Abstract
To better understand coronavirus disease 2019 (COVID-19) transmission among healthcare workers (HCWs), we investigated occupational and nonoccupational risk factors associated with cumulative COVID-19 incidence among a Massachusetts HCW cohort. The retrospective cohort study included adult HCWs in a single healthcare system from March 9 to June 3, 2020. The SARS-CoV-2 nasopharyngeal RT-PCR results and demographics of the study participants were deidentified and extracted from an established occupational health, COVID-19 database at the healthcare system. HCWs from each particular job grouping had been categorized into frontline or nonfrontline workers. Incidence rate ratios (IRRs) and odds ratios (ORs) were used to compare subgroups after excluding HCWs involved in early infection clusters before universal masking began. A sensitivity analysis was performed comparing jobs with the greatest potential occupational risks with others. Of 5,177 HCWs, 152 (2.94%) were diagnosed with COVID-19. Affected HCWs resided in areas with higher community attack rates (median, 1,755.2 vs 1,412.4 cases per 100,000; P < .001; multivariate-adjusted IRR, 1.89; 95% CI, 1.03-3.44 comparing fifth to first quintile of community rates). After multivariate adjustment, African-American and Hispanic HCWs had higher incidence of COVID-19 than non-Hispanic white HCWs (IRR, 2.78; 95% CI, 1.78-4.33; and IRR, 2.41, 95% CI, 1.42-4.07, respectively). After adjusting for race and residential rates, frontline HCWs had a higher IRR (1.73, 95% CI, 1.16-2.54) than nonfrontline HCWs overall, but not within specific job categories nor when comparing the highest risk jobs to others. After universal masking was instituted, the strongest risk factors associated with HCW COVID-19 infection were residential community infection rate and race.
Highlights
After universal masking was instituted, the strongest risk factors associated with healthcare workers (HCWs) COVID-19 infection were residential community infection rate and race. (Received 12 August 2020; accepted 15 January 2021)
The health of healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic is of great public interest.[1]
Epidemiological research indicates that proper protective equipment (PPE) provides good protection against viral transmission to frontline HCWs
Summary
The SARS-CoV-2 nasopharyngeal RT-PCR results and demographics of the study participants were deidentified and extracted from an established occupational health, COVID-19 database at the healthcare system. The HCWs of a Massachusetts community healthcare system have been under surveillance for COVID-19 infection, including from March 9 to the end of the current study period, June 3, 2020. A COVID-19 “hotline” was set up by the occupational medicine service of the healthcare system to telephonically triage any HCW with regard to their symptoms, travel, and exposure history, followed by further referral for SARS-CoV-2 testing as clinically indicated. To optimally understand HCW infection rates, the occupational health hotline collected HCW demographic and administrative information, which included age, race, sex, and their residential area from the system’s human resources department. The contracted, permanently remote work force consisting of HCWs residing outside the New England area was excluded for the analyses involving residential locations.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
