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Lee DH, Yeom S, Lee HS, Cho HH. Effect of air sterilizers in an outpatient clinic at a tertiary university hospital. Front Med (Lausanne) 2024; 11:1375260. [PMID: 38638931 PMCID: PMC11024432 DOI: 10.3389/fmed.2024.1375260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Background After the COVID-19 outbreak, interest in airborne virus infections has increased. We considered ways to reduce the risk of infection to other people by inactivating the virus before it is inhaled into the heating, ventilation, and air conditioning (HVAC) systems. We installed a recently developed air sterilizer in the newly remodeled outpatient clinic of a tertiary university hospital and confirmed its effectiveness. Methods After remodeling the ENT outpatient clinic at Chonnam National University Hospital, 15 KOKKOS air sterilizers (Bentech Frontier Co., Ltd., Gwangju, Korea) were installed. Total culturable microorganisms (TCMs) and volatile organic compounds (VOCs) were measured in five separate inspection areas three days before installation, 2 weeks after installation, and 4 weeks after installation. Results After measurement of TCMs, improvement in air quality occurred 2 weeks after air sterilizer instatement at all timepoints except inspection area 5, and further improvement was achieved after 4 weeks (p < 0.05). After assessment of VOCs, improvement occurred 4 weeks after air sterilizer connection at all points (p < 0.05). Conclusion KOKKOS air sterilizers are effective in improving air quality in an outpatient clinic at a tertiary university hospital.
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Affiliation(s)
- Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
| | - Sujung Yeom
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
| | - Hwa Sin Lee
- Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hyong-Ho Cho
- Chonnam National University Hospital, Gwangju, Republic of Korea
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2
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Zambrana W, Boehm AB. Occurrence of Human Viruses on Fomites in the Environment: A Systematic Review and Meta-analysis. ACS ENVIRONMENTAL AU 2023; 3:277-294. [PMID: 37743950 PMCID: PMC10515712 DOI: 10.1021/acsenvironau.3c00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 09/26/2023]
Abstract
Documenting the occurrence of viruses on fomites is crucial in determining the significance of fomite-mediated transmission and the potential use of fomites for environmental disease surveillance. We conducted a systematic review and meta-analysis to compile information on the occurrence of human viruses on fomites in the environment; we identified 134 peer-reviewed papers. We compiled sampling and measurement methods, results, quality control information, and whether virus data were compared with community health data from the papers. We conducted univariate and multivariate analyses to investigate if presence of virus on fomites was associated with virus type (enveloped, nonenveloped), sampling location (healthcare setting, nonhealthcare temporary setting, nonhealthcare nontemporary setting), and area of fomite swabbed (<50, 50-100, >100 cm2). Across 275 data sets from the 134 papers, there was the most data available for Coronaviridae and from fomites at hospitals. Positivity rates, defined as the percent positive fomite samples, were low (median = 6%). Data were available on viruses from 16 different viral families, but data on viruses from 9 families had few (n < 5) data sets. Many human virus families were not identified in this review (11 families). Less than 15% of the data sets reported virus concentrations in externally valid units (viruses per area of surface), and 16% provided a quantitative comparison between virus and health data. Virus type and area swabbed were significant predictors of virus presence on fomites, and the positivity rate of data sets collected from healthcare settings and nonhealthcare nontemporary settings (e.g., individual housing) were significantly higher than those collected in nonhealthcare temporary settings (e.g., restaurants). Data from this review indicates that viruses may be present on fomites, that fomite-mediated virus transmission may occur, and that fomites may provide information on circulation of infectious diseases in the community. However, more quantitative data on diverse viruses are needed, and method reporting needs significant improvements.
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Affiliation(s)
- Winnie Zambrana
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Alexandria B. Boehm
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
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3
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Oksanen L, Auvinen M, Kuula J, Malmgren R, Romantschuk M, Hyvärinen A, Laitinen S, Maunula L, Sanmark E, Geneid A, Sofieva S, Salokas J, Veskiväli H, Sironen T, Grönholm T, Hellsten A, Atanasova N. Combining Phi6 as a surrogate virus and computational large-eddy simulations to study airborne transmission of SARS-CoV-2 in a restaurant. INDOOR AIR 2022; 32:e13165. [PMID: 36437671 PMCID: PMC10100099 DOI: 10.1111/ina.13165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 05/18/2023]
Abstract
COVID-19 has highlighted the need for indoor risk-reduction strategies. Our aim is to provide information about the virus dispersion and attempts to reduce the infection risk. Indoor transmission was studied simulating a dining situation in a restaurant. Aerosolized Phi6 viruses were detected with several methods. The aerosol dispersion was modeled by using the Large-Eddy Simulation (LES) technique. Three risk-reduction strategies were studied: (1) augmenting ventilation with air purifiers, (2) spatial partitioning with dividers, and (3) combination of 1 and 2. In all simulations infectious viruses were detected throughout the space proving the existence long-distance aerosol transmission indoors. Experimental cumulative virus numbers and LES dispersion results were qualitatively similar. The LES results were further utilized to derive the evolution of infection probability. Air purifiers augmenting the effective ventilation rate by 65% reduced the spatially averaged infection probability by 30%-32%. This relative reduction manifests with approximately 15 min lag as aerosol dispersion only gradually reaches the purifier units. Both viral findings and LES results confirm that spatial partitioning has a negligible effect on the mean infection-probability indoors, but may affect the local levels adversely. Exploitation of high-resolution LES jointly with microbiological measurements enables an informative interpretation of the experimental results and facilitates a more complete risk assessment.
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Affiliation(s)
- Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Joel Kuula
- Finnish Meteorological InstituteHelsinkiFinland
| | - Rasmus Malmgren
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Martin Romantschuk
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiLahtiFinland
| | | | | | - Leena Maunula
- Faculty of Veterinary Medicine, Food Hygiene and Environmental HealthUniversity of HelsinkiHelsinkiFinland
| | - Enni Sanmark
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Svetlana Sofieva
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Julija Salokas
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Helin Veskiväli
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Tarja Sironen
- Department of Virology, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Veterinary Biosciences, Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | | | | | - Nina Atanasova
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
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4
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Wilson AM, Sleeth DK, Schaefer C, Jones RM. Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. Annu Rev Public Health 2022; 43:311-330. [DOI: 10.1146/annurev-publhealth-052120-110009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health care workers (HCWs) can acquire infectious diseases, including coronavirus disease 2019 (COVID-19), from patients. Herein, COVID-19 is used with the source–pathway–receptor framework as an example to assess evidence for the role of aerosol transmission and indirect contact transmission of viral respiratory infectious diseases. Evidence for both routes is strong for COVID-19 and other respiratory viruses, but aerosol transmission is likely dominant for COVID-19. Key knowledge gaps about transmission processes and control strategies include the distribution of viable virus among respiratory aerosols of different sizes, the mechanisms and efficiency by which virus deposited on the facial mucous membrane moves to infection sites inside the body, and the performance of source controls such as face coverings and aerosol containment devices. To ensure that HCWs are adequately protected from infection, guidelines and regulations must be updated to reflect the evidence that respiratory viruses are transmitted via aerosols. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Amanda M. Wilson
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | - Darrah K. Sleeth
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Camie Schaefer
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Rachael M. Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
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5
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Wilson AM, Kaur K, Jones RM, Kelly KE. Feasibility of a High-Volume Filter Sampler for Detecting SARS-CoV-2 RNA in COVID-19 Patient Rooms. Ann Work Expo Health 2021; 66:276-280. [PMID: 34791020 PMCID: PMC8767856 DOI: 10.1093/annweh/wxab100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/19/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
Aerosolization of SARS-CoV-2 by COVID-19 patients can put healthcare workers and susceptible individuals at risk of infection. Air sampling for SARS-CoV-2 has been conducted in healthcare settings, but methods vary widely and there is need for improvement. The objective of this study was to evaluate the feasibility of using a high-volume filter sampler, BioCapture z720, to detect SARS-CoV-2 in COVID-19 patient rooms in a medical intensive care unit, a dedicated COVID-19 ward, and at nurses’ stations. In some locations, the BioSpot-VIVAS, known for high efficiency in the collection of virus-containing bioaerosols, was also operated. The samples were processed for SARS-CoV-2 RNA with multi-plex nested polymerase chain reaction. One of 28 samples collected with the high-volume filter sampler was positive for SARS-CoV-2; all 6 samples collected with BioSpot-VIVAS were negative for SARS-CoV-2. The high-volume filter sampler was more portable and less intrusive in patient rooms than the BioSpot-VIVAS, but limits of detection remain unknown for this device. This study will inform future work to evaluate the reliability of these types of instruments and inform best practices for their use in healthcare environments for SARS-CoV-2 air sampling.
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Affiliation(s)
- Amanda M Wilson
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
| | - Kamaljeet Kaur
- Department of Chemical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Rachael M Jones
- Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kerry E Kelly
- Department of Chemical Engineering, University of Utah, Salt Lake City, UT, USA
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6
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Pineda-Santoyo C, Campos-Romero A, Luna-Ruiz Esparza MA, López-Luna LE, Sánchez-Zarate ME, Zepeda-González A, Fernández-Rojas MA, Alcántar-Fernández J. Control and Prevention of SARS-CoV-2 Outbreaks among Healthcare Workers from 129 Healthcare Facilities in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211772. [PMID: 34831527 PMCID: PMC8625209 DOI: 10.3390/ijerph182211772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022]
Abstract
Few reports have shared the workflows to reduce SARS-CoV-2 infections among risk groups, including healthcare workers (HCWs). This study describes an occupational health program implemented to reduce the incidence of COVID-19 and establishes a back-to-work algorithm in HCWs of 129 Salud Digna outpatient care clinics in Mexico. This program was composed of training plans, screening SARS-CoV-2 infections, the containment of infections, follow-up COVID-19 cases, and continuing supervision in addition to the steady supply and training for the correct use of PPE. From 16 April 2020 to 15 April 2021, 7376 individuals were enrolled, of which 423 were excluded because they did not meet the inclusion criteria or refused the follow-up. In the cohort studied, we found a COVID-19 incidence of 35.4% (2610 individuals), lower hospitalization (0.11%), ICU (0.04%) and lethality rate (0.04%). Additionally, 85.9% of COVID-19 cases tested negative for SARS-CoV-2 after 14 days of the first positive test with an average isolation time of 26–33 days. Finally, 99% of people received personal protective equipment and adequate training to use it. Our results show that the program implemented reduced the hospitalization ICU admission and lethality in HCWs; we consider this workflow to help other workplaces offer safe conditions for HCWs and patients.
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Affiliation(s)
- César Pineda-Santoyo
- Hygiene and Occupational Safety Department, Salud Digna, Culiacan 80000, Mexico;
- Human Resources Department, Salud Digna, Culiacan 80000, Mexico
| | - Abraham Campos-Romero
- Innovation and Research Department, Salud Digna, Culiacan 80000, Mexico; (A.C.-R.); (M.A.L.-R.E.); (M.A.F.-R.)
| | - Marco A. Luna-Ruiz Esparza
- Innovation and Research Department, Salud Digna, Culiacan 80000, Mexico; (A.C.-R.); (M.A.L.-R.E.); (M.A.F.-R.)
| | | | | | | | - Miguel A. Fernández-Rojas
- Innovation and Research Department, Salud Digna, Culiacan 80000, Mexico; (A.C.-R.); (M.A.L.-R.E.); (M.A.F.-R.)
| | - Jonathan Alcántar-Fernández
- Innovation and Research Department, Salud Digna, Culiacan 80000, Mexico; (A.C.-R.); (M.A.L.-R.E.); (M.A.F.-R.)
- Correspondence: ; Tel.: +52-667-713-7521
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7
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Bäumler W, Eckl D, Holzmann T, Schneider-Brachert W. Antimicrobial coatings for environmental surfaces in hospitals: a potential new pillar for prevention strategies in hygiene. Crit Rev Microbiol 2021; 48:531-564. [PMID: 34699296 DOI: 10.1080/1040841x.2021.1991271] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recent reports provide evidence that contaminated healthcare environments represent major sources for the acquisition and transmission of pathogens. Antimicrobial coatings (AMC) may permanently and autonomously reduce the contamination of such environmental surfaces complementing standard hygiene procedures. This review provides an overview of the current status of AMC and the demands to enable a rational application of AMC in health care settings. Firstly, a suitable laboratory test norm is required that adequately quantifies the efficacy of AMC. In particular, the frequently used wet testing (e.g. ISO 22196) must be replaced by testing under realistic, dry surface conditions. Secondly, field studies should be mandatory to provide evidence for antimicrobial efficacy under real-life conditions. The antimicrobial efficacy should be correlated to the rate of nosocomial transmission at least. Thirdly, the respective AMC technology should not add additional bacterial resistance development induced by the biocidal agents and co- or cross-resistance with antibiotic substances. Lastly, the biocidal substances used in AMC should be safe for humans and the environment. These measures should help to achieve a broader acceptance for AMC in healthcare settings and beyond. Technologies like the photodynamic approach already fulfil most of these AMC requirements.
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Affiliation(s)
- Wolfgang Bäumler
- Department of Dermatology, University Hospital, Regensburg, Germany
| | - Daniel Eckl
- Department of Microbiology, University of Regensburg, Regensburg, Germany
| | - Thomas Holzmann
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
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8
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Bouchoucha SL, Phillips NM, Lucas J, Kilpatrick M, Hutchinson A. An investigation into nursing students' application of infection prevention and control precautions. NURSE EDUCATION TODAY 2021; 104:104987. [PMID: 34098422 DOI: 10.1016/j.nedt.2021.104987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Undergraduate education of Health Care Workers is pivotal to ensuring that frontline clinicians have appropriate knowledge and skills in Infection Prevention and Control (IPC). OBJECTIVES The aim of this study was to describe undergraduate nursing students' self-reported compliance with Standard Precautions and to explore the psychosocial factors that influence adherence in clinical practice. DESIGN A cross-sectional survey design was used. SETTING The study was conducted in the School of Nursing and Midwifery at an Australian University. PARTICIPANTS All undergraduate nursing students were invited to participate in an online survey; 321 participated, mean age 25.7 years (SD = 8.4). The majority, 196 (61%), had no healthcare work experience, 54 (17%) were patient-care assistants, 40 (13%) enrolled nurses, and 31 (9%) were nurses registered overseas. METHODS Two validated instruments were used: the Compliance with Standard Precautions Scale (CSPS) and the Factors Influencing Adherence to Standard Precautions Scale- Student version (FIASPS-SV). Linear regression was used to measure the impact of psychosocial factors on self-reported compliance. RESULTS Overall self-reported compliance with prevention of cross-infection was 83%, use of Personal Protective Equipment (81%), correct disposal of sharps (83%) and general waste (75%), and equipment decontamination (69%). The predominant factors endorsed on the FIASPS-SV were 'Leadership' (M = 15.21 SD = 5.28) and 'Contextual cues' (M = 19.09 SD = 6.37). Multivariate linear regression demonstrated that after adjusting for age, gender and years of nursing study, the Leadership factor predicted participants' self-reported compliance on the 'prevention of cross-infection' (p < .001), 'use of PPE' (p < .001), 'waste disposal' (p = .021), and 'decontamination of equipment' (p < .001) sub-domains of the CSPS. CONCLUSIONS These findings highlight that strong clinical leadership and role modelling are essential to ensure all healthcare students prioritise rigorous adherence with infection prevention and control guidelines.
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Affiliation(s)
- Stéphane L Bouchoucha
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia.
| | - Nicole M Phillips
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia
| | - James Lucas
- Deakin University Geelong, Australia, School of Health and Social Development, Australia
| | - Mataya Kilpatrick
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia
| | - Ana Hutchinson
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia; Deakin University Geelong, Centre for Quality and Patient Safety Research, Epworth Healthcare Partnership, Australia
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9
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Jones RM, Rempel D. Standards for Surgical Respirators and Masks: Relevance for Protecting Healthcare Workers and the Public During Pandemics. Ann Work Expo Health 2021; 65:495-504. [PMID: 33942848 PMCID: PMC8135753 DOI: 10.1093/annweh/wxab008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/02/2020] [Accepted: 01/20/2021] [Indexed: 12/30/2022] Open
Abstract
National standards for surgical respirators and masks are written and enforced to protect healthcare workers from particles and microorganisms such as Severe Acute Respriatory Syndrome Coronavirus 2 (SARS-CoV-2). In addition to the ability to filter particles (e.g. filtration efficiency, FE), the standards address breathability (e.g. differential pressure), how well the mask seals to a worker’s face (e.g. fit test), the level of protection from a fluid splash, and other factors. Standards used in the USA, European Union (EU), and China were compared with respect to testing methods and certification criteria. Although there are substantial similarities in standards for respirators, such as surgical N95, FFP2, and KN95 filtering facepiece respirators (FFRs), there are differences with respect to who performs that testing and fit-testing requirements that influence certification. There is greater variation in test methods between countries for surgical (USA) or medical (EU and China) masks than for FFRs. Surgical/medical masks can be certified to different levels of protection. The impact of the similarities and differences in testing methods and certification criteria on FFR and mask performance for protecting healthcare workers from SARS-CoV-2 are discussed, as well as the value of a new standard in the EU for testing fabrics for masks used by the public. Health and safety personnel in healthcare settings must understand the differences between standards so that they can select respirators and masks that provide appropriate protection for healthcare workers.
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Affiliation(s)
- Rachael M Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake, UT, USA
| | - David Rempel
- Division of Occupational and Environmental Medicine, University of California, San Francisco, USA
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10
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Iversen AM, Stangerup M, From-Hansen M, Hansen R, Sode LP, Kostadinov K, Hansen MB, Calum H, Ellermann-Eriksen S, Knudsen JD. Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors. Am J Infect Control 2021; 49:733-739. [PMID: 33186676 PMCID: PMC7654366 DOI: 10.1016/j.ajic.2020.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/30/2022]
Abstract
Background Evidence-based practices to increase hand hygiene compliance (HHC) among health care workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC. Methods During this 14-month prospective, observational study, an automated monitoring system was implemented in a 29-bed surgical ward. Hand hygiene opportunities and alcohol-based hand rubbing events were measured in patient and working rooms (medication, utility, storerooms, toilets). We compared baseline HHC of health care workers across periods with light-guided nudging from sensors on dispensers and data-driven performance feedback (multimodal strategy) using the Student's t test. Results The doctors (n = 10) significantly increased their HHC in patient rooms (16% vs 42%, P< .0001) and working rooms (24% vs 78%, P= .0006) when using the multimodal strategy. The nurses (n = 26) also increased their HHC significantly from baseline in both patient rooms (27% vs 43%, P = .0005) and working rooms (39% vs 64%, P< .0001). The nurses (n = 9), who subsequently received individual performance feedback, further increased HHC, compared with the period when they received group performance feedback (patient rooms: 43% vs 55%, P< .0001 and working rooms: 64% vs 80%, P< .0001). Conclusions HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system.
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Affiliation(s)
| | - Marie Stangerup
- Department of Quality and Education, Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
| | - Michelle From-Hansen
- Department of Quality and Education, Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
| | - Rosa Hansen
- Department of Orthopedic, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Louise Palasin Sode
- Department of Orthopedic, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | | | - Henrik Calum
- Department of Quality and Education, Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark; Department of Clinical Microbiology, Amager and Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jenny Dahl Knudsen
- Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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11
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Salazar MÁ, Chavez-Galan L, Castorena-Maldonado A, Mateo-Alonso M, Diaz-Vazquez NO, Vega-Martínez AM, Martínez-Orozco JA, Becerril-Vargas E, Sosa-Gómez FM, Patiño-Gallegos H, Alonso-Martínez D, López-Segundo E, Vidal F, Velasco-González LJ, Pérez-Pulido S, Santillán-Doherty P, Regalado-Pineda J, Salas-Hernández J, Buendía-Roldán I. Low Incidence and Mortality by SARS-CoV-2 Infection Among Healthcare Workers in a Health National Center in Mexico: Successful Establishment of an Occupational Medicine Program. Front Public Health 2021; 9:651144. [PMID: 33928064 PMCID: PMC8076634 DOI: 10.3389/fpubh.2021.651144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) constitute a population which is significantly affected by SARS-CoV-2 infection worldwide. In Mexico, the Instituto Nacional de Enfermedades Respiratorias (INER) is the principal national reference of respiratory diseases. Aim: To evaluate the efficiency of the INER-POL-TRAB-COVID19 program to mitigate the SARS-CoV-2 infection risk among the INER-healthcare workers (INER-HCW). Methods: Currently, the INER has 250 beds and 200 respiratory ventilators to support COVID-19 patients in critical condition. On March 1st, 2020, the INER-POL-TRAB-COVID19 program was launched to mitigate the SARS-CoV-2 infection risk among the INER-HCW. Findings: From March 1st to October 1st, 2020, 71.5% of INER-HCWs were tested for SARS-CoV-2 infection, and 77% of them were frontline workers. Among the tested INER-HCWs, 10.4% were positive for SARS-CoV-2 infection. Nonetheless, nosocomial infection represented only 3.8% of the cases and the mortality was null. Fifty-three of INER-HCWs positive to SARS-CoV-2 had a negative test 42–56 days post-diagnosis and were returned to service. Finally, although a change in the PPE implemented on May 11th, 2020, the incidence of SARS-CoV-2 infection was not affected. Conclusion: INER has a lower incidence of HCWs infected with SARS-CoV-2 as compared to the mean of the national report. The implementation of the INER-POL-TRAB-COVID19 program is efficient to decrease the risk of infection among the HCWs. Our findings suggest that the implementation of a similar program at a national level can be helpful to provide a safe environment to HCWs and to prevent the collapse of health institutions.
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Affiliation(s)
- Miguel Ángel Salazar
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | - Leslie Chavez-Galan
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | | | - Maribel Mateo-Alonso
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | | | | | | | | | | | - Hilda Patiño-Gallegos
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | | | - Enrique López-Segundo
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | - Fernando Vidal
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | | | - Silvia Pérez-Pulido
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | | | | | - Jorge Salas-Hernández
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
| | - Ivette Buendía-Roldán
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico, Mexico
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12
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Tian Y, Nian B, Ma Y, Guo X, Wang F, Rong L. The Status of Occupational Protection During COVID-19 Pandemic: Knowledge, Attitudes, and Practice of Healthcare Workers in Endoscopy Units, China. Front Public Health 2021; 9:632608. [PMID: 33829007 PMCID: PMC8019814 DOI: 10.3389/fpubh.2021.632608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background: SARS-CoV-2 spreads rapidly around the world, and some patients present gastrointestinal symptoms. The existence of the virus in the gastrointestinal tract makes digestive endoscopy a high-risk operation, which associated with an increased risk of infection rate in healthcare workers. This study aimed at exploring current knowledge, practice and attitudes of healthcare workers in endoscopy units in China regarding the status of occupational protection during COVID-19 pandemic. Methods: A cross-sectional study of a national online survey involving 717 healthcare workers in endoscopy units from 94 medical structures in 24 provinces and municipalities around China was conducted online via a questionnaire platform called Wenjuanxing (wjx.cn). The data were analyzed using correlation approaches, Kruskal-Wallis test for independent samples, and linear regression models. Results: Most Chinese healthcare workers in endoscopy units had a good knowledge of COVID-19 (median: 10; range: 7–12), showed a strikingly positive attitude (median: 65; range: 39–65), and carried out good practice (median: 47; range: 14–50) in strengthening the protection, disinfection and management of COVID-19. In terms of attitudes, female staff was more concerned about protection against COVID-19 than male staff (KW = 8.146, P = 0.004). Nurses performed better in both attitude (KW = 2.600, P = 0.009) and practice (KW = 6.358, P < 0.001) than endoscopic physicians when carrying out personal protection, patient care and environmental disinfection against SARS-CoV-2 infection. More positive attitudes in protection were related to better protective behavior in endoscopic daily medical work (r = 0.312; P < 0.001). Conclusion: The findings of this study suggest that Chinese endoscopy healthcare workers have an excellent mastery of knowledge about COVID-19, which is transformed into positive beliefs and attitudes, contributing to good practice during daily endoscopic procedures. Medical staff may benefit from further education. With the gradual normalization amid the ongoing COVID-19 pandemic, protection and management in endoscopy units may be changed accordingly.
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Affiliation(s)
- Yuan Tian
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Bixiao Nian
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Yongchen Ma
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Xinyue Guo
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Feng Wang
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Long Rong
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
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13
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Yao D, Yan K, Duan J, Zhang X, Zhou L. Coronavirus Disease 2019 (COVID-19): Prevention and Control in Gynecological Outpatient Clinic. Front Public Health 2021; 8:618494. [PMID: 33490027 PMCID: PMC7820776 DOI: 10.3389/fpubh.2020.618494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/03/2020] [Indexed: 12/25/2022] Open
Abstract
Objective: The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health challenge around the world, and outbreaks of the SARS-CoV-2 have constituted a public health emergency of international concern. Infection control measures are necessary to prevent further spread of the virus and to help control the epidemic situation. Due to the characteristics of gynecological settings, the risk of cross infection between patients and gynecologic practitioners can be high, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces prevention and control measures for use in gynecological outpatient clinics and provides recommended management for gynecologists in (potentially) affected areas.
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Affiliation(s)
- Dongmei Yao
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Yan
- State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan, China
| | - Jie Duan
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xian Zhang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Limin Zhou
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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14
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Jones RM. Contribuciones relativas de las vías de transmisión de la COVID-19 entre el personal sanitario que presta atención a pacientes. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:S61-S69. [PMID: 33822691 DOI: 10.1080/15459624.2021.1877053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
RESUMENLas vías de transmisión de la COVID-19 desde pacientes infectados al personal de la salud son actualmente objeto de debate, pero su consideración resulta fundamental para la selección del equipo de protección personal. El objetivo de este documento es explorar las contribuciones de tres vías de transmisión-contacto, gota e inhalación-al riesgo de infección de COVID-19 adquirida por el personal sanitario en el ámbito laboral. El método consistió en la evaluación cuantitativa de los riesgos microbianos y de un modelo de exposición cuyos posibles parámetros se basaron en datos específicos del virus SARS-CoV-2 cuando se disponía de ellos. El hallazgo clave fue que las vías de transmisión por gotas e inhalación predominan sobre la vía de contacto, contribuyendo en promedio 35%, 57% y 8.2% a la probabilidad de infección cuando no se usa equipo de protección personal. En promedio, 80% de la exposición a la inhalación ocurre cuando el personal sanitario está cerca de los pacientes. La contribución relativa de las gotas y la inhalación depende de la emisión de SARS-CoV-2 en las partículas respirables (<10 μm) a través de la exhalación, y la inhalación se vuelve predominante, en promedio, cuando la emisión supera las cinco copias genéticas por minuto. La concentración prevista del SARS-CoV-2 en el aire de la habitación del paciente es baja (<1 copia del gen por m3 en promedio) y probablemente se encuentre por debajo del límite de cuantificación de muchos métodos de muestreo del aire. Los resultados demuestran el valor que supone la protección respiratoria del personal sanitario y que el muestreo de campo puede no ser lo suficientemente sensible para verificar la contribución que realiza la inhalación del SARS-CoV-2 al riesgo de infección de COVID-19 adquirida por el personal. La emisión e ineficacia del SARS-CoV-2 en gotas respiratorias de diferente tamaño es aún una brecha en el conocimiento, fundamental para comprender y controlar la transmisión de la COVID-19.
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Affiliation(s)
- Rachael M Jones
- Departamento de Medicina Familiar y Preventiva, Facultad de Medicina, Universidad de Utah, Salt Lake City, Utah
- Centro Rocky Mountain de Salud Ambiental y Ocupacional, Universidad de Utah, Salt Lake City, Utah
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15
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Ge XY, Pu Y, Liao CH, Huang WF, Zeng Q, Zhou H, Yi B, Wang AM, Dou QY, Zhou PC, Chen HL, Liu HX, Xu DM, Chen X, Huang X. Evaluation of the exposure risk of SARS-CoV-2 in different hospital environment. SUSTAINABLE CITIES AND SOCIETY 2020; 61:102413. [PMID: 32834932 PMCID: PMC7375302 DOI: 10.1016/j.scs.2020.102413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 05/03/2023]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has imposed a significant impact on social and economic activities. As a high infectious pathogen, the existence of SARS-CoV-2 in public space is very important for its transmission. During the COVID-19 pandemic, hospitals are the main places to deal with the diseases. In this work, we evaluated the exposure risk of SARS-CoV-2 in hospital environment in order to protect healthcare workers (HCWs). Briefly, air and surface samples from 6 different sites of 3 hospitals with different protection levels were collected and tested for the SARS-CoV-2 nucleic acid by reverse transcription real-time fluorescence PCR method during the COVID-19 epidemic. We found that the positive rate of SARS-CoV-2 nucleic acid was 7.7 % in a COVID-19 respiratory investigation wards and 82.6 % in a ICUs with confirmed COVID-19 patients. These results indicated that in some wards of the hospital, such as ICUs occupied by COVID-19 patients, the nucleic acid of SARS-CoV-2 existed in the air and surface, which indicates the potential occupational exposure risk of HCWs. This study has clarified retention of SARS-CoV-2 in different sites of hospital, suggesting that it is necessary to monitor and disinfect the SARS-CoV-2 in hospital environment during COVID-19 pandemic, and will help to prevent the iatrogenic infection and nosocomial transmission of SARS-CoV-2 and to better protect the HCWs.
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Affiliation(s)
- Xing-Yi Ge
- Institute of Pathogen Biology and Immunology, College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China
| | - Ying Pu
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Ce-Heng Liao
- Institute of Pathogen Biology and Immunology, College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China
| | - Wen-Fen Huang
- Department of Infectious Diseases, Chenzhou Second People's Hospital, Chenzhou, China
| | - Qi Zeng
- Department of Infectious Diseases, Shaoyang Central Hospital, Shaoyang, China
| | - Hui Zhou
- Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, China
| | - Bin Yi
- Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, China
| | - Ai-Min Wang
- Department of Emergency Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Qing-Ya Dou
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
| | - Peng-Cheng Zhou
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
| | - Hui-Ling Chen
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Hui-Xia Liu
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Dao-Miao Xu
- Department of Critical Care Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
| | - Xun Huang
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Center for Clinical Medicine of Geriatric Diseases, Changsha, China
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16
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Jones RM. Relative contributions of transmission routes for COVID-19 among healthcare personnel providing patient care. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:408-415. [PMID: 32643585 DOI: 10.1080/15459624.2020.1784427] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The routes of COVID-19 transmission to healthcare personnel from infected patients is the subject of debate, but is critical to the selection of personal protective equipment. The objective of this paper was to explore the contributions of three transmission routes-contact, droplet, and inhalation-to the risk of occupationally acquired COVID-19 infection among healthcare personnel (HCP). The method was quantitative microbial risk assessment, and an exposure model, where possible model parameters were based on data specific to the SARS-CoV-2 virus when available. The key finding was that droplet and inhalation transmission routes predominate over the contact route, contributing 35%, 57%, and 8.2% of the probability of infection, on average, without use of personal protective equipment. On average, 80% of inhalation exposure occurs when HCP are near patients. The relative contribution of droplet and inhalation depends upon the emission of SARS-CoV-2 in respirable particles (<10 µm) through exhaled breath, and inhalation becomes predominant, on average, when emission exceeds five gene copies per min. The predicted concentration of SARS-CoV-2 in the air of the patient room is low (< 1 gene copy per m3 on average), and likely below the limit of quantification for many air sampling methods. The findings demonstrate the value of respiratory protection for HCP, and that field sampling may not be sensitive enough to verify the contribution of SARS-CoV-2 inhalation to the risk of occupationally acquired COVID-19 infection among healthcare personnel. The emission and infectivity of SARS-CoV-2 in respiratory droplets of different sizes is a critical knowledge gap for understanding and controlling COVID-19 transmission.
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Affiliation(s)
- Rachael M Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, Utah
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17
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Schulz-Stübner S, Kunitz O. [Infection Prevention in Anesthesiology during the SARS-CoV 2-pandemic]. Anasthesiol Intensivmed Notfallmed Schmerzther 2020; 55:494-502. [PMID: 32736389 PMCID: PMC7416219 DOI: 10.1055/a-1174-7359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
It is necessary to discuss the sometimes competing goals of sufficient critical care capacity, maintenance of regular patient care, protection of medical staff, interruption of infectious chains within the general public and individual aspects of patient care in anesthesia and the operating room in times of the SARS CoV-2 pandemic, given the uncertainty of many data on which decisions need to be based. Basic hygiene remains the cornerstone of infection prevention especially when resources are sparse and SARS-CoV-2 specific additional measures need to be taken according to a risk analysis taking the dynamic of the pandemic as well as local factors into account.
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Affiliation(s)
- Sebastian Schulz-Stübner
- Korrespondenzadresse PD Dr. med. Sebastian Schulz-Stübner BZH GmbH – Deutsches Beratungszentrum für HygieneSchnewlinstraße 479098 Freiburg im BreisgauDeutschland
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18
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Aerosol distribution in the cabin and cockpit of an ambulance helicopter. Infect Control Hosp Epidemiol 2020; 42:370-371. [PMID: 32519632 DOI: 10.1017/ice.2020.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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19
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Cadnum JL, Li DF, Jones LD, Redmond SN, Pearlmutter B, Wilson BM, Donskey CJ. Evaluation of Ultraviolet-C Light for Rapid Decontamination of Airport Security Bins in the Era of SARS-CoV-2. Pathog Immun 2020; 5:133-142. [PMID: 32582873 PMCID: PMC7307442 DOI: 10.20411/pai.v5i1.373] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Contaminated surfaces are a potential source for spread of respiratory viruses including SARS-CoV-2. Ultraviolet-C (UV-C) light is effective against RNA and DNA viruses and could be useful for decontamination of high-touch fomites that are shared by multiple users. Methods: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of UV-C light for rapid decontamination of plastic airport security bins inoculated at 3 sites with methicillin-resistant Staphylococcus aureus (MRSA) and bacteriophages MS2, PhiX174, and Phi6, an enveloped RNA virus used as a surrogate for coronaviruses. Reductions of 3 log10 on inoculated plastic bins were considered effective for decontamination. Results: UV-C light administered as 10-, 20-, or 30-second cycles in proximity to a plastic bin reduced contamination on each of the test sites, including vertical and horizontal surfaces. The 30-second cycle met criteria for decontamination of all 3 test sites for all the test organisms except bacteriophage MS2 which was reduced by greater than 2 log10 PFU at each site. Conclusions: UV-C light is an attractive technology for rapid decontamination of airport security bins. Further work is needed to evaluate the utility of UV-C light in real-world settings and to develop methods to provide automated movement of bins through a UV-C decontamination process.
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Affiliation(s)
- Jennifer L Cadnum
- Research Service; Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio
| | - Daniel F Li
- Research Service; Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio
| | - Lucas D Jones
- Department of Molecular Biology and Microbiology; Case Western Reserve University School of Medicine; Cleveland Ohio
| | - Sarah N Redmond
- Case Western Reserve University School of Medicine; Cleveland, Ohio
| | - Basya Pearlmutter
- Research Service; Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio
| | - Brigid M Wilson
- Geriatric Research, Education, and Clinical Center; Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio
| | - Curtis J Donskey
- Case Western Reserve University School of Medicine; Cleveland, Ohio.,Geriatric Research, Education, and Clinical Center; Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio
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20
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Respiratory viruses on personal protective equipment and bodies of healthcare workers. Infect Control Hosp Epidemiol 2019; 40:1356-1360. [DOI: 10.1017/ice.2019.298] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AbstractObjective:To characterize the magnitude of virus contamination on personal protective equipment (PPE), skin, and clothing of healthcare workers (HCWs) who cared for patients having acute viral infections.Design:Prospective observational study.Setting:Acute-care academic hospital.Participants:A total of 59 HCWs agreed to have their PPE, clothing, and/or skin swabbed for virus measurement.Methods:The PPE worn by HCW participants, including glove, face mask, gown, and personal stethoscope, were swabbed with Copan swabs. After PPE doffing, bodies and clothing of HCWs were sampled with Copan swabs: hand, face, and scrubs. Preamplification and quantitative polymerase chain reaction (qPCR) methods were used to quantify viral RNA copies in the swab samples.Results:Overall, 31% of glove samples, 21% of gown samples, and 12% of face mask samples were positive for virus. Among the body and clothing sites, 21% of bare hand samples, 11% of scrub samples, and 7% of face samples were positive for virus. Virus concentrations on PPE were not statistically significantly different than concentrations on skin and clothing under PPE. Virus concentrations on the personal stethoscopes and on the gowns were positively correlated with the number of torso contacts (P < .05). Virus concentrations on face masks were positively correlated with the number of face mask contacts and patient contacts (P < .05).Conclusions:Healthcare workers are routinely contaminated with respiratory viruses after patient care, indicating the need to ensure that HCWs complete hand hygiene and use other PPE to prevent dissemination of virus to other areas of the hospital. Modifying self-contact behaviors may decrease the presence of virus on HCWs.
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