Determinants Of Transmission Risk Research Articles

Exposure to a SARS-CoV-2 infection at work: development of an international job exposure matrix (COVID-19-JEM).

ObjectiveThis study aimed to construct a job exposure matrix (JEM) for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting.MethodsExperts in occupational epidemiology from three European countries (Denmark, The Netherlands and the United Kingdom) defined the relevant exposure and workplace characteristics with regard to possible exposure to the SARS-CoV-2 virus. In an iterative process, experts rated the different dimensions of the COVID-19-JEM for each job title within the International Standard Classification of Occupations system 2008 (ISCO-08). Agreement scores, weighted kappas, and variances were estimated.ResultsThe COVID-19-JEM contains four determinants of transmission risk [number of people, nature of contacts, contaminated workspaces and location (indoors or outdoors)], two mitigation measures (social distancing and face covering), and two factors for precarious work (income insecurity and proportion of migrants). Agreement scores ranged from 0.27 [95% confidence interval (CI) 0.25–0.29] for ‘migrants’ to 0.76 (95% CI 0.74–0.78) for ‘nature of contacts’. Weighted kappas indicated moderate-to-good agreement for all dimensions [ranging from 0.60 (95% CI 0.60–0.60) for ‘face covering’ to 0.80 (95% CI 0.80–0.80) for ‘contaminated workspaces’], except for ‘migrants’ (0.14 (95% CI -0.07–0.36). As country differences remained after several consensus exercises, the COVID-19-JEM also has a country-axis.ConclusionsThe COVID-19-JEM assesses the risk at population level using eight dimensions related to SARS-COV-2 infections at work and will improve our ability to investigate work-related risk factors in epidemiological studies. The dimensions of the COVID-19-JEM could also be valuable for other future communicable diseases in the workplace.

COVID-19 and the Workplace

BACKGROUND AND AIM: The SARS-CoV-2 virus pandemics has raised several challenges at the workplace. METHODS: Within the omega-net COVID-19 taskforce, we developed standardized COVID-19 questionnaires for occupational research, a multi-country COVID-19 Job Exposure Matrix, and research on COVID-19 as an occupational disease. RESULTS:The compiled questionnaire resource covers all key aspects of the COVID-19 pandemic, including: COVID-19 diagnosis & prevention, Health and demographic, Use of personal protective equipment, Health effects, Work-related effects, Financial effects, Work-based risk factors, Psychosocial risk factors, Lifestyle risk factors, and Personal evaluation of the impact of COVID-19. For each of the domains additional questions are available. A second questionnaire (in a short and along version) focusses on occupational risk factors for SARS-CoV-2 infection and COVID-19 disease. The questionnaires are available online at https://omeganetcohorts.eu/news/covid19-questionnaires-omeganet/. The JEM was developed by experts from three European countries (Denmark, the Netherlands, UK), who defined the relevant exposure and workplace characteristics with regard to the possible exposure to SARS-COV 2 infection. The C19-JEM contains four determinants of transmission risk (number of people, type of people, indirect contact and location), two mitigation measures (social distance and face covering), and two social factors (income insecurity and migrant workers). Finally, we developed and piloted a questionnaire on COVID-19 as occupational disease, which provide data on 1) COVID-19 as occupational disease or injury, 2) criteria for recognition and compensation regarding exposure, disease, role of use of PPE and of competing non-occupational exposure; and 3) what can be compensated. Results are available from 36 largely European countries. CONCLUSIONS:Through the development and implementation of tools we not only provide instruments, but also insights on the occupational risks and diseases in relation to SAR-COV 2. KEYWORDS: COVID-19, questionnaires, JEM, occupational disease

Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.

Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013–2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD.