Lin Ling-Qing, Chen Yu-Yan, Lin Gen-Zhao, Shen Xu, Yang Tian-Ci, Liu Li-Li, Xiao Yao
Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No.201-209 Hubinnan Road, Xiamen, 361004, China.
School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.
J Epidemiol Glob Health. 2025 Jan 29;15(1):10. doi: 10.1007/s44197-025-00343-8.
During the COVID-19 outbreak in December 2022 in China, some laboratory workers in SARS-CoV-2 nucleic acid testing (NAT) laboratories remained uninfected.
To evaluate if the incidence of SARS-CoV-2 infection was reduced in laboratory workers who performed SARS-CoV-2 NAT, and whether this reduction resulted from the healthy worker effect.
This retrospective cohort study included 423 laboratory workers from 14 SARS-CoV-2 NAT laboratories in Xiamen, China. The incidence of SARS-CoV-2 infection among laboratory workers was analysed based on whether and how long they were engaged in NAT. The healthy worker effect among the laboratory workers engaged in NAT was examined.
The incidence of SARS-CoV-2 infection was lower in workers engaged in SARS-CoV-2 NAT, with a gradual reduction observed as the cumulative time of SARS-CoV-2 NAT increased. A healthy worker effect was observed and eliminated after matching and stratification based on gender, age, education level, and vaccination. Workers who had ever participated in SARS-CoV-2 NAT had a lower cumulative probability of SARS-CoV-2 infection and a longer duration from vaccination to SARS-CoV-2 infection, and this trend was found to be more prominent with a longer cumulative time to SARS-CoV-2 NAT.
A reduction in SARS-CoV-2 infections was observed among laboratory workers conducting SARS-CoV-2 NAT after controlling for the healthy worker effect. This finding has broader implications for understanding the role of natural immunity and its interaction with vaccine immunity in defending against SARS-CoV-2 infection.
在2022年12月中国新冠疫情爆发期间，一些从事严重急性呼吸综合征冠状病毒2（SARS-CoV-2）核酸检测（NAT）实验室的工作人员未被感染。
评估从事SARS-CoV-2 NAT的实验室工作人员中SARS-CoV-2感染率是否降低，以及这种降低是否源于健康工人效应。
这项回顾性队列研究纳入了来自中国厦门14个SARS-CoV-2 NAT实验室的423名实验室工作人员。根据实验室工作人员是否从事NAT以及从事NAT的时长，分析其SARS-CoV-2感染率。研究从事NAT的实验室工作人员中的健康工人效应。
从事SARS-CoV-2 NAT的工作人员中SARS-CoV-2感染率较低，且随着SARS-CoV-2 NAT累计时间的增加呈逐渐下降趋势。在根据性别、年龄、教育水平和疫苗接种情况进行匹配和分层后，观察到并消除了健康工人效应。曾参与SARS-CoV-2 NAT的工作人员SARS-CoV-2感染的累积概率较低，从接种疫苗到感染SARS-CoV-2的持续时间较长，并且随着SARS-CoV-2 NAT累积时间的延长，这一趋势更为明显。
在控制健康工人效应后，观察到从事SARS-CoV-2 NAT的实验室工作人员中SARS-CoV-2感染率有所降低。这一发现对于理解自然免疫在抵御SARS-CoV-2感染中的作用及其与疫苗免疫的相互作用具有更广泛的意义。
