Hospital Virgen de la Poveda.
Alcorcón Foundation University Hospital.
Workplace Health Saf. 2023 May;71(5):229-237. doi: 10.1177/21650799221135587. Epub 2023 Jan 27.
At the time of our study, occupational health evidence specific for long-term care employees was mostly lacking. The purpose of this study was to determine the proportion of positive cases in employees after the first COVID-19 wave in May 2020. We also determined the prevalence of asymptomatic cases.
The study population included all health care workers (HCW) employed at one mid-size long-term hospital in Spain (May 2020). A cross-sectional study design included an interviewer-administered self-reported questionnaire (including sociodemographic questions, risk factors for COVID-19 complications such as hypertension or diabetes, and previous polymerase chain reaction [PCR] results) and antibody determination (Biozek rapid test). Data were analyzed using Student's , Fisher, and chi-square tests. Two multivariate logistic models were created to evaluate exposure factors and symptoms separately on the outcome of having had COVID-19.
Of the 97% of workers who participated (580/596), 300 (51.7%) suffered symptoms of COVID-19, 161 (27.8%) of the rapid antibody tests were positive for IgM and/or IgG, 160 (27.6%) workers had at least one risk factor, and 32 (19.0%) of the 168 SARS-CoV-2-positive cases were asymptomatic. The proportion of negative or unavailable PCRs, with positive antibody, was 11.7% (56/477). Casual contact without protection (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.1-3.4), doctor occupation (OR 3.3, 95% CI: 1.1-10.2), and nursing assistant occupation (OR 2.5, 95% CI: 1.2-5.8) were independently associated with SARS-CoV-2 infection.
Physicians and nursing assistants in a long-term care setting were at a higher risk of SARS-COV-2 infection over other occupations in the first wave of the pandemic, especially when in contact with patients without protection. Almost one-fifth of the workers with a positive PCR test for SARS-COV-2 were asymptomatic and seroprevalence (27.8%) was well below the approximated herd immunity cutoff (60-70%). Essential workers in long-term care must be monitored frequently by Employee Health Service and should be required to wear personal protective equipment including a fit-tested N-95 while in close contact with patients and coworkers.
在我们进行研究时，针对长期护理员工的职业健康证据大多缺乏。本研究的目的是确定 2020 年 5 月第一波 COVID-19 后员工中阳性病例的比例。我们还确定了无症状病例的流行率。
研究人群包括在西班牙一家中型长期医院工作的所有医护人员（2020 年 5 月）。采用横断面研究设计，包括访谈者管理的自我报告问卷（包括社会人口学问题、COVID-19 并发症的危险因素，如高血压或糖尿病，以及之前的聚合酶链反应[PCR]结果）和抗体测定（Biozek 快速检测）。使用学生 t 检验、Fisher 检验和卡方检验进行数据分析。建立了两个多变量逻辑模型，分别评估接触因素和症状对 COVID-19 结局的影响。
在参与的 97%的工作人员中（580/596），有 300 人（51.7%）出现 COVID-19 症状，161 人（27.8%）快速抗体检测 IgM 和/或 IgG 阳性，160 人（27.6%）有至少一个危险因素，32 人（19.0%）SARS-CoV-2 阳性病例无症状。PCR 结果阴性或无法获得、抗体阳性的比例为 11.7%（56/477）。无保护的偶然接触（比值比[OR]：1.9，95%置信区间[CI]：1.1-3.4）、医生职业（OR 3.3，95%CI：1.1-10.2）和护理助理职业（OR 2.5，95%CI：1.2-5.8）与 SARS-CoV-2 感染独立相关。
在大流行的第一波中，长期护理机构的医生和护理助理比其他职业更容易感染 SARS-CoV-2，尤其是在与无保护的患者接触时。近五分之一的 SARS-CoV-2 PCR 检测阳性的患者无症状，血清阳性率（27.8%）远低于估计的群体免疫临界值（60-70%）。长期护理机构的基本工作人员必须由员工健康服务部门定期监测，并要求在与患者和同事密切接触时佩戴个人防护设备，包括适合测试的 N-95 口罩。
