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Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case–control study in Québec, Canada

Published online by Cambridge University Press:  09 September 2022

Sara Carazo*
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Jasmin Villeneuve
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Denis Laliberté
Affiliation:
Direction de la santé publique de la Capitale-Nationale, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada Faculty of Medicine, Laval University, Québec, Québec, Canada
Yves Longtin
Affiliation:
Infection Prevention and Control Unit, Jewish General Hospital, Montreal, Québec, Canada McGill University Faculty of Medicine, Montreal, Québec, Canada
Denis Talbot
Affiliation:
Faculty of Medicine, Laval University, Québec, Québec, Canada Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
Richard Martin
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Geoffroy Denis
Affiliation:
McGill University Faculty of Medicine, Montreal, Québec, Canada CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada
Francine Ducharme
Affiliation:
Faculté des sciences infirmières, Université de Montréal, Montreal, Québec, Canada Centre de recherche de l’Institut de gériatrie de Montréal, Montreal, Québec, Canada
Bianka Paquet-Bolduc
Affiliation:
Infection Prevention and Control Unit, Institut Universitaire en cardiologie et pneumologie de Québec, Québec, Québec, Canada
Geneviève Anctil
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Sandrine Hegg-Deloye
Affiliation:
Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
Gaston De Serres
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada Faculty of Medicine, Laval University, Québec, Québec, Canada Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
*
Author for correspondence: Sara Carazo, E-mail: sara.carazo@inspq.qc.ca

Abstract

Objectives:

In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs.

Design:

Test-negative case-control study.

Setting:

Provincial health system.

Participants:

HCWs with PCR-confirmed coronavirus disease 2019 (COVID-19) diagnosed between November 15, 2020, and May 29, 2021 (ie, cases), were compared to HCWs with compatible symptoms who tested negative during the same period (ie, controls).

Methods:

Adjusted odds ratios (aORs) of infection were estimated using regression logistic models evaluating demographic and employment characteristics (all 4,919 cases and 4,803 controls) or household and workplace exposures and IPC measures (2,046 patient-facing cases and 1,362 controls).

Results:

COVID-19 risk was associated with working as housekeeping staff (aOR, 3.6), as a patient-support assistant (aOR, 1.9), and as nursing staff (aOR, 1.4), compared to administrative staff. Other risk factors included being unexperienced (aOR, 1.5) and working in private seniors’ homes (aOR, 2.1) or long-term care facilities (aOR, 1.5), compared to acute-care hospitals. Among patient-facing HCWs, exposure to a household contact was reported by 9% of cases and was associated with the highest risk of infection (aOR, 7.8). Most infections were likely attributable to more frequent exposure to infected patients (aOR, 2.7) and coworkers (aOR, 2.2). Wearing an N95 respirator during contacts with COVID-19 patients (aOR, 0.7) and vaccination (aOR, 0.2) were the measures associated with risk reduction.

Conclusion:

In the context of the everchanging SARS-CoV-2 virus with increasing transmissibility, measures to ensure HCW protection, including vaccination and respiratory protection, and patient safety will require ongoing evaluation.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. Some of these data were presented in an official report of the “Institut Nationale de Santé Publique de Québec” [in French]. Available at their website: https://www.inspq.qc.ca/sites/default/files/publications/3192-enquete-epidemiologique-travailleurs-sante-covid-19.pdf.

References

COVID data tracker. Centers for Disease Control and Prevention website. https://covid.cdc.gov/covid-data-tracker/#health-care-personnel. Published 2022. Accessed April 15, 2022.Google Scholar
COVID-19 cases and deaths in healthcare workers in Canada. Canadian Institute for Health Information website. https://www.cihi.ca/en/covid-19-cases-and-deaths-in-health-care-workers-in-canada. Published 2022. Accessed April 15, 2022.Google Scholar
Jespersen, S, Mikkelsen, S, Greve, T, et al. Severe acute respiratory syndrome coronavirus 2 seroprevalence survey among 17,971 healthcare and administrative personnel at hospitals, prehospital services, and specialist practitioners in the central Denmark region. Clin Infect Dis 2020;ciaa1471.CrossRefGoogle Scholar
Yassi, A, Grant, JM, Lockhart, K, et al. Infection control, occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers from variants of concern: a 14-month observational study using surveillance data. PLoS One 2021;16:e0254920.CrossRefGoogle ScholarPubMed
Wilkins, JT, Gray, EL, Wallia, A, et al. Seroprevalence and correlates of SARS-CoV-2 antibodies in healthcare workers in Chicago. Open Forum Infect Dis 2020;8:ofaa582.CrossRefGoogle ScholarPubMed
Données Covid-19 au Québec. Institut national de santé publique du Québec website. https://www.inspq.qc.ca/covid-19/donnees. Published 2022. Accessed April 15, 2022.Google Scholar
Données sur les variants du SRAS-CoV-2 au Québec. Institut national de santé publique du Québec website. https://www.inspq.qc.ca/covid-19/donnees/variants. Published 2022. Accessed April 15, 2022.Google Scholar
Gilca, R, Amini, R, Carazo, S, et al. The changing landscape of respiratory viruses contributing to respiratory hospitalisations: results from a hospital-based surveillance in Québec, Canada, 2012–13 to 2021–22. medRxiv 2022. doi: 10.1101/2022.07.01.22277061v1.CrossRefGoogle Scholar
Gamache, P, Hamel, D, Blaser, C. Material and social deprivation index: a summary. Institut national de santé publique du Québec website. https://www.inspq.qc.ca/sites/default/files/publications/2639_material_social_deprivation_index.pdf. Published 2020. Accessed April 15, 2022.Google Scholar
COVID-19—la CNESST oblige le port du N95 ou d’une protection supérieure en zone chaude. Commission des normes de l’équité de la santé et de la sécurité du travail website. https://www.cnesst.gouv.qc.ca/fr/salle-presse/communiques/covid-19-cnesst-oblige-port-n95-dune-protection. Published 2021. Accessed May 15, 2022.Google Scholar
COVID-19—la CNESST oblige également le port du N95, ou d’une protection supérieure, en zone tiède. Commission des normes, de l’équité, de la santé et de la sécurité du travail website. https://www.cnesst.gouv.qc.ca/fr/salle-presse/communiques/n95-zone-tiede. Published 2021. Accessed May 15, 2022.Google Scholar
Jacob, JT, Baker, JM, Fridkin, SK, et al. Risk factors associated with SARS-CoV-2 seropositivity among US healthcare personnel. JAMA Netw Open 2021;4:e211283.CrossRefGoogle Scholar
Akinbami, LJ, Chan, PA, Vuong, N, et al. Severe acute respiratory syndrome coronavirus 2 seropositivity among healthcare personnel in hospitals and nursing homes, Rhode Island, USA, July–August 2020. Emerg Infect Dis 2021;27:823834.CrossRefGoogle Scholar
Wratil, PR, Schmacke, NA, Osterman, A, et al. In-depth profiling of COVID-19 risk factors and preventive measures in healthcare workers. Infection 2021;50;381394.CrossRefGoogle ScholarPubMed
Vitrat, V, Maillard, A, Raybaud, A, et al. Effect of professional and extra-professional exposure on seroprevalence of SARS-CoV-2 infection among healthcare workers of the French Alps: a multicentric cross-sectional study. Vaccines 2021;9:824.CrossRefGoogle ScholarPubMed
Iversen, K, Bundgaard, H, Hasselbalch, RB, et al. Risk of COVID-19 in healthcare workers in Denmark: an observational cohort study. Lancet Infect Dis 2020;20:14011408.CrossRefGoogle ScholarPubMed
Erber, J, Kappler, V, Haller, B, et al. Infection control measures and prevalence of SARS-CoV-2 IgG among 4,554 university hospital employees, Munich, Germany. Emerg Infect Dis 2022;28:572581.CrossRefGoogle ScholarPubMed
Moran, KR, Del Valle, SY. A meta-analysis of the association between gender and protective behaviors in response to respiratory epidemics and pandemics. PLoS One 2016;11:e0164541.CrossRefGoogle ScholarPubMed
Shorten, RJ, Haslam, S, Hurley, MA, et al. Seroprevalence of SARS-CoV-2 infection in healthcare workers in a large teaching hospital in the northwest of England: a period prevalence survey. BMJ Open 2021;11:e045384.CrossRefGoogle Scholar
Shields, A, Faustini, SE, Perez-Toledo, M, et al. SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study. Thorax 2020;75:10891094.CrossRefGoogle ScholarPubMed
Baker, JM, Nelson, KN, Overton, E, et al. Quantification of occupational and community risk factors for SARS-CoV-2 seropositivity among healthcare workers in a large US healthcare system. Ann Intern Med 2021;174:649654.CrossRefGoogle Scholar
Eyre, DW, Lumley, SF, O’Donnell, D, et al. Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study. Elife 2020;9:e60675.CrossRefGoogle ScholarPubMed
Kapilashrami, A, Otis, M, Omodara, D, et al. Ethnic disparities in health and social care workers’ exposure, protection, and clinical management of the COVID-19 pandemic in the UK. Crit Public Health 2022;32:6881.CrossRefGoogle Scholar
Naesens, R, Mertes, H, Clukers, J, et al. SARS-CoV-2 seroprevalence survey among health care providers in a Belgian public multiple-site hospital. Epidemiol Infect 2021;149:e172.CrossRefGoogle Scholar
van der Plaat, DA, Madan, I, Coggon, D, et al. Risks of COVID-19 by occupation in NHS workers in England. Occup Environ Med 2021. doi: 10.1136/oemed-2021-107628.CrossRefGoogle Scholar
Poletti, P, Tirani, M, Cereda, D, et al. Seroprevalence of and risk factors associated with SARS-CoV-2 infection in healthcare workers during the early COVID-19 pandemic in Italy. JAMA Netw Open 2021;4:e2115699.CrossRefGoogle ScholarPubMed
Belan, M, Charmet, T, Schaeffer, L, et al. SARS-CoV-2 exposures of healthcare workers from primary care, long-term care facilities and hospitals: a nationwide matched case-control study. medRxiv 2022. doi: 10.1101/2022.02.26.22271545v1.CrossRefGoogle Scholar
Zheng, C, Hafezi-Bakhtiari, N, Cooper, V, et al. Characteristics and transmission dynamics of COVID-19 in healthcare workers at a London teaching hospital. J Hosp Infect 2020;106:325329.CrossRefGoogle Scholar
Choi, UY, Kwon, YM, Kang, HJ, et al. Surveillance of the infection prevention and control practices of healthcare workers by an infection control surveillance-working group and a team of infection control coordinators during the COVID-19 pandemic. J Infect Public Health 2021;14:454460.CrossRefGoogle Scholar
Picard, C, Edlund, M, Keddie, C, et al. The effects of trained observers (dofficers) and audits during a facility-wide COVID-19 outbreak: a mixed-methods quality improvement analysis. Am J Infect Control 2021;49:11361141.CrossRefGoogle ScholarPubMed
Science, M, Bolotin, S, Silverman, M, et al. SARS-CoV-2 antibodies in Ontario healthcare workers during and after the first wave of the pandemic: a cohort study. CMAJ Open 2021;9:E929E939.CrossRefGoogle ScholarPubMed
De Serres, G, Carazo, S, Villeneuve, J, Laliberté, D. Enquête épidémiologique sur les travailleurs de la santé atteints par la COVID-19. Institut national de santé publique du Québec website. https://www.inspq.qc.ca/sites/default/files/publications/3192-enquete-epidemiologique-travailleurs-sante-covid-19.pdf. Published 2022. Accessed May 15, 2022.Google Scholar
Chou, R, Dana, T, Jungbauer, R. Update alert 7: masks for prevention of respiratory virus infections, including SARS-CoV-2, in healthcare and community settings. Ann Intern Med 2022;175:W58W59.CrossRefGoogle ScholarPubMed
Chu, DK, Akl, EA, Duda, S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020;395:19731987.CrossRefGoogle ScholarPubMed
Lentz, RJ, Colt, H, Chen, H, et al. Assessing coronavirus disease 2019 (COVID-19) transmission to healthcare personnel: the global ACT-HCP case–control study. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.455.CrossRefGoogle Scholar
Wilson, S, Mouet, A, Jeanne-Leroyer, C, et al. Professional practice for COVID-19 risk reduction among health-care workers: a cross-sectional study with matched case–control comparison. PLoS One 2022;17:e0264232.CrossRefGoogle ScholarPubMed
Haller, S, Güsewell, S, Egger, T, et al. Impact of respirator versus surgical masks on SARS-CoV-2 acquisition in healthcare workers: a prospective multicentre cohort. Antimicrob Resist Infect Control 2022;11:27.CrossRefGoogle ScholarPubMed
Guo, X, Wang, J, Hu, D, et al. Survey of COVID-19 disease among orthopaedic surgeons in Wuhan, People’s Republic of China: J Bone Jt Surg Am 2020;102:547554.CrossRefGoogle Scholar
O’Hara, LM, Schrank, GM, Frisch, M, et al. Coronavirus disease 2019 (COVID-19) symptoms, patient contacts, polymerase chain reaction (PCR) positivity and seropositivity among healthcare personnel in a Maryland healthcare system. Infect Control Hosp Epidemiol 2021. doi: 10.1017/ice.2021.373.CrossRefGoogle Scholar
Schnitzer, ME, Harel, D, Ho, V, Koushik, A, Merckx, J. Identifiability and estimation under the test-negative design with population controls with the goal of identifying risk and preventive factors for SARS-CoV-2 infection. Epidemiology 2021;32:690697.CrossRefGoogle ScholarPubMed
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