations with increases in psychopathological symptoms during the first COVID-19 wave via effects on perceived COVID-19 risk and stress. These results further strengthen the notion of performance monitoring event-related potentials as transdiagnostic neural risk markers and highlight the relevance of stress as a catalyst for symptom development.

Biological risk assessment: A challenge for occupational safety and health practitioners during the COVID-19 (SARS-CoV-2) pandemic.

BACKGROUND: The COVID-19 global pandemic brought several challenges to occupational safety and health practice. One of these is the need to (re)assess the occupational risks, particularly, biological risks. OBJECTIVE: The purpose of this work is to promote guidance to occupational safety and health practitioners when conducting a biological risk assessment in this context. METHODS: The main steps of the biological risk assessment are explained with some inputs regarding the novelty posed by SARS-CoV-2 and an example of a qualitative risk assessment method is presented. Also, its application to two different activities was exemplified. RESULTS: In both cases, the assessment considered that vulnerable workers were working from home or in medical leave. The results showed low or medium risk level for the assessed tasks. For medium risk level, additional controls are advised, such maintain social distancing, sanitize instruments/equipment before use, use proper and well-maintained PPE (when applicable), and promote awareness sessions to spread good practices at work. Employers must be aware of their obligations regarding biological risk assessment and OSH practitioners must be prepared to screen and link the abundance of scientific evidence generated following the outbreak, with the technical practice. CONCLUSIONS: This paper could be an important contribution to OSH practice since it highlights the need to (re)assess occupational risks, especially biological risk, to ensure a safe return to work, providing technical guidance.

Optimizing Island Refuges against global Catastrophic and Existential Biological Threats: Priorities and Preparations.

Human civilization is vulnerable to global catastrophic biological threats and existential threats. Policy to mitigate the impact of major biological threats should consider worst-case scenarios. We aimed to strengthen existing research on island refuges as a mitigating mechanism against such threats by considering five additional factors as well as recent literature on catastrophic risks and resilience. We also analyzed the performance of potential refuge islands during early phases the COVID-19 pandemic. Using a composite indicator (scored from 0-1) based on 14 global macroindices, we present analysis supporting Australia (0.71), New Zealand (0.64), and Iceland (0.58) as the leading candidate island nation refuges to safeguard the survival of humanity and a flourishing technological civilization from the threat of a catastrophic pandemic. Data from the COVID-19 pandemic supports this finding where islands have performed relatively well. We discuss the persisting weaknesses of even the best candidate refuges and the growing literature describing what preparations such a refuge should ensure to enhance resilience. Refuge preparations by Australia and New Zealand, in particular, may additionally provide some immunity against winter-inducing catastrophes such as global nuclear war. Existing disaster resilience frameworks such as the Sendai framework could be worded to mandate preventive measures against global catastrophic and existential threats. The issue of island refuges against certain global catastrophic risks should be raised at relevant international political summits.

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) in Dentistry. Management of Biological Risk in Dental Practice.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel coronavirus first identified in Wuhan, China, and the etiological agent of Coronavirus Disease-2019 (COVID-19). This infection spreads mainly through direct contact with Flügge micro droplets or core droplets that remain suspended as aerosol. Moreover, it has been reported that infected subjects, both with and without clinical signs of COVID-19, can transmit the virus. Since the infection typically enters through mouth, nose, and eyes, dentistry is one of the medical practices at highest risk of infection due to the frequent production of aerosol and the constant presence of saliva. The World Health Organization (WHO) has suggested that only emergency/urgent procedures should be performed during the coronavirus outbreak. Considering the virus' route of transmission, a specific protocol should be applied to reduce the risk of infection in addition to measures that prevent the spread of infection from a patient to another person or medical tools and equipment (cross-infection). This protocol should be implemented by modifying both patient management and clinical practice, introducing particular devices and organizational practices. This paper aims to discuss and suggest the most appropriate procedures in every aspect of dental practice to reduce infection risk.