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The Synergistic Effect of Time of Exposure, Distance and No Use of Personal Protective Equipment in the Determination of SARS-CoV-2 Infection: Results of a Contact Tracing Follow-Up Study in Healthcare Workers.
La Torre, Giuseppe; Marte, Mattia; Previte, Carlo Maria; Barone, Lavinia Camilla; Picchioni, Filippo; Chiappetta, Marta; Faticoni, Augusto; Marotta, Daniela; Mazzalai, Elena; Barletta, Vanessa India; Kibi, Shizuka; Cammalleri, Vittoria; Dorelli, Barbara; Giffi, Monica; Pocino, Roberta Noemi; Massetti, Anna Paola; Fimiani, Caterina; Turriziani, Ombretta; Romano, Ferdinando; Antonelli, Guido; Deales, Alberto; Mastroianni, Claudio Maria; Vasaturo, Fortunata.
  • La Torre G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Marte M; Unit of Occupational Medicine, Teaching Hospital Policlinico Umberto I, 00161 Roma, Italy.
  • Previte CM; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Barone LC; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Picchioni F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Chiappetta M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Faticoni A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Marotta D; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Mazzalai E; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Barletta VI; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Kibi S; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Cammalleri V; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Dorelli B; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Giffi M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Pocino RN; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Massetti AP; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Fimiani C; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Turriziani O; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Romano F; Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Roma, Italy.
  • Antonelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • Deales A; Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Roma, Italy.
  • Mastroianni CM; Health Direction, Teaching Hospital Policlinico Umberto I, 00161 Roma, Italy.
  • Vasaturo F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy.
  • On Behalf Of Collaborative Group Sapienza; Clinica Medica Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00185 Roma, Italy.
Int J Environ Res Public Health ; 18(18)2021 09 08.
Article in English | MEDLINE | ID: covidwho-1547312
ABSTRACT
The aim of this study is to assess the effect of contact time, contact distance and the use of personal protective equipment on the determination of SARS-CoV-2 infection in healthcare workers (HCWs). This study consists of an analysis of data gathered for safety reasons at the Sapienza Teaching Hospital Policlinico Umberto I in Rome through the surveillance system that was put into place after the worsening of the COVID-19 pandemic. The studied subjects consist of HCWs who were put under health surveillance, i.e., all employees who were in contact with subjects who were confirmed to have tested positive for SARS-CoV-2. The HCWs under surveillance were monitored for a period encompassing ten days after the date of contact, during which they undertook nasopharyngeal swab tests analysed through RT-PCR (RealStar® SARS-CoV-2 Altona Diagnostic-Germany). Descriptive and univariate analyses have been undertaken, considering the following as risk factors (a) no personal protective equipment use (PPE); (b) Distance < 1 m between the positive and contact persons; (c) contact time > 15'. Finally, a Cox regression and an analysis of the level of synergism between factors, as specified by Rothman, were carried out. We analysed data from 1273 HCWs. Of these HCWs, 799 (62.8%) were females, with a sample average age of 47.8 years. Thirty-nine (3.1%) tested positive during surveillance. The overall incidence rate was 0.4 per 100 person-days. Time elapsed from the last exposure and a positive RT-PCR result ranged from 2 to 17 days (mean = 7, median = 6 days). In the univariate analysis, a distance <1 m and a contact time > 15' proved to be risk factors for the SARS-CoV-2 infection, with a hazard ratio (HR) of 2.62 (95% CI 1.11-6.19) and 3.59 (95% IC 1.57-8.21), respectively. The synergism analysis found the highest synergism between the "no PPE use" x "Contact time". The synergy index S remains strongly positive also in the analysis of the factors "no PPE use" x "Distance" and "Time of contact" x "Distance". This study confirms the absolute need to implement safety protocols during the pandemic and to use the correct PPE within health facilities in order to prevent SARS-CoV-2 infection. The analysis shows that among the factors considered (contact time and distance, no use of PPE), there is a strong synergistic effect.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Personal Protective Equipment / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Middle aged Language: English Year: 2021 Document Type: Article Affiliation country: Ijerph18189456

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Personal Protective Equipment / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Middle aged Language: English Year: 2021 Document Type: Article Affiliation country: Ijerph18189456