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1.
BMC Health Serv Res ; 24(1): 424, 2024 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-38570843

RESUMEN

BACKGROUND: Healthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital. METHODS: The present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant. RESULTS: Out of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B. CONCLUSIONS: Most HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.


Asunto(s)
Líquidos Corporales , Hepatitis B , Exposición Profesional , Masculino , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Camerún/epidemiología , Estudios Transversales , Hepatitis B/prevención & control , Hospitales , Exposición Profesional/prevención & control , Personal de Salud , Derivación y Consulta
2.
J Med Imaging Radiat Sci ; 55(1): 61-66, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38172010

RESUMEN

INTRODUCTION: Amidst the COVID-19 pandemic, healthcare workers (HCWs) were found to be at a greater risk of becoming infected with severe acute respiratory syndrome (SARS-CoV-2). This disease is highly contagious and is for the most part preventative if correct Personal Protective Equipment (PPE) is used while attending to patients. Subsequently, a lack of PPE in South Africa was putting the lives of health care workers at risk impacting on the functioning of the healthcare system. METHODS: This exploratory, descriptive, qualitative study used purposeful sampling to obtain data saturation. The study comprised twelve individual interviews with radiographers from both private and government hospitals in Gauteng, South Africa who worked in x-ray departments during the COVID-19 pandemic. Online video interviews were conducted. The transcripts of the interviews were further coded into themes and categorised using thematic analysis and verified by an independent coder. RESULTS: The radiographers' experiences of PPE during COVID-19 in Gauteng, South Africa generated 3 themes: radiographers' experiences with PPE supplied during COVID-19, workplace practices and procedures for PPE during COVID-19 and emotional challenges faced during PPE shortage. DISCUSSION: While there was an understandable fear of contracting the COVID-19 virus during the height of the pandemic. The researcher also believes that radiographers would benefit greatly by receiving training on how to use PPE correctly for infection control in highly stressful situations. Education is required for use of PPE when supply is scarce and the number of infected patients outweighs the quantities of PPE available. This study further found that there needs to be more support given to healthcare workers (HCW's) to assess their mental health and emotional stress experienced when facing a pandemic. CONCLUSION: While COVID-19 has started to settle, the lessons learnt should inform recommendations on PPE use, regarding procurement and preservation. In addition, mental health assessments can be considered for radiographers during future pandemic.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , Pandemias/prevención & control , Sudáfrica , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal
3.
Am J Infect Control ; 52(4): 381-386, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38069921

RESUMEN

BACKGROUND: Infection precautions (IP) facilitate standardized and safe patient care. Research has demonstrated several barriers to IP adherence among health care personnel (HCP) but potential exposure risk to SARS-CoV-2 and job role has not been considered. METHODS: Researchers used self-reported baseline surveys with 191 HCPs at a university medical center to examine factors that may have affected IP adherence (eg, personal protective equipment [PPE] and hand hygiene errors) over the 2 weeks prior to the survey. Chi-square tests were used to determine if differences existed first, among job role and IP adherence, and second, the potential risk of exposure to SARS-CoV-2 and IP adherence. A binary logistic regression estimated if PPE nonadherence was associated with COVID-19 stress, job role, and potential exposure risk to SARS-CoV-2. RESULTS: PPE nonadherence varied by job role. Those in the Other group (ie, nonphysician/non-nursing HCP) reported significantly fewer errors (9.6%) compared to Physicians (26.5%) and Registered Nurses (33.3%). Hand/glove hygiene errors between COVID-19 patient rooms varied by job role. Respondents who had higher risks of exposure to SARS-CoV-2 were 5.74 times more likely to experience errors. CONCLUSIONS: The results provide implications for adopting systems-level approaches to support worker knowledge and engagement across job roles to improve IP adherence.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal , Personal de Salud
4.
Small ; 20(14): e2306324, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37990401

RESUMEN

Although the personal protective equipment (PPE) used by healthcare workers (HCWs) effectively blocks hazardous substances and pathogens, it does not fully rule out the possibility of infection, as pathogens surviving on the fabric surface pose a substantial risk of cross-infection through unintended means. Therefore, PPE materials that exhibit effective biocidal activity while minimizing contamination by viscous body fluids (e.g., blood and saliva) and pathogen-laden droplets are highly sought. In this study, petal-like nanostructures (PNSs) are synthesized through the vertical rearrangement of colloidal lamellar bilayers via evaporation-induced self-assembly of octadecylamine, silica-alumina sol, and diverse photosensitizer. The developed method is compatible with various fabrics and imparts visible-light-activated antimicrobial and superhydrophobic-based antifouling activities. PNS-coated fabrics could provide a high level of protection and effectively block pathogen transmission as exemplified by their ability to roll off viscous body fluids reducing bacterial droplet adhesion and to inactivate various microorganisms. The combination of antifouling and photobiocidal activities results in the complete inactivation of sprayed pathogen-laden droplets within 30 min. Thus, this study paves the way for effective contagious disease management and the protection of HCWs in general medical environments, inspiring further research on the fabrication of materials that integrate multiple useful functionalities.


Asunto(s)
Antiinfecciosos , Incrustaciones Biológicas , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal , Personal de Salud , Antiinfecciosos/farmacología
5.
Infect Control Hosp Epidemiol ; 45(2): 221-226, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37609833

RESUMEN

BACKGROUND: Patients diagnosed with coronavirus disease 2019 (COVID-19) aerosolize severe acute respiratory coronavirus virus 2 (SARS-CoV-2) via respiratory efforts, expose, and possibly infect healthcare personnel (HCP). To prevent transmission of SARS-CoV-2 HCP have been required to wear personal protective equipment (PPE) during patient care. Early in the COVID-19 pandemic, face shields were used as an approach to control HCP exposure to SARS-CoV-2, including eye protection. METHODS: An MS2 bacteriophage was used as a surrogate for SARS-CoV-2 and was aerosolized using a coughing machine. A simulated HCP wearing a disposable plastic face shield was placed 0.41 m (16 inches) away from the coughing machine. The aerosolized virus was sampled using SKC biosamplers on the inside (near the mouth of the simulated HCP) and the outside of the face shield. The aerosolized virus collected by the SKC Biosampler was analyzed using a viability assay. Optical particle counters (OPCs) were placed next to the biosamplers to measure the particle concentration. RESULTS: There was a statistically significant reduction (P < .0006) in viable virus concentration on the inside of the face shield compared to the outside of the face shield. The particle concentration was significantly lower on the inside of the face shield compared to the outside of the face shield for 12 of the 16 particle sizes measured (P < .05). CONCLUSIONS: Reductions in virus and particle concentrations were observed on the inside of the face shield; however, viable virus was measured on the inside of the face shield, in the breathing zone of the HCP. Therefore, other exposure control methods need to be used to prevent transmission from virus aerosol.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Aerosoles y Gotitas Respiratorias , Equipo de Protección Personal , Tos , Atención a la Salud
6.
Odontology ; 112(2): 309-316, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37702832

RESUMEN

Personal protective equipment (PPE) has long been a high priority in dental aerosol-producing treatments. Since COVID-19 pandemic, its importance has increased yet again. While importance of PPE in preventing transmission and thus possible infection of pathogens is well known, contamination potential of PPE after treatment itself is less investigated. This review aims to give an overview of the current literature and contamination potential (viral, blood, bacterial) of components of protective equipment itself. The literature search was performed using the Medline database; furthermore, a hand search was conducted. Last search took place on 23 November 2022. Two categories of hygiene-related keywords were formed (category A: mask, face shield, goggles, eyewear, personal protective equipment; category B: contamination, aerosol). Each keyword from one category was combined with all keywords from the other one. In addition, the keyword "dental" was always added. First, a title and abstract screening was performed. Afterward, a full-text analysis was followed for the included studies. A total of 648 search hits were found in the Medline database. 47 were included after title and abstract screening. 22 studies were excluded after full-text analysis, 25 studies were included. The hand search resulted in 4 studies that were included. Bacterial contamination of PPE after treatment has been adequately studied, contamination with blood less. Microorganisms mainly originate from the oral and cutaneous flora; however, a transmission of potential pathogens like Staphylococcus aureus or Escherichia coli was also described. Studies showing transmission pathways starting from PPE and its various components are lacking. No measures have yet been described that fully protect the protective equipment from contamination. There is growing awareness that PPE itself can be a source of pathogen transmission, and thus possible infection. Therefore, not only wearing of protective clothing, but also conscious handling of it is crucial for transmission and possible infection prevention. However, studies showing transmission pathways starting from PPE and its various components are lacking. Several studies have investigated what measures can be taken to protect the protective equipment itself. So far, none of the methods evaluated can prevent contamination of PPE.


Asunto(s)
COVID-19 , Pandemias , Humanos , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Aerosoles y Gotitas Respiratorias , Equipo de Protección Personal , COVID-19/prevención & control
7.
J Hosp Infect ; 144: 75-84, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38040038

RESUMEN

BACKGROUND: The contagiousness of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is known to be linked to the emission of bioaerosols. Thus, aerosol-generating procedures (AGPs) could increase the risk of infection among healthcare workers (HCWs). AIM: To investigate the impact of an aerosol protection box, the SplashGuard Caregiver (SGGC) with suction system, by direct analysis of the presence of viral particles after an AGP, and by using the computational fluid dynamics (CFD) simulation method. METHODS: This prospective observational study investigated HCWs caring for patients with SARS-CoV-2 admitted to an intensive care unit (ICU). Rooms were categorized as: SGCG present and SGCG absent. Virus detection was performed through direct analysis, and using a CFD model to simulate the movement dynamics of airborne particles produced by a patient's respiratory activities. FINDINGS: Of the 67 analyses performed, three samples tested positive on quantitative polymerase chain reaction: one of 33 analyses in the SCCG group (3%) and two of 34 analyses in the non-SGCG group (5.9%). CFD simulations showed that: (1) reduction of the gaps of an SGCG could decrease the number of emitted particles remaining airborne within the room by up to 70%; and (2) positioning HCWs facing the opposite direction to the main air flow would reduce their exposure. CONCLUSIONS: This study documented the presence of SARS-CoV-2 among HCWs in a negative pressure ICU room of an infected patient with or without the use of an SGCG. The simulation will help to improve the design of the SGCG and the positioning of HCWs in the room.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/prevención & control , Cuidadores , Estudios Prospectivos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Aerosoles y Gotitas Respiratorias , Unidades de Cuidados Intensivos
8.
J Infect Dis ; 229(Supplement_2): S207-S212, 2024 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-38019754

RESUMEN

This report summarizes risk assessment interviews and follow-up with health care personnel (HCP) after exposure to patients with mpox disease during 17 May to 8 July 2022. HCP-case interactions were assessed using a standard questionnaire to categorize the risk associated with patient encounters. We assessed 150 interactions among 142 HCP and 30 cases. Four (2.7%) interactions were defined as high risk, 5 (3.3%) intermediate, 107 (71.3%) low, and 31 (20.7%) no risk. High and intermediate exposures were offered postexposure prophylaxis; 4 accepted. No documented mpox transmission after exposure was identified. These findings suggest transmission risk in health care settings during routine patient care is low.


Asunto(s)
Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Mpox , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Chicago , Personal de Salud , Illinois , Medición de Riesgo , Brotes de Enfermedades , Atención a la Salud
9.
Adv Skin Wound Care ; 36(11): 1-9, 2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-37861670

RESUMEN

OBJECTIVE: To understand the problems experienced by healthcare workers (HCWs) who used personal protective equipment (PPE) on their face during the COVID-19 pandemic, their interventions to prevent these problems, and their recommendations for improving the quality of PPE. METHODS: This descriptive and qualitative study included HCWs (N = 29) from health institutions at different levels in Turkey. Researchers collected data using a semistructured data collection form (13 items) and in-depth individual interviews. Data were analyzed with descriptive statistics and qualitative inductive content analysis. RESULTS: Of the 29 participants, 15 (51.7%) were women, and 18 (62.1%) were nurses. Participants' answers regarding problems related to PPE use were grouped into four main categories, answers regarding the prevention of these problems were grouped into three main categories, and answers regarding improving the quality of PPE were grouped into three main categories. Skin concerns were the most commonly reported problems related to PPE, and interventions to prevent these problems primarily related to skin protection and care. Recommendations to improve the quality of PPE focused on using materials for masks and face shields that reduce pressure and friction; participants also suggested that face shields be produced in sterile and disposable packages. CONCLUSIONS: This research indicates that HCWs need support and they are able to create individual solutions for the problems with PPE that they experience. Skin-friendly PPE that ensures the safety and comfort of HCWs should be produced, and hospitals should develop policies for institutional use to prevent PPE injury.


Asunto(s)
COVID-19 , Pandemias , Femenino , Humanos , Masculino , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal/efectos adversos , Personal de Salud , COVID-19/prevención & control
10.
Euro Surveill ; 28(32)2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37561052

RESUMEN

The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.


Asunto(s)
COVID-19 , Control de Infecciones , Equipo de Protección Personal , Humanos , COVID-19/prevención & control , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Aerosoles y Gotitas Respiratorias
11.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 54(4): 798-803, 2023 Jul.
Artículo en Chino | MEDLINE | ID: mdl-37545077

RESUMEN

Objective: To examine the application effect of body mechanics principles in the process of health workers doffing personal protective equipment (PPE). Methods: A total of 360 health workers from a Fangcang shelter hospital, also known as alternate care site, in Shanghai were involved in a centralized 1-day training concerning essential skills for taking off PPE. The training was focused on integrating body mechanics principles, including expanding the support surface, lowering the center of gravity, reducing the shift in the the center of gravity, using the principle of leverage, and creating the appropriate operating space, in the PPE doffing process. Through remote video monitoring and recording, observations were made of the physical stability, pollution risks, and operational smoothness of the health workers when they applied body mechanics principles in their actions. Results: The results of binary logistic regression showed that, compared with the actions taken without applying body mechanics principles, performing the operation of the body leaning forward and then slightly leaning backward was positively correlated with stability in the doffing process (odds ratio [O R]=3.291, 95% confidence interval [ CI]: 1.627-6.656), negatively correlated with pollution risks ( OR=0.203, 95% CI: 0.100-0.412), and positively correlated with operational smoothness ( OR=20.847, 95% CI: 8.061-53.916); performing the operation of taking off the boot sleeve in a horse-riding stance, with one foot standing ahead of the other, was positively correlated with stability ( OR=5.299, 95% CI: 1.041-26.957), negatively correlated with pollution risks ( OR=0.079, 95% CI: 0.009-0.692), and positive correlated with operational smoothness ( OR=16.729, 95% CI: 1.238-226.077); performing the operation of taking off the boot sleeve by lifting the heel and then the toes was positively correlated with stability ( OR=19.361, 95% CI: 8.391-44.671), negatively correlated with pollution risks ( OR=0.181, 95% CI: 0.084-0.393), and positively correlated with operational smoothness ( OR=10.977, 95% CI: 3.764-32.008); performing the operation of the leaning forward and keeping the face looking forward when taking off the mask was positively correlated with stability ( OR=2.935, 95% CI: 1.412-6.101), negatively correlated with pollution risks ( OR=0.123, 95% CI: 0.059-0.258), and positively correlated with operational smoothness ( OR=18.126, 95% CI: 6.665-49.297). Conclusion: In the process of medical staffs doffing PPE, correct and proper mechanical postures and actions can effectively assist medical staffs to maintain balance and stability and reduce the risks of infection, which has major significance and should be widely incorporated in personal protection skills training and applied in clinical practice.


Asunto(s)
Fiebre Hemorrágica Ebola , Hospitales Especializados , Animales , Caballos , Fiebre Hemorrágica Ebola/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Unidades Móviles de Salud , China , Equipo de Protección Personal
12.
Can J Public Health ; 114(4): 534-546, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37410364

RESUMEN

OBJECTIVES: During the first wave of COVID-19 in Québec, healthcare workers (HCWs) represented 25% of the cases in Montréal. A study was conducted to describe SARS-CoV-2-infected HCWs in Montréal, and certain workplace and household characteristics. Secondary objectives included estimating the associations between having had access to personal protective equipment (PPE) and training, and following self-isolation recommendations, and certain sociodemographic and workplace characteristics. METHODS: A cross-sectional study was conducted, based on a stratified random sample, among Montréal HCWs who tested positive for SARS-CoV-2 between March and July 2020. A total of 370 participants answered a telephone-administered questionnaire. Descriptive statistics were conducted, followed by log binomial regressions to estimate the associations. RESULTS: Study participants were mostly female (74%), born outside of Canada (65%), and identified as Black, Indigenous, and People of Colour (BIPOC; 63%). In terms of healthcare positions, most were orderlies (40%) or registered nurses (20%). Half (52%) of the participants reported having had insufficient access to PPE and 30% reported having received no training related to SARS-CoV-2 infection prevention, with large proportions being BIPOC women. Working evening or night shifts decreased chances of having had sufficient access to PPE (OR 0.50; 0.30-0.83). CONCLUSION: This study describes the profile of the HCWs who were infected during the first wave of the pandemic in Montréal. Recommendations include collecting comprehensive sociodemographic data on SARS-CoV-2 infections and ensuring equitable access to infection prevention and control training and PPE during health crises, particularly those at highest risk of exposure.


RéSUMé: OBJECTIFS: Lors de la première vague de la COVID-19 au Québec, les travailleurs de la santé (TS) représentaient 25 % des cas à Montréal. Une étude a été menée pour décrire les TS infectés par le SRAS-CoV-2 à Montréal, ainsi que certaines caractéristiques liées au travail et au ménage. Les objectifs secondaires visaient à estimer les associations entre le fait d'avoir eu accès à un équipement de protection individuelle (EPI) et à une formation, ainsi que la capacité de suivre les recommandations d'auto-isolement et différentes caractéristiques sociodémographiques et du lieu de travail. MéTHODOLOGIE: Une étude transversale a été menée, sur la base d'un échantillon aléatoire stratifié, parmi les TS de Montréal qui ont été testés positifs pour le SRAS-CoV-2 entre mars et juillet 2020. Un total de 370 participants a répondu à un questionnaire administré par téléphone. Des statistiques descriptives ont été réalisées, suivies de régressions log binomiales pour estimer les associations. RéSULTATS: Les participants étaient en majorité des femmes (74 %), nés à l'extérieur du Canada (65 %) et s'identifiaient comme des personnes Noires, des Autochtones et des personnes de couleur (BIPOC; 63 %). En termes d'emploi dans le système de santé, 40 % étaient des préposés aux bénéficiaires et 20 % des infirmières cliniciennes. La moitié (52 %) des participants ont déclaré ne pas avoir eu un accès suffisant à l'EPI et 30 % ont déclaré n'avoir reçu aucune formation liée à la prévention des infections SRAS-CoV-2, une grande partie d'entre eux étant des femmes BIPOC. Le fait de travailler le soir ou la nuit diminuait les chances d'avoir un accès suffisant aux EPI (OR 0,50; 0,30­0,83). CONCLUSION: Cette étude décrit le profil des travailleurs de santé qui ont été infectés lors de la première vague de la pandémie à Montréal. Les recommandations comprennent la collecte de données sociodémographiques complètes et de s'assurer de fournir de l'EPI et des formations en prévention et contrôle des infections pendant les crises sanitaires, en particulier pour les personnes les plus à risque d'exposition.


Asunto(s)
COVID-19 , SARS-CoV-2 , Femenino , Humanos , Masculino , COVID-19/epidemiología , Estudios Transversales , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Personal de Salud
14.
Semin Respir Crit Care Med ; 44(3): 340-348, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37015285

RESUMEN

Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Estudios Retrospectivos , Estudios Prospectivos , Estudios Transversales , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Personal de Salud , Factores de Riesgo
15.
Clin Chest Med ; 44(2): 215-226, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37085215

RESUMEN

Because of the potential for high aerosol transmission during pulmonary function testing and pulmonary procedures, performing these tests and procedures must be considered carefully during the coronavirus disease-2019 (COVID-19) pandemic. Much has been learned about the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by aerosols and the potential for such transmission through pulmonary function tests and pulmonary procedures, and subsequently preventative practices have been enhanced and developed to reduce the risk of transmission of virus to patients and personnel. This article reviews what is known about the potential for transmission of SARS-CoV-2 during pulmonary function testing and pulmonary procedures and the recommended mitigation steps to prevent the spread of COVID-19.


Asunto(s)
COVID-19 , Humanos , COVID-19/prevención & control , SARS-CoV-2 , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Aerosoles y Gotitas Respiratorias , Pruebas de Función Respiratoria
16.
Antimicrob Resist Infect Control ; 12(1): 43, 2023 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-37122021

RESUMEN

We conducted a qualitative interview-based study to examine the perception of infection prevention and control (IPC) measures implemented during the COVID-19 pandemic among healthcare workers (HCWs) without patient contact in a tertiary academic care center. We compared these findings to those derived from interviews of HCWs with patient contact from the same institution using the same study design. The following main four themes were identified: (1) As for HCWs with patient contact, transparent communication strongly contributes to employees' sense of security. (2) Information on personal protective equipment (PPE) usage needs to be stratified according to different educational backgrounds and professions. (3) Consistency of IPC measures was positively perceived yet a desire for constant reminders to counteract the fatigue effect played a more significant role for HCWs without patient contact. (4) As compared to HCWs with patient contact, HCWs without patient contact preferred uniform digital training resources rather than more face-to-face training. This study shows that the needs of HCWs with and without patient contact differ and need to be considered in pandemic management.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/prevención & control , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Personal de Salud , Percepción
17.
BMC Oral Health ; 23(1): 167, 2023 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-36964540

RESUMEN

BACKGROUND: Health care professionals including dental staff are at greater risk of occupational exposure to life threatened blood-borne pathogens. Occupational exposures will continue to occur despite improved techniques of prevention and using the post exposure prophylaxis (PEP) in these situations are of great importance. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of post exposure prophylaxis for fifth year dental students at a private Egyptian university. METHODS: This cross-sectional study was conducted among 404 dental students in the fifth year at a private Egyptian university from July 2019 to March 2020. Data were collected using self-administrated questionnaires including personal information, knowledge, attitude, and practice questions. RESULTS: Our study showed that the total mean knowledge score was (0.45 ± 0.50), for attitude (0.70 ± 0.46), and that for practice (0.45 ± 0.50). There was no gender difference regarding PEP (P > 0.05). A total of 213 (47.5%) dental students believed that PEP should be indicated for any needlestick injury in the workplace. A number of 379 of the students (94%) chose "Yes" when asked if they thought PEP is important. While, 143 students (32.5%) were unaware of the existence of PEP service and protocol when asked about the reasons for not taking PEP after occupational exposure. CONCLUSIONS: Knowledge and practice of fifth year dental students at a private Egyptian university toward post exposure prophylaxis are not satisfactory. Awareness and curriculum modifications are important regarding PEP.


Asunto(s)
Infecciones por VIH , Humanos , Estudios Transversales , Estudiantes de Odontología , Profilaxis Posexposición/métodos , Conocimientos, Actitudes y Práctica en Salud , Egipto , Universidades , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Encuestas y Cuestionarios
18.
J Hosp Infect ; 135: 18-27, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36805081

RESUMEN

BACKGROUND: Healthcare workers (HCWs) are at increased risk of infection with blood-borne pathogens due to occupational blood exposures (OBEs). Early reporting, detection and postexposure prophylaxis (PEP) help to prevent infections. AIM: To investigate the incidence of OBEs, related epidemiological characteristics, PEP completion rate, time and reason for PEP discontinuation, and seroconversion rate reported over 10 years. METHODS: This retrospective study analysed 1086 cases of OBE and PEP management from January 2012 to December 2021 among staff in a South Korean tertiary hospital. FINDINGS: The mean incidence of OBE was 7.82 per 100 beds and 3.0 per 100 HCWs. Of 1086 cases of OBE, 633 (58.3%) HCWs required PEP and 453 (41.7%) did not. After OBE, 70.1% (444/633) of HCWs subject to PEP completed tracking, and 29.9% (189/633) stopped PEP tracking (P<0.001). The PEP completion rate showed a significant difference by gender (P=0.024), occupation (P<0.001) and exposure frequency (P<0.001). None of the 444 HCWs who completed PEP seroconverted to hepatitis B virus, hepatitis C virus, human immunodeficiency virus or Treponema pallidum (syphilis). CONCLUSION: The study findings demonstrate the need to improve follow-up care among HCWs following OBE. There is a need for education in healthcare facilities; moreover, establishing a national surveillance system is necessary to ensure that HCWs undergo PEP proactively and complete their follow-up visits.


Asunto(s)
Infecciones por VIH , Exposición Profesional , Humanos , Infecciones por VIH/prevención & control , Estudios Retrospectivos , Seroconversión , Personal de Salud , Exposición Profesional/prevención & control , Patógenos Transmitidos por la Sangre , VIH , Profilaxis Posexposición , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control
19.
PLoS One ; 18(1): e0272716, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36608021

RESUMEN

The Coronavirus Disease 2019 (COVID-19) pandemic renewed interest in infectious aerosols and reducing risk of airborne respiratory pathogen transmission, prompting development of devices to protect healthcare workers during airway procedures. However, there are no standard methods for assessing the efficacy of particle containment with these protective devices. We designed and built an aerosol bio-containment device (ABCD) to contain and remove aerosol via an external suction system and tested the aerosol containment of the device in an environmental chamber using a novel, quantitative assessment method. The ABCD exhibited a strong ability to control aerosol exposure in experimental and computational fluid dynamic (CFD) simulated scenarios with appropriate suction use and maintenance of device seals. Using a log-risk-reduction framework, we assessed device containment efficacy and showed that, when combined with other protective equipment, the ABCD can significantly reduce airborne clinical exposure. We propose this type of quantitative analysis serves as a basis for rating efficacy of aerosol protective enclosures.


Asunto(s)
COVID-19 , Humanos , COVID-19/prevención & control , Aerosoles y Gotitas Respiratorias , Equipo de Protección Personal , Equipos de Seguridad , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control
20.
Artículo en Inglés | MEDLINE | ID: mdl-36613180

RESUMEN

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.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Bioaseguramiento , México/epidemiología , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal , Hospitales , Personal de Salud
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