Personal Risk Perception Research Articles

Visiting nuclear reactors–Safety and security aspects

• Nuclear power plants implement various safety and security protocols while hosting visitors to the site. • Most people are ready to follow safety and security protocols but are less willing to comply with protocols that invade their privacy. • The public image of nuclear energy shows that respondents are not primarily in favour of it, yet they are also not against it. The social benefit perception of the nuclear energy index and the general attitude toward the nuclear energy index are relatively average. • The personal risk perception of nuclear energy negatively affects attitude towards it as well as the perception of its social benefits. • Visits to nuclear plants could negatively affect personal risk perception and positively affect attitude towards nuclear energy and the perception of its social benefits. Visiting nuclear reactors is a niche tourism offer within energy (industrial) tourism, which leads tourists through areas that are not primarily meant for them. Hence, safety and security issues are even more critical in this case. This study aims to highlight different aspects of safety and security issues in nuclear power plant tours and to present measures taken to address these concerns. In addition, we studied the connection between plant visits and the public image of nuclear energy. Information was gathered through participant observation (personal visits of factory tours) and an online survey. There, we identified safety and security nuclear power plant visit protocols and a positive correlation between the visit variable and the two variables of the public image of nuclear energy, which suggests energy (industrial) tourism as a suitable tool to enhance awareness and knowledge about nuclear energy.

Health workers’ perception vs medically approved COVID-19 infection risk: the risk communication gap

Abstract Background This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organisational measures. We aim to explore ‘blind spots’ of pandemic protection and identify mental health needs. Methods A German multi-method hospital study at Hannover Medical School serves as an ‘optimal-case’ scenario of a high-income country, well-resourced hospital sector and an organisation with low HCW infection rate serves to explore governance gaps in HCW protection. Document analysis, expert information and survey data (n = 1163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care. Results Our study reveals a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed ‘some’ to ‘very strong’ fear of acquiring infection at the workplace. Individual protective behaviour and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived ‘no’ or ‘little’ protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behaviour, but nursing was correlated with higher levels of personal risk estimations and fear of infection. Conclusions A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through improved information, risk communication and inclusion of mental health support in pandemic preparedness. Key messages • Healthcare workers’ perceptions of COVID-19 infection risks are much higher than medically approved infection risk. • Pandemic preparedness and protection plans must pay greater attention to information, risk communication and mental health needs.

Factors affecting worriedness: A study of the COVID-19 pandemic in Japan

The global effect of COVID-19 is no longer simply a public health issue; it is causing an economic crisis that has a significant impact on the job market and people's lives. The disease has led to 43% of businesses temporarily closing, and almost all these closures are due to COVID-19. Organizations that have temporarily suspended their activities have pointed mainly to a decline in demand and employee health issues as the reasons for closure. In emergency and disaster management, perception often helps shape personality and how people act in certain situations. This study aims to examine personal risk perception of COVID-19 from many viewpoints and whether it affects motivation with regard to improving personal preparedness. We collected data from three major Japanese cities through a questionnaire survey and analyzed the results of the survey through factor analysis and multiple regression analysis by using the Partial Least Square Structural Equation Modeling (PLS-SEM). The three study areas include (1) the most damaged regions from the 2011 Great East Japan earthquake and tsunami, (2) the capital city and surrounding areas of Tokyo, and (3) Kumamoto, which has recently experienced an earthquake. The findings show a correlation between the nature of the information received during COVID-19 and worriedness and the necessity for adequate information. The expected benefit of this study is to provide guidelines for the government or organizations to make a suitable emergency management plan based on pertinent factors for future pandemics.

The Relationship Between Barriers and Drivers of COVID-19 Protective Behaviors in Germany and the UK.

Objectives: To explore and evaluate the impact of factors including public risk perceptions on COVID-19 protective behaviors across the UK and Germany. Methods: We used survey data collected from a representative sample for Germany and the UK (total N = 1,663) between April and May 2021. Using a Structural Equation Model, we evaluate the role of personal health risk perceptions, official message quality, source of news, age and political orientation on COVID-19 protective behaviors in the context of German and UK risk communication strategies. Results: Personal health risk perceptions had a significant positive influence on protective behaviors. Economic risk perceptions had a negative direct influence on protective behaviors, particularly in Germany, as well as a positive indirect influence. Official message quality, use of official news sources and age had positive impacts on risk perceptions and protective behaviors. Left-wing political orientation was linked to greater likelihood of undertaking protective behaviors. Conclusion: For future pandemics, more attention should be paid to evaluating and conceptualizing different varieties of risk perceptions, risk communication strategies, and demographic variables alongside their impacts on undertaking protective behaviors.

‘Why can't they just evacuate early’ –a study of the effect of a virtual reality experience on residents' intentions related to a wildfire risk

Late evacuation during a wildfire is dangerous and potentially fatal. Yet it is surprisingly common and a key challenge for organizations who manage wildfire risks. Encouraging at-risk residents to make wise and timely protective decisions in response to wildfire threats is an important task. Using the protective action decision model and structural equation modelling, the research explored the relative importance of wildfire risk perception, protective action perception and stakeholder perceptions on predicting the intention to ‘leave early’ among participants who indicated they would ‘wait and see’ on a day forecast as severe fire danger. The effect of a virtual wildfire scenario which was designed to allow participants to experience the dynamic nature of wildfire was also investigated on predictors of intention. The results showed that the predictors of intention significantly strengthened the desire to leave early rather than ‘wait and see’ after exposure to the virtual experience. The results of the regression analysis indicated that situational perception of personal risk, its interaction with stakeholder perception, protective action and stakeholder perception significantly predicted the intention to leave early after experiencing the virtual scenario. Moreover, the results indicated that there is a statistically significant difference between male and female participants in their tendency to leave in response to the socio environmental cues embedded in the VR intervention. The study highlights the need for thoughtfully designed interventions for residents who tend to ‘wait and see’ in response to wildfire threats as well as the need for gender wise strategies.

The Influence of SNS on Policy Support to Mitigate Public Health Crises: The Mediating Role of General and Personal Risk Perceptions.

Recent evidence suggests that social networking sites (SNS) motivate people, in the form of civic engagement, in times of crisis. Yet, there is a lack of empirical investigations that help to understand how SNS use increases civic judgment or participatory behavior. In this study, we examine how the use of SNS in a public health crisis is related to policy support for effective mitigation of risk, particularly focusing on the role of two distinct types of risk perceptions—general and personal risk perceptions. Using an online survey conducted on the issue of fine dust pollution in South Korea (N = 510), this study found that reliance on SNS for learning (i.e., SNS learning dependency) is positively associated with general risk perception, which, in turn, promotes policy support. Moreover, the results revealed a serial mediation process in which SNS learning dependency increases general risk perception, which ultimately increases personal risk perception and policy support. Overall, this study suggests that SNS has the potential to facilitate public engagement in a crisis and that individual motivation to engage with a crisis is not just a function of individual or societal-level risk perception but can be a simultaneous function of different levels of risk perceptions.

Predicting the sharing and reception of COVID-19-related information on social media

In a health crisis, social media is one of the primary means of disseminating and receiving information. Nevertheless, questions remain regarding what facilitates individual engagement in sharing or receiving information in the context of COVID-19, specifically for the Indonesian context. Analysis of a questionnaire survey among 255 from the random population of Indonesian showed that sharing information is predicted by gender and education. There was no significant relationship between social-demographic and receiving information. For psychosocial characteristics, personal risk perception predicted receiving information, while sharing information was predicted by societal risk perception. Societal risk perception and self-efficacy interacted with each other to predict the sharing of COVID-19-related information. One of the findings indicated a socio-cultural feature through which is considered to play an important role in personal and societal risk perception when sharing or expressing information. Given the benefits of social media communication during this pandemic, this study suggested that governments and policymakers should pay closer attention to a local community that is more effective in keeping everyone safe. Unfortunately, on another side, social media provides less information about narratives, storytelling, and empathy to maintain public trust.

1446P Barriers and facilitators for genetic/epigenetic screening trials attendance in healthy populations at high-risk for cancer: A qualitative study

For several tumors the possibility to detect suspected lesions in early stages could make a difference between life and death. New directions in research projects and cancer screening trials (CST) aimed at stratifying populations at high risk (HR) for cancer by integrating omics, imaging data and epidemiologic risk factors. A comprehensive understanding of factors that hinder or enhance participant’s adherence to these trials is needed, to also improve the criteria and approach to returning results. The aims are a) identify facilitators and barriers influencing HR populations’ adherence to CST; b) compare the effect of constructs from the Health Belief Model (HBM) and the Theory of Planned Behaviors (TPB) on the decision-making process. 3 Focus Group Discussions (FGDs) were conducted with 1st-degree relatives of cancer patients (N=18). Transcripts from the FGDs were analyzed using NVivo software to perform thematic analysis. Preliminary results identified two main facilitators and two main barriers. The facilitators were: a) the availability of a structured prevention program in association with the genetic/epigenetic returning of result; b) the reception of detailed information and counseling concerning the probabilistic/uncertain nature of genetic/epigenetic data. The barriers were: a) the psychological impact of “negative” screening results on participants and their families; b) younger age and related perception of personal risk. Social norms and perceived behavioral control (TPB) seem not crucial constructs in the decision-making process, whereas constructs such as knowledge, perceived susceptibility, perceived seriousness, preventive behaviors and cues to actions (HBM) might explain HR subject’s adherence to cancer screening trials. Technological advances in (epi)genetics, diagnostic technologies and clinical trials for cancer screening must be matched by parallel advances on how we support the informed choices, essential to public participation. Our study contributes to the promise of 4P medicine personalizing preventive screening interventions at the psychosocial dimension, as well as biological dimension.

Can International Students’ Risk Perception and Place Image Create an Advantage in Safeguarding Place Loyalty in Post-COVID-19 Tourism?

International students enrolled in the long term are considered habitual residents. They act as hosts to their friends and relatives, generating word-of-mouth recommendations and revisiting the host country. In order to facilitate inbound tourism in post-COVID-19 tourism, it is necessary to understand their risk perception, place image, and loyalty and provide meaningful insights for tourism markets. This study explores how social and personal risk perception of COVID-19 and cognitive and affective place image explain place loyalty. International students for degree programs comprised the sample population for this study. Findings revealed that social risk perception negatively shapes cognitive and affective place image, while personal risk perception only explains affective place image. Both cognitive and affective place image significantly affects place loyalty and mediates between social risk perception and place loyalty. The research provides new evidence on the risk perception of COVID-19, showing that internal factors such as social and personal risk perception may cause somewhat different results contrary to previous studies. Although gender moderates the relationship between cognitive place image and loyalty, the influence of gender on the theoretical and empirical relationships between risk perception, place image, and loyalty is not significant for international students. Implications for theory and practice, limitations, and future studies are discussed.

Risk Perception and Adherence to Precautionary Protocols; the Experience at the Height of the COVID-19 Outbreak in Nigeria

<p><strong>Aim</strong>: The study is aimed at examining COVID-19 personal risk perception and adherence to lockdown precautionary protocol during the peak of COVID-19 outbreak in Nigeria.</p><strong>Methodology</strong>: A descriptive cross-sectional study was adopted in which 4864 responses were retrieved between April to June 2020 through an online questionnaire to assess risk perception to COVID-19 in Nigeria. Information sought was on personal risk perception, frequency of lockdown protocol violations, general perception regarding COVID-19 lockdown in Nigeria, Pearson’s <p>chi square and frequencies were examined from the data with SPSS version 25.</p><p><strong>Results</strong>: 55.3% were between the ages of 26-35 years, 59.2% were males, 61.2% were singles, and 80.9% lived in urban areas. About half, (54.6%) had moderate risk perception, 41.4% had high personal COVID-19 risk perception. Though 40.1% strictly adhered to the lockdown protocols, 71.7% of the respondents had a positive perception regarding the lockdown. Pearson’ chi-square revealed significant relationship between being 26-35 years old, being male, being married, having at least a bachelor’s degree, being Hausa, being a public servant and having a moderate to high COVID-19 risk perception (p>0.05).</p><p><strong>Conclusion</strong>: There was a good level of COVID19 personal risk perception in the majority of the Nigerian populace and although majority had a positive perception regarding lockdown as a precautionary measure to curtail the spread of COVID-19, less than half of the respondents adhered strictly to the lockdown protocols.</p>

Nurses’ perception and compliance with personal protective equipment and hand hygiene during the third wave of COVID-19 pandemic

BackgroundHealthcare workers' (HCWs) compliance with infection prevention and control (IPC) measures during the COVID-19 pandemic is crucial to reducing the spread of infection to their colleagues, families, and community. This study assessed the risk perception and compliance with personal protective equipment (PPE) usage, hand hygiene, and specific IPC measures and explored the factors associated with compliance among nurses during the third wave of the COVID-19 pandemic in Egypt.MethodsA hospital-based cross-sectional survey was conducted at the Alexandria Main University Hospital (AMUH) in Alexandria city from May to August 2021, where 354 nurses were included with a response rate of 94.9%. A structured interviewer-administered questionnaire was used for data collection. Univariate and multivariate logistic regression analyses were conducted.ResultsThe overall compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The mean risk perception score was 40.9 ± 3.3. More than 95% of nurses were aware of the high risk of COVID-19 infection at their workplace, the serious consequences of the disease, and the risk that can be minimized by using PPE, whereas a relatively low percentage of nurses believed that the risk of COVID-19 infection could be reduced by using a surgical mask (19.2%) or gloves (50.5%). Good compliance was independently predicted by risk perception (OR = 1.25; 95% CI = 1.13, 1.39), and knowledge about PPE usage and hand hygiene (OR = 3.53; 95%CI = 2.40, 5.19). Facilitators of compliance with the PPE usage were attending suspected or confirmed COVID-19 cases in their hospital (overline{x} = 9.82), comfort to use the PPE (overline{x} = 9.16), availability of PPE (overline{x} = 8.96), hospital policy (overline{x} = 8.74), and senior compliance (overline{x} = 6.5).ConclusionsNurses at AMUH reported high risk perceptions. The rate of compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The personal risk perception and knowledge about the PPE usage and hand hygiene are the keys to improving compliance in a healthcare facility.

Risk perception, but also political orientation, modulate behavioral response to COVID-19: A randomized survey experiment.

Prior work has shown that accurately perceiving the risk for COVID-19 is associated with higher adherence to protective health behaviors, like face mask use, and more acceptance of governmental restrictive measures such as partial or complete banning of indoor activities and social gatherings. In this study we explored these associations at the beginning of the second wave of COVID-19 in Argentina through a national representative probabilistic survey that evaluated personal and contextual risk perception, self-reported compliance with protective health behaviors, attitude to governmental restrictive measures, and political orientation and psychological distress as potential modulators. Also, going beyond measures of association, here we sought to test whether messages highlighting potential risks increased acceptance of restrictive measures. Three types of messages were randomized to the participants. Two messages conveyed risk-related content (either through emotional arousal or cognitive appraisal) and the third a prosocial, altruistic content. Between March 29th and 30th, 2021, 2,894 participants were recruited (57.57% female). 74.64% of those surveyed evaluated the current health situation as “quite serious” or “very serious” and 62.03% estimated that the situation will be “worse” or “much worse” in the following 3 months. The perception of personal risk and the level of adherence to protective behaviors gradually increased with age. Through a regression model, age, perceived personal risk, and contextual risk appraisal were the variables most significantly associated with protective behaviors. In the case of the acceptance of restrictive measures, political orientation was the most associated variable. We then found messages aimed at increasing risk perception (both emotionally or cognitively focused) had a significantly greater effect on increasing the acceptance of restrictive measures than the prosocial message, mainly for government supporters but also for non-supporters. However, the level of response was also modulated by the political orientation of the participants. We propose a mechanism of “ideological anchoring” to explain that participants were responsive to risk modulation, but within the limits established by their pre-existent political views. We conclude that messages highlighting risk can help reinforce the acceptance of restrictive measures even in the presence of polarized views, but must be calibrated by age and political orientation.

Association between perceived risk of COVID-19 and support for transportation policies

The association between perceived risk of COVID-19 at the individual level and support for transportation policies designed to mitigate coronavirus transmission has received little attention. We surveyed a nationally representative sample of U.S. adults (N = 2,011) in June 2020 to examine how support for public policy varied according to perceived risk. We used logistic regression models to control for demographic factors and identify the effect of perceived risk, defined as a combination of self-reported perceptions of personal risk of acquiring the disease and the severity of the illness if infected, on support for a range of policies related to transportation. We found that perceived risk did not vary significantly by sex, race, urbanicity, income, or age. Support for policies aimed at mitigating COVID-19 transmission was consistently higher among those with higher perceived risk of the disease.

Remember the past, plan for the future: How interactions between risk perception and behavior during the COVID-19 pandemic can inform future Canadian public health policy.

The ongoing COVID-19 pandemic necessitated the implementation of numerous temporary public health policies, including social distancing, masking, and movement limitations. These types of measures require most citizens to follow them to be effective at a population level. This study examined population adherence to emergency public health measures using early data collected in the Spring of 2020, when all Canadian jurisdictions were under relatively strict measures. In total, 1,369 participants completed an online questionnaire package to assess adherence, perceptions of government response, and perceptions of COVID-19 risk. Results indicated that most Canadians were pleased with the government's handling of the early phases of the pandemic and immediately engaged new public health mandates. Willingness to change behaviors was unrelated to satisfaction with the government response. Similarly, behavioral adherence was also unrelated to satisfaction with government, or personal risk perceptions; however, adherence to public health guidelines was related to elevated psychological distress. As the pandemic continues, public health officials must balance the mental health of the population with the physical health concerns posed by COVID-19 when applying public health mandates.

Health worker experiences of implementing TB infection prevention and control: A qualitative evidence synthesis to inform implementation recommendations.

Implementation of TB infection prevention and control (IPC) measures in health facilities is frequently inadequate, despite nosocomial TB transmission to patients and health workers causing harm. We aimed to review qualitative evidence of the complexity associated with implementing TB IPC, to help guide the development of TB IPC implementation plans. We undertook a qualitative evidence synthesis of studies that used qualitative methods to explore the experiences of health workers implementing TB IPC in health facilities. We searched eight databases in November 2021, complemented by citation tracking. Two reviewers screened titles and abstracts and reviewed full texts of potentially eligible papers. We used the Critical Appraisals Skills Programme checklist for quality appraisal, thematic synthesis to identify key findings and the GRADE-CERQual method to appraise the certainty of review findings. The review protocol was pre-registered on PROSPERO, ID CRD42020165314. We screened 1062 titles and abstracts and reviewed 102 full texts, with 37 studies included in the synthesis. We developed 10 key findings, five of which we had high confidence in. We describe several components of TB IPC as a complex intervention. Health workers were influenced by their personal occupational TB risk perceptions when deciding whether to implement TB IPC and neglected the contribution of TB IPC to patient safety. Health workers and researchers expressed multiple uncertainties (for example the duration of infectiousness of people with TB), assumptions and misconceptions about what constitutes effective TB IPC, including focussing TB IPC on patients known with TB on treatment who pose a small risk of transmission. Instead, TB IPC resources should target high risk areas for transmission (crowded, poorly ventilated spaces). Furthermore, TB IPC implementation plans should support health workers to translate TB IPC guidelines to local contexts, including how to navigate unintended stigma caused by IPC, and using limited IPC resources effectively.

Knowledge and perception of cardiovascular disease risk in women of reproductive age

ObjectiveWomen who experience adverse pregnancy outcomes (APO) are at increased risk for cardiovascular disease (CVD); however, their knowledge of CVD risk is not well characterized. We aimed to evaluate knowledge and perception of CVD risk in young women and to determine whether these factors differ based on experience of an APO. MethodsWe conducted a cross-sectional study among women with a recent live birth at an urban medical center. Knowledge and perception of CVD risk were assessed through a self-administered online survey adapted from the American Heart Association Survey of Women's CVD Awareness. ResultsOf 5612 individuals contacted between 3/1/21 and 4/18/21, 714 completed the survey; the mean (SD) age was 34 (4) years and 25% reported an APO. While 62% of respondents identified CVD as the leading cause of death in women, there was no significant difference in CVD knowledge scores between participants who reported experiencing an APO and those who did not (6.9 vs 6.8 out of 10; p = 0.51). Participants who reported experiencing an APO had higher perception of personal risk for CVD (adjusted odds ratio, 2.64 [95% CI 1.83-3.80]) compared with participants who did not. Half of participants who experienced an APO reported perceiving average, or below average, risk for CVD and only 41 (22.5%) reported speaking with a healthcare professional about CVD within the past year. ConclusionsGaps remain in knowledge of CVD risk among young women, particularly after an APO. The peripartum period may represent a unique opportunity for targeted education when healthcare engagement is high.

A Comparative Study on the Cultural Dimensions and Health Perception of the COVID-19 Pandemic between China and the United States.

When a public crisis such as COVID-19 occurs, factors that affect health-related behaviors, such as compliance with safety precautions, health professionals, and directives from government agencies will become more obvious. This research explores the differences between the people of the United States and China regarding preventive behavioral intentions, perceptions of personal and social risks, seriousness, and other cultural characteristics in the context of the COVID-19 health crisis. The purpose is to provide insights that can be used when global public health events occur in the future. A total of 536 people who lived in the US and China from 12 July to 7 September 2020 were recruited in the survey. Through a web-based survey, differences in the attitudes and perceptions of COVID-19 between the two countries were identified. Overall, the people of China scored higher than Americans on several measures regarding personal risk perception, social risk perception, and seriousness. Chinese citizens also had higher preventive behavioral intentions than their US counterparts. In addition, the relationships between cultural dimensions and health-related variables were also different.

How do the framing effects, environmental factors and personal risk perceptions influence our decision about a hypothetical COVID-19 pill?

ABSTRACT This study investigates the willingness to pay for the real COVID-19 vaccine and the framing effect for a hypothetical COVID-19 pill. The way how a message concerning a risky situation is formulated impacts decisions. However, personal characteristics, like attitude to risk, also strongly impact this decision. In this study, risk attitudes are measured with the DOSPERT Scale. As many studies proved, the intention to be vaccinated is not just related to risk preferences, but also strongly influenced by socioemotional factors. The extent to which friends and relatives are vaccinated in our social circles as well as the concern for both others and for ourselves influence this decision. Using an online survey, personal pricing and acceptance of both real and hypothetical COVID-19 medicines were studied. The results of the descriptive and inference statistics concerning how the message frame impacts pricing are ambiguous, but the significant effects of environmental and individual factors are confirmed.

Recruitment, Retention, and Future Direction for a Heart Health Education and Risk Reduction Intervention Led by Community Health Workers in an African American Majority City

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD = 15.9). Ninety-two percent had health insurance. Seventy-six percent of participants averaged blood pressure (BP) readings > 130/80 mmHg. Eleven percent of participants had a 30% or higher probability of developing cardiovascular disease in the next 10 years. Six-month follow-up was completed with 96% of participants. There were statistically significant increases in knowledge and in perception of personal risk for heart disease. However, slightly more participants (n = 77, 80.2%) had BP > 130/80 mmHg. The Community Advisory Group recommended expanding the intervention to 12 months and incorporating telehealth with home BP monitoring. Limited intervention duration did not meet longer term objectives such as better control of high BP and sharing risk reduction planning with primary care providers.

Healthcare Workers' Perceptions and Medically Approved COVID-19 Infection Risk: Understanding the Mental Health Dimension of the Pandemic. A German Hospital Case Study.

IntroductionThis study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible.MethodsWe have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data (n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.ResultsThe results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection.ConclusionsA strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.