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1.
Am J Ind Med ; 64(1): 39-47, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33210336

RESUMO

BACKGROUND: The disease burden of coronavirus disease 2019 (COVID-19) is not uniform across occupations. Although healthcare workers are well-known to be at increased risk, data for other occupations are lacking. In lieu of this, models have been used to forecast occupational risk using various predictors, but no model heretofore has used data from actual case numbers. This study assesses the differential risk of COVID-19 by occupation using predictors from the Occupational Information Network (O*NET) database and correlating them with case counts published by the Washington State Department of Health to identify workers in individual occupations at highest risk of COVID-19 infection. METHODS: The O*NET database was screened for potential predictors of differential COVID-19 risk by occupation. Case counts delineated by occupational group were obtained from public sources. Prevalence by occupation was estimated and correlated with O*NET data to build a regression model to predict individual occupations at greatest risk. RESULTS: Two variables correlate with case prevalence: disease exposure (r = 0.66; p = 0.001) and physical proximity (r = 0.64; p = 0.002), and predict 47.5% of prevalence variance (p = 0.003) on multiple linear regression analysis. The highest risk occupations are in healthcare, particularly dental, but many nonhealthcare occupations are also vulnerable. CONCLUSIONS: Models can be used to identify workers vulnerable to COVID-19, but predictions are tempered by methodological limitations. Comprehensive data across many states must be collected to adequately guide implementation of occupation-specific interventions in the battle against COVID-19.


Assuntos
/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Aviação , Barbearia , Bombeiros/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Aplicação da Lei , Práticas Mortuárias , Saúde do Trabalhador , Prevalência , Fatores de Risco , Professores Escolares/estatística & dados numéricos , Fatores de Tempo , Transportes , Washington/epidemiologia , Local de Trabalho
2.
Public Health Rep ; 136(1): 88-96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33108976

RESUMO

OBJECTIVES: Widespread global transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing coronavirus disease 2019 (COVID-19), continues. Many questions remain about asymptomatic or atypical infections and transmission dynamics. We used comprehensive contact tracing of the first 2 confirmed patients in Illinois with COVID-19 and serologic SARS-CoV-2 antibody testing to determine whether contacts had evidence of undetected COVID-19. METHODS: Contacts were eligible for serologic follow-up if previously tested for COVID-19 during an initial investigation or had greater-risk exposures. Contacts completed a standardized questionnaire during the initial investigation. We classified exposure risk as high, medium, or low based on interactions with 2 index patients and use of personal protective equipment (PPE). Serologic testing used a SARS-CoV-2 spike enzyme-linked immunosorbent assay on serum specimens collected from participants approximately 6 weeks after initial exposure to either index patient. The 2 index patients provided serum specimens throughout their illness. We collected data on demographic, exposure, and epidemiologic characteristics. RESULTS: Of 347 contacts, 110 were eligible for serologic follow-up; 59 (17% of all contacts) enrolled. Of these, 53 (90%) were health care personnel and 6 (10%) were community contacts. Seventeen (29%) reported high-risk exposures, 15 (25%) medium-risk, and 27 (46%) low-risk. No participant had evidence of SARS-CoV-2 antibodies. The 2 index patients had antibodies detected at dilutions >1:6400 within 4 weeks after symptom onset. CONCLUSIONS: In serologic follow-up of the first 2 known patients in Illinois with COVID-19, we found no secondary transmission among tested contacts. Lack of seroconversion among these contacts adds to our understanding of conditions (ie, use of PPE) under which SARS-CoV-2 infections might not result in transmission and demonstrates that SARS-CoV-2 antibody testing is a useful tool to verify epidemiologic findings.


Assuntos
/epidemiologia , Busca de Comunicante/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , /imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Illinois/epidemiologia , Masculino , Pandemias , Equipamento de Proteção Individual , Medição de Risco
3.
Public Health Rep ; 136(1): 117-123, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33207130

RESUMO

OBJECTIVES: Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19-related risk factors among Bhutanese and Burmese refugees in the United States. METHODS: We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection. RESULTS: Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers. CONCLUSION: Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.


Assuntos
/etnologia , Refugiados/estatística & dados numéricos , Adulto , Butão/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/etnologia , Exposição Ocupacional/estatística & dados numéricos , Pandemias , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia
4.
Br J Radiol ; 94(1117): 20200774, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33180554

RESUMO

OBJECTIVES: In fluoroscopy-guided interventional practices, new dose reduction systems have proved to be efficient in the reduction of patient doses. However, it is not clear whether this reduction in patient dose is proportionally transferred to operators' doses. This work investigates the secondary radiation fields produced by two kinds of interventional cardiology units from the same manufacturer with and without dose reduction systems.Methods:Data collected from a large sample of clinical procedures over a 2-year period (more than 5000 procedures and 340,000 radiation events) and the DICOM radiation dose structured reports were analysed. RESULTS: The average cumulative Hp(10) per procedure measured at the C-arm was similar for the standard and the dose reduction systems (452 vs 476 µSv respectively). The events analysis showed that the ratio Hp(10)/KAP at the C-arm was (mean ± SD) 5 ± 2, 10 ± 4, 14 ± 4 and 14 ± 6 µSv·Gy-1·cm-2 for the beams with no added filtration, 0.1, 0.4 and 0.9 mm Cu respectively and suggested that the main cause for the increment of the ratio Hp(10)/KAP vs the "standard system" is the use of higher beam filtration in the "dose reduction" system. CONCLUSION: Dose reduction systems are beneficial to reduce KAP in patients and their use should be encouraged, but they may not be equally effective to reduce occupational doses. Interventionalists should not overlook their own personal protection when using new technologies with dose reduction systems. ADVANCES IN KNOWLEDGE: Dose reduction technology in interventional systems may increase scatter dose for operators. Personal protection should not be overlooked with dose reduction systems.


Assuntos
Exposição Ocupacional/estatística & dados numéricos , Doses de Radiação , Monitoramento de Radiação/estatística & dados numéricos , Proteção Radiológica/métodos , Radiografia Intervencionista/estatística & dados numéricos , Fluoroscopia , Humanos , Monitoramento de Radiação/métodos
5.
Res Social Adm Pharm ; 17(1): 1882-1887, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32499159

RESUMO

INTRODUCTION: Since the beginning of the 2020 Sars-CoV-2 Italian outbreak, healthcare workers have been among the most exposed categories. There is little information about community pharmacists' on occupational exposure, symptoms development, and testing practices in the community pharmacist cohort. METHODS: Between April 30th and May 10th, a questionnaire was administered through social media to Italian community pharmacists. From 67000 pharmacists currently working in community pharmacies, 1632 answered the survey. RESULTS: The survey population reflected the general Italian community pharmacists population in terms of age, gender, and number of co-workers. Protective measures were adopted in up to 99.9% of pharmacies. 624 pharmacists (38.2%) developed at least one COVID-19 related symptom in the period between February 28th and May 10th. Also, 102 pharmacists (6.2%) were tested for COVID-19 and 15, the 15% of the tested population and 0.92% of the whole survey population, resulted positive on nasopharyngeal swab. However, while the number of symptomatic pharmacists decreased, a higher number of tests were performed, thus COVID-19 prevalence among community pharmacists could have been underestimated and is probably intermediate between other healthcare workers and the general population (0.31%). CONCLUSION: Community pharmacists have probably been one of the first categories to experience increased contact risk to SARS-CoV-2. COVID-19 prevalence among pharmacists could have been underestimated. In addition, the rates of protection measures adoption might have helped to reduce the spread of COVID-19 among co-workers and the community.


Assuntos
/transmissão , Serviços Comunitários de Farmácia , Exposição Ocupacional/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Adulto , /epidemiologia , Feminino , Humanos , Itália , Masculino , Prevalência , Inquéritos e Questionários
6.
Ecotoxicol Environ Saf ; 207: 111270, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32949927

RESUMO

Risk assessment is an important tool in predicting the possible risk to health. It heightens awareness by estimating the probability of adverse health effects in humans who are exposed to chemicals in the course of their work. Therefore, the present work aims to determine the occupational exposure of operating room staff to the volatile anesthetic gases, isoflurane and sevoflurane, and estimates non-cancer risk using the United States Environmental Protection Agency method. Air samples from the breathing zone of staff members were collected using the Occupational Safety and Health Administration Method 103 and analyzed using gas chromatography-mass spectroscopy. The results indicate that the measured concentrations of isoflurane and sevoflurane are below the National Institute of Occupational Safety and Health standard (2 ppm) for technicians and nurses, but not for anesthesiologists and surgeons. Moreover, the estimated non-cancer risk due to isoflurane is above the acceptable value for anesthesiologists (but acceptable for other occupational categories). A sensitivity analysis indicates that exposure time has the most effect on calculated risk (53.4%). Occupational exposure to anesthetic gases may endanger the health of operating room personnel. Therefore, control measures, such as daily testing of anesthetic devices, ensuring the effectiveness of ventilation systems, advanced scavenging methods, and regular training of staff are highly recommended.


Assuntos
Poluentes Ocupacionais do Ar/análise , Anestésicos Inalatórios/análise , Isoflurano/análise , Exposição Ocupacional/estatística & dados numéricos , Sevoflurano/análise , Humanos , Exposição Ocupacional/análise , Salas Cirúrgicas , Medição de Risco , Estados Unidos
7.
Ecotoxicol Environ Saf ; 207: 111562, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33254416

RESUMO

BACKGROUND: Low benzene exposure leads to hematotoxicity, but we still lack sensitive early monitoring and early warning markers. Benzene is associated with inflammation, which is mainly mediated by cytokines network. However, until now few studies have conducted high-throughput detection of multi-cytokines to get a global view of cytokine changes and screen for markers of benzene-induced toxicity. We hypothesized that cytokine profiles mediate benzene-induced hematotoxicity. METHODS: 228 subjects consisting of 114 low benzene exposed workers and 114 healthy controls were recruited at Research Center of Occupational Medicine, Peking University Third Hospital, Beijing. The serum concentrations of 27 cytokines were detected by cytokinomics array, urinary benzene series metabolites were measured by UPLC-MS/MS, and peripheral blood cell counts were observed by basic blood test. RESULTS: Among 27 cytokines, IL-9 and MIP1-α were significantly lower, but IL-4, IL-10, IL-15, MCP-1, TNF-α and VEGF were significantly higher in benzene exposure group than controls. Urinary benzene metabolite S-phenylmercapturic acid (S-PMA) was significantly higher in benzene exposure group and had a negative linear relationship with WBC count. S-PMA was only significantly associated with IL-9, meanwhile IL-9, IL-15 and VEGF had a positive linear relationship with WBC count. The bootstrapping mediation models showed that the effect of S-PMA on WBC count was partially explained by IL-9 for 10.11%. CONCLUSION: This study suggests that exposure to benzene was associated with alternation of blood cell count and cytokine profiles in workers exposed to low levels of benzene, especially decreases of WBC count and IL-9. We also found IL-9 partially mediated the effect of low benzene exposure on WBC count, which may be a potential and promising early monitoring and early warning marker of benzene hematotoxicity.


Assuntos
Poluentes Ocupacionais do Ar/metabolismo , Benzeno/metabolismo , Citocinas/sangue , Exposição Ocupacional/análise , Acetilcisteína/análogos & derivados , Adulto , Grupo com Ancestrais do Continente Asiático , Benzeno/análise , Biomarcadores/urina , Contagem de Células Sanguíneas , Cromatografia Líquida , Estudos Transversais , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Espectrometria de Massas em Tandem
8.
Front Public Health ; 8: 590275, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33330335

RESUMO

The COVID-19 pandemic has laid bare the inadequacy of the U.S. healthcare system to deliver timely and resilient care. According to the American Hospital Association, the pandemic has created a $202 billion loss across the healthcare industry, forcing health care systems to lay off workers and making hospitals scramble to minimize supply chain costs. However, as the demand for personal protective equipment (PPE) grows, hospitals have sacrificed sustainable solutions for disposable options that, although convenient, will exacerbate supply strains, financial burden, and waste. We advocate for reusable gowns as a means to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers. Reusable gowns' polyester material provides comparable capacity to reduce microbial cross-transmission and liquid penetration. In addition, previous hospitals have reported a 50% cost reduction in gown expenditures after adopting reusable gowns; given the current 2000% price increase in isolation gowns during COVID-19, reusable gown use will build both healthcare resilience and security from price fluctuations. Finally, with the United States' medical waste stream worsening, reusable isolation gowns show promising reductions in energy and water use, solid waste, and carbon footprint. The gowns are shown to withstand laundering 75-100 times in contrast to the single-use disposable gown. The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.


Assuntos
/prevenção & controle , Equipamentos Descartáveis/economia , Reutilização de Equipamento/economia , Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/economia , Pandemias/prevenção & controle , Roupa de Proteção/economia , Adulto , Equipamentos Descartáveis/estatística & dados numéricos , Reutilização de Equipamento/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/economia , Exposição Ocupacional/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Estados Unidos
9.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33213266

RESUMO

BACKGROUND: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. OBJECTIVE: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. METHODS: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. RESULTS: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master's degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). CONCLUSION: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.


Assuntos
Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/etiologia , Medição de Risco , Adulto , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Gravidez , Medição de Risco/métodos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
10.
Med Pr ; 71(6): 725-734, 2020 Dec 03.
Artigo em Polonês | MEDLINE | ID: mdl-33063769

RESUMO

BACKGROUND: Chronic skin exposure to a wet work environment, as well as disinfectants are factors contributing to epidermal barrier damage. This disturbs its protective functions and promotes the development of dermatoses. All these factors occur in the work environment of a laboratory diagnostician. The aim of the paper was to analyze selected skin parameters and skin lesions in the hands of laboratory diagnosticians. MATERIAL AND METHODS: Overall, 50 laboratory diagnosticians employed in a laboratory in Kraków, Poland, took part in the study. After the interview, the skin pH and moisture content were examined. Measurements were performed on the dorsal side of the dominant hand using the Skin-ph-Meter® PH 905 and Corneometer® CM 825 devices. RESULTS: The obtained moisture level values were qualified as dry or very dry skin, and the skin pH was within the reference range. No correlation between the skin pH value and the features examined (professional experience, the number of hours spent in protective gloves during the day, the number of hand washing episodes during the day) was not indicated. The level of skin moisture content seems to positively correlate with the time of wearing gloves. The use of hand moisturizers after each hand washing episode correlated with the level of skin moisture content. CONCLUSIONS: During the COVID-19 pandemic, this professional group has been facing huge challenges, and mental and physical stressors (including wet work environment) will be the source of future occupational diseases. Med Pr. 2020;71(6):725-34.


Assuntos
/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Perda Insensível de Água , Dermatite Ocupacional/epidemiologia , Feminino , Luvas Protetoras/estatística & dados numéricos , Dermatoses da Mão/epidemiologia , Humanos , Exposição Ocupacional/efeitos adversos , Polônia , Local de Trabalho/organização & administração
11.
MMWR Morb Mortal Wkly Rep ; 69(43): 1605-1610, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119557

RESUMO

Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP† exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk§ (3). Higher-risk exposures involved direct patient care (66%) and nonpatient care interactions (e.g., with coworkers and social and household contacts) (34%). Within 14 days following a higher-risk exposure, nearly one third (31%) of HCP who were enrolled in monitoring reported COVID-19-like symptoms,¶ and more than one half (52%) of enrolled HCP with symptoms received positive SARS-CoV-2 test results. Among all HCP with higher-risk exposures, irrespective of monitoring enrollment, 7% received positive SARS-CoV-2 test results. Compared with HCP with higher-risk exposures working in acute care settings, those working in congregate living or long-term care settings more often returned to work (57%), worked while symptomatic (5%), and received a positive test result (10%) during 14-day postexposure monitoring than did HCP working outside of such settings. These data highlight the need for awareness of nonpatient care SARS-CoV-2 exposure risks and for targeted interventions to protect HCP, in addition to residents, in congregate living and long-term care settings. To minimize exposure risk among HCP, health care facilities need improved infection prevention and control, consistent personal protective equipment (PPE) availability and use, flexible sick leave, and SARS-CoV-2 testing access. All health care organizations and HCP should be aware of potential exposure risk from coworkers, household members, and social contacts.


Assuntos
Infecções por Coronavirus/transmissão , Pessoal de Saúde/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Humanos , Pessoa de Meia-Idade , Minnesota/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Medição de Risco , Adulto Jovem
12.
MMWR Morb Mortal Wkly Rep ; 69(43): 1569-1570, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119564

RESUMO

On August 11, 2020, a confirmed case of coronavirus disease 2019 (COVID-19) in a male correctional facility employee (correctional officer) aged 20 years was reported to the Vermont Department of Health (VDH). On July 28, the correctional officer had multiple brief encounters with six incarcerated or detained persons (IDPs)* while their SARS-CoV-2 test results were pending. The six asymptomatic IDPs arrived from an out-of-state correctional facility on July 28 and were housed in a quarantine unit. In accordance with Vermont Department of Corrections (VDOC) policy for state prisons, nasopharyngeal swabs were collected from the six IDPs on their arrival date and tested for SARS-CoV-2, the virus that causes COVID-19, at the Vermont Department of Health Laboratory, using real-time reverse transcription-polymerase chain reaction (RT-PCR). On July 29, all six IDPs received positive test results. VDH and VDOC conducted a contact tracing investigation† and used video surveillance footage to determine that the correctional officer did not meet VDH's definition of close contact (i.e., being within 6 feet of infectious persons for ≥15 consecutive minutes)§,¶; therefore, he continued to work. At the end of his shift on August 4, he experienced loss of smell and taste, myalgia, runny nose, cough, shortness of breath, headache, loss of appetite, and gastrointestinal symptoms; beginning August 5, he stayed home from work. An August 5 nasopharyngeal specimen tested for SARS-CoV-2 by real-time RT-PCR at a commercial laboratory was reported as positive on August 11; the correctional officer identified two contacts outside of work, neither of whom developed COVID-19. On July 28, seven days preceding his illness onset, the correctional officer had multiple brief exposures to six IDPs who later tested positive for SARS-CoV-2; available data suggests that at least one of the asymptomatic IDPs transmitted SARS-CoV-2 during these brief encounters.


Assuntos
Infecções por Coronavirus/diagnóstico , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/diagnóstico , Prisões , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Masculino , Exposição Ocupacional/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Vermont/epidemiologia , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-32998195

RESUMO

Many insulating materials are used in construction, although few have been reported to cause non-malignant respiratory illnesses. We aimed to investigate associations between exposures to insulating materials and non-malignant respiratory illnesses in insulators. In this cross-sectional study, 990 insulators (45 ± 14 years) were screened from 2011-2017 in Alberta. All participants underwent pulmonary function tests and chest radiography. Demographics, work history, and history of chest infections were obtained through questionnaires. Chronic obstructive pulmonary disease (COPD) was diagnosed according to established guidelines. Associations between exposures and respiratory illnesses were assessed by modified Poisson regression. Of those screened, 875 (88%) were males. 457 (46%) participants reported having ≥ 1 chest infection in the past 3 years, while 156 (16%) were diagnosed with COPD. In multivariate models, all materials (asbestos, calcium silicate, carbon fibers, fiberglass, and refractory ceramic fibers) except aerogels and mineral fibers were associated with recurrent chest infections (prevalence ratio [PR] range: 1.18-1.42). Only asbestos was associated with COPD (PR: 1.44; 95% confidence interval [CI]: 1.01, 2.05). Therefore, occupational exposure to insulating materials was associated with non-malignant respiratory illnesses, specifically, recurrent chest infections and COPD. Longitudinal studies are urgently needed to assess the risk of exposure to these newly implemented insulation materials.


Assuntos
Asbestos/toxicidade , Asbestose/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Alberta/epidemiologia , Asbestos/análise , Criança , Estudos Transversais , Humanos , Masculino , Fibras Minerais/análise , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos
14.
Clin Med (Lond) ; 20(6): e234-e237, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33067188

RESUMO

The British Thoracic Society have published SPACES (Sharing Patient Assessments Cuts Exposure for Staff) guidance recommending the use of telecommunications as a means of inpatient clinical assessment during the COVID-19 pandemic. The aim of this audit was to reduce face-to-face exposure time during inpatient care of patients with suspected/confirmed COVID-19 using a telecommunications-based approach. 76 patients were included in the audit. 46 patients were included in cycle 1, which measured the average face-to-face time for clinical consultation per patient. 30 patients were included in cycle 2, whereby history-taking was conductedusing telecommunications and, if required, face-to-face physical examination.Average face-to-face exposure time was reduced to a median of 0 seconds (IQR 0-146.3 seconds) in the telecommunications group, from a median of 312.5 seconds (IQR 178.8-442.3 seconds) in the comparator group (p<0.0001). Patient satisfaction was high with individuals' responses revealing a perception of improved safety by maintaining social distancing. No adverse events were noted.The audit confirms telecommunications can be integrated successfully into the daily inpatient ward round structure, reducing face-to-face exposure time while maintaining patient satisfaction and safety.


Assuntos
Infecções por Coronavirus , Hospitais , Exposição Ocupacional , Pandemias , Satisfação do Paciente/estatística & dados numéricos , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Inglaterra , Humanos , Auditoria Médica , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Telemedicina
15.
Aust J Gen Pract ; 49(11): 728-732, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33123703

RESUMO

BACKGROUND: General practitioners (GPs) have some of the highest rates of mortality from COVID-19 among healthcare workers. SARS-CoV-2 has unique properties that place GPs at particular risk. OBJECTIVE: The aim of this article is to discuss the nose-related features of SARS-CoV-2 that place GPs at risk, and to make recommendations pertinent to the safety and protection of primary healthcare physicians. DISCUSSION: The highest viral load of SARS-CoV-2 is in the nose and nasopharynx. It is often highest early in the illness, before the development of symptoms. Further, SARS-CoV-2 replicates and continues to shed in the nasopharynx long after the virus is no longer detectable in the lower respiratory tract. This places any physician performing examinations on, or procedures involving, the upper respiratory tract at risk for contracting COVID-19. New-onset hyposmia and dysgeusia are indicators for COVID-19 and should be included in screening protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Clínicos Gerais/estatística & dados numéricos , Controle de Infecções , Cavidade Nasal/virologia , Nasofaringe/virologia , Transtornos do Olfato/virologia , Pandemias , Pneumonia Viral , Austrália , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Mucosa Nasal/metabolismo , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Gestão de Riscos , Carga Viral
16.
Nat Commun ; 11(1): 5064, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33033249

RESUMO

SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6-39.5) and ageusia (OR 19.2, 95% CI 14.3-26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9-4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2-5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Hospitais , Humanos , Imunoglobulina G/sangue , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/transmissão , Estudos Soroepidemiológicos , Suécia/epidemiologia
20.
Environ Health Prev Med ; 25(1): 58, 2020 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-33010808

RESUMO

BACKGROUND: Occupational exposure to blood and body fluids is a major risk factor for the transmission of blood-borne infections to healthcare workers. There are several primary studies in Ethiopia yet they might not be at the national level to quantify the extent of occupational blood and body fluid exposures (splash of blood or other body fluids into the eyes, nose, or mouth) or blood contact with non-intact skin among the healthcare workers. This systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational blood and body fluid exposure of healthcare workers in Ethiopia. METHODS: PubMed, Science Direct, Hinari, Google Scholar, and the Cochrane library were systematically searched; withal, the references of appended articles were also checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effects meta-analysis model was used to estimate the lifetime and 12-month prevalence of occupational exposure to blood and body fluids among healthcare workers in Ethiopia. RESULTS: Of the 641 articles identified through the database search, 36 studies were included in the final analysis. The estimated pooled lifetime and 12-month prevalence on occupational exposure to blood and body fluids among healthcare workers were found to be at 54.95% (95% confidence interval (CI), 48.25-61.65) and 44.24% (95% CI, 36.98-51.51), respectively. The study identified a variation in healthcare workers who were exposed to blood and body fluids across Ethiopian regions. CONCLUSION: The finding of the present study revealed that there was a high level of annual and lifetime exposures to blood and body fluids among healthcare workers in Ethiopia.


Assuntos
Sangue , Líquidos Corporais , Pessoal de Saúde/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Etiópia
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