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Risk factors and protective measures for healthcare worker infection during highly infectious viral respiratory epidemics: A systematic review and meta-analysis.
Tian, Chenchen; Lovrics, Olivia; Vaisman, Alon; Chin, Ki Jinn; Tomlinson, George; Lee, Yung; Englesakis, Marina; Parotto, Matteo; Singh, Mandeep.
  • Tian C; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Lovrics O; Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Vaisman A; Infection Prevention and Control, University Health Network, Toronto, Ontario, Canada.
  • Chin KJ; Department of Anesthesia and Pain Management, University Health Network, Toronto, Ontario, Canada.
  • Tomlinson G; Department of Medicine, University Health Network, Toronto, Canada.
  • Lee Y; Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Englesakis M; Library and Information Services, University Health Network, Toronto, Ontario, Canada.
  • Parotto M; Department of Anesthesia and Pain Management, University Health Network, Toronto, Ontario, Canada.
  • Singh M; Department of Anesthesia and Pain Management, Women's College Hospital, Toronto, Ontario, Canada.
Infect Control Hosp Epidemiol ; 43(5): 639-650, 2022 05.
Article in English | MEDLINE | ID: covidwho-1046045
ABSTRACT

OBJECTIVE:

To investigate risk factors for healthcare worker (HCW) infection in viral respiratory pandemics severe acute respiratory coronavirus virus 2 (SARS-CoV-2), Middle East respiratory syndrome (MERS), SARS CoV-1, influenza A H1N1, influenza H5N1. To improve understanding of HCW risk management amid the COVID-19 pandemic.

DESIGN:

Systematic review and meta-analysis.

METHODS:

We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL databases from conception until July 2020 for studies comparing infected HCWs (cases) and noninfected HCWs (controls) and risk factors for infection. Outcomes included HCW types, infection prevention practices, and medical procedures. Pooled effect estimates with pathogen-specific stratified meta-analysis and inverse variance meta-regression analysis were completed. We used the GRADE framework to rate certainty of evidence. (PROSPERO no. CRD42020176232, 6 April 2020.).

RESULTS:

In total, 54 comparative studies were included (n = 191,004 HCWs). Compared to nonfrontline HCWs, frontline HCWs were at increased infection risk (OR, 1.66; 95% CI, 1.24-2.22), and the risk was greater for HCWs involved in endotracheal intubations (risk difference, 35.2%; 95% CI, 21.4-47.9). Use of gloves, gown, surgical mask, N95 respirator, face protection, and infection training were each strongly protective against infection. Meta-regression showed reduced infection risk in frontline HCWs working in facilities with infection designated wards (OR, -1.04; 95% CI, -1.53 to -0.33, P = .004) and performing aerosol-generating medical procedures in designated centers (OR, -1.30; 95% CI, -2.52 to -0.08; P = .037).

CONCLUSIONS:

During highly infectious respiratory pandemics, widely available protective measures such as use of gloves, gowns, and face masks are strongly protective against infection and should be instituted, preferably in dedicated settings, to protect frontline HCW during waves of respiratory virus pandemics.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Diseases / Influenza, Human / Influenza A Virus, H1N1 Subtype / Influenza A Virus, H5N1 Subtype / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article Affiliation country: Ice.2021.18

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Diseases / Influenza, Human / Influenza A Virus, H1N1 Subtype / Influenza A Virus, H5N1 Subtype / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article Affiliation country: Ice.2021.18