Risk For Healthcare Workers Research Articles

Assessing the Impact of the Pandemic on Treatment Outcomes for Cardiac Arrest Patients Utilizing Mechanical CPR: A Nationwide Population-Based Observational Study in South Korea

Introduction: Cardiopulmonary resuscitation with mechanical devices (MCPR) was developed to provide high-quality cardiopulmonary resuscitation (CPR) for patients with cardiac arrest. However, the effect of this procedure on treatment outcomes remains controversial. Nevertheless, during the coronavirus disease-19 (COVID-19) pandemic, in-hospital MCPR gained attention, owing to its advantages such as saving medical staff and preventing infection. This study compared the treatment outcomes of in-hospital MCPR and manual CPR for out-of-hospital cardiac arrest (OHCA) patients during the COVID-19 pandemic. Materials and Methods: This retrospective nationwide population-based study was conducted in South Korea. Data were collected from the Out-of-Hospital Cardiac Arrest surveillance database managed by the Korea Disease Control and Prevention Agency. We included adult OHCA patients transported by emergency medical services from 2016 to 2021. The study compared outcomes during the COVID-19 pandemic years (2020–2021) with the preceding non-pandemic years (2018–2019). The primary outcome was survival to hospital discharge, and the secondary outcomes were good neurological outcome and sustained return of spontaneous circulation (ROSC). Results: The entire study included 72,050 patients with OHCA and, in the multivariable analyses, MCPR was associated with lower survival rates compared to manual CPR (AOR 0.63; 95% CI 0.51–0.77; p < 0.001). Interestingly, during the COVID-19 pandemic, while MCPR use increased, the survival rate did not differ significantly between the MCPR and manual-CPR groups. Conclusion: Our study findings suggest that while MCPR may offer potential benefits, such as decreased infection risk for healthcare workers, it did not demonstrate superior outcomes compared to manual CPR in our study population.

Burnout and turnover risks for healthcare workers in the United States: downstream effects from moral injury exposure

Moral injury has emerged as a construct of interest in healthcare workers’ (HCW) occupational stress and health. We conducted one of the first multidisciplinary, longitudinal studies evaluating the relationship between exposure to potentially morally injurious events (PMIEs), burnout, and turnover intentions. HCWs (N = 473) completed surveys in May of 2020 (T1) and again in May of 2021 (T2). Generalized Linear Models (robust Poisson regression) were used to test relative risk of turnover intentions, and burnout at T2 associated with PMIE exposure, controlling for T1 covariates. At T1, 17.67% reported they had participated in a PMIE, 41.44% reported they witnessed a PMIE and 76.61% reported feeling betrayed by healthcare or a public health organization. In models including all T1 PMIE exposures and covariates, T2 turnover intentions were increased for those who witnessed a PMIE at T1 (Relative Risk [RR] = 1.66, 95% Confidence Interval [CI] 1.17–2.34) but not those that participated or felt betrayed. T2 burnout was increased for those who participated in PMIE at T1 (RR = 1.38, 95%CI 1.03–1.85) but not those that witnessed or felt betrayed. PMIE exposure is highly prevalent among HCWs, with specific PMIEs associated with turnover intentions and burnout. Organizational interventions to reduce and facilitate recovery from moral injury should account for differences in the type of PMIE exposures that occur in healthcare work environments.

Risk of SARS-CoV-2 infection in healthcare workers with insufficient use of personal protective equipment in Denmark.

The aim was to evaluate the role of insufficient use of personal protective equipment (PPE) in SARS-CoV-2 transmission risk for healthcare workers (HCW) during the COVID-19 pandemic. Prospective study within the COBRA cohort, including 15,127 HCW. Daily assessment of insufficient use of PPE, defined as self-reported PPE failure or noncompliance, in relation to SARS-CoV-2 infection ascertained by polymerase chain reaction (PCR) test. Statistical analysis involved calculating incidence rate ratios with 95% confidence intervals (CI). The included HCW contributed to 780,515 risk days including 67,723 d (8.7%) with insufficient PPE use and 133 events (positive PCR test). Self-reported insufficient use of PPE was slightly associated with infection with COVID-19 in HCW, but the data were statistically consistent with parameter values ranging from a protective effect to a to a doubling in risk (IRR 1.3, 95% CI 0.8; 2.3). Sensitivity analyses restricted to high-risk departments and to a period with a sufficient supply of PPE and a fully developed testing system, respectively, confirmed these findings. Insufficient use of PPE among HCW during the pandemic in Denmark was uncommon but associated with a slightly increased risk of COVID-19 among HCW. However, the findings are uncertain due to the limited number of cases and the potential for misclassification bias stemming from the self-reported nature of the exposure.

The impact of psychological stress on physiological indicators in healthcare workers: a cross-sectional study.

Medical health workers play an essential role in the healthcare system and face unique workplace stressors. However, the impact of psychological stress on their physical health has received less attention compared to the general population. We retrospectively analyzed the Self-rating Depression Scale (SDS) questionnaires and blood testing results from 1963 medical health workers. Multivariate linear regression analysis using a backward stepwise selection strategy to identify physical examination indicators that were significantly affected by depression. Depression severity, as measured by SDS index score, was positively correlated with the levels of hemoglobin (coefficient 0.0027, p = 0.0412), platelet count (coefficient 0.0005, p = 0.0198), and uric acid (coefficient 0.0004, p = 0.0492), while negatively correlated with red blood cell count (coefficient-0.0895, p = 0.0406). Similar results were observed in the subgroup analysis stratified by age and sex. Our study found a significant association between higher levels of depression and specific physiological indicators in healthcare professionals, including elevated hemoglobin, platelet counts, and uric acid levels, as well as decreased red blood cell counts. These changes in blood parameters may reflect underlying physiological stress and inflammation, potentially increasing overall health risks for healthcare workers. Addressing these physiological changes may be crucial for mitigating the health risks associated with depression. To validate our findings and develop targeted interventions, larger multi-center studies are needed to further explore the relationship between depression severity and blood parameters in healthcare professionals.

Occupational biological risk in healthcare workers

Biohazardous occupational accidents represent a significant challenge in the healthcare field due to the constant exposure of healthcare workers to pathogens. These accidents, which include needle sticks, cuts, splashes of body fluids, and contact with contaminated materials, can lead to serious infections, such as hepatitis B (HBV), hepatitis C (HCV), and HIV. World Health Organization (WHO) estimates that approximately two million healthcare workers experience sharps injuries annually, resulting in a significant risk of exposure to blood-borne pathogens [1]. A study conducted in hospitals in Europe revealed that the prevalence rate of needlestick injuries ranges from 10% to 30% per year, with the highest rates in areas such as surgery and intensive care [2]. The high frequency of these incidents underscores the importance of implementing effective preventive strategies to protect these workers.

Mpox: what sexual health physicians need to know?

Monkeypox virus (MPXV) is another zoonotic virus spilled over to the man and resulted in pandemic. World Health Organization declared it as a 'Public Health Emergency of International Concern (PHEIC) on July 22, 2022. Mpox affected over 95226 individuals among them claimed the lives of 185. Despite the fact that Mpox is generally mild and self-limited, immunocompromised people with low CD4 counts may experience severe disease course. Management of Mpox patients has three pillars. First symptomatic approach includes pain management, prophylaxis for secondary infections and when needed effective treatment of superinfections. Second, vaccines developed against smallpox can be used in preexposure or postexposure prophylaxis strategies against Mpox. Third, current antiviral options include tecovirimat, cidofovir and birincidofovir all of which have been recommended relying on experience from animal studies, clinical case reports or case series. Results of well-planned randomized control trials are not available. Occupational exposure to MPXV is especially a manageable risk for health care workers. Prevention of Mpox also requires risk communication with vulnerable population and their involvement in mitigation efforts.

Use of wearable ventilation for reducing the infection risk of healthcare workers in isolation wards: A numerical study

This study investigates the protective effectiveness of a novel head-mounted air supply (HAS) system on healthcare workers (HCWs) in COVID-19 isolation wards. The study employs computational fluid dynamics (CFD) to explore the effectiveness of the HAS and the infection probability for HCWs during constant exhaling and coughing of patients. It also studies the effect of air changes per hour (ACH) and exhaust outlet locations in the isolation ward on the infection probability of the HCW. Additionally, the effectiveness between the HAS and various types of common masks is compared. Results indicate that when the flow rate of the HAS reaches 10 L/s with supplying clean air, the infection probability of the HCW can be reduced from approximately 30 % without protection to below 0.18 %. Patients' coughing increases the infection probability of the HCW by approximately tenfold within a short period, and wearing the HAS can effectively reduce the effect of patients’ coughing on the HCW. When ACH increases, the infection probability of the HCW decreases. Wearing the HAS can mitigate the effects of changes in ACH, with an infection probability below 0.18 % at 9 ACH or above. Ceiling-level exhausts are more effective than floor-level exhausts in removing pollutants from the ward. Under experimental settings, HAS with suitable parameters may be more effective than commonly used masks in terms of reducing the infection probability of the wearer. These findings provide valuable references for the application of wearable ventilations in hospital environments.

Providing healthcare under the threat of gang-violence: a survey of Haitian healthcare providers

In addition to having some of the worst health outcomes in the region, Haiti faces a political and economic crisis. The most recent humanitarian crisis includes an increase in homicides and kidnappings in the capital Port-au-Prince. This study is a cross-sectional, mixed methods online survey of health workers and medical students in Port-au-Prince from May 20 – September 15, 2023. It provides evidence of the kidnapping risk healthcare workers face and shares the perspective of a medical community operating in a challenging context to provide a continuity of care under the threat of violence. The survey of Haitian health workers and students show a significant risk of kidnapping with 44% of respondents reporting that they had a colleague kidnapped in the previous 2 years. 5 of the 249 respondents had been kidnapped and all were young, female health workers. 74% of health workers and students surveyed reported they plan to continue their profession abroad. Although teletraining was viewed as a positive opportunity to continue training cadres of medical professionals, health workers shared numerous limitations present for the expansion of telemedicine in the Haitian context. In addition to describing the experience of the Haitian healthcare professional during this crisis and documenting barriers to teletraining and telemedicine, this survey documents design considerations for mobile phone surveys with healthcare providers working in areas affected by conflict.

Assessing molecular genetic and immunological predictors of COVID-19 course in healthcare worker risk group

Relevance. Studying features of innate and adaptive mechanisms of immune response in medical workers (MW), the most vulnerable social group with a high risk of infection, is an urgent research task. The aim of the study: Comprehensive study of innate and adaptive immune mechanisms and analyzing relationships between clinically significant polymorphisms (SNPs) in TLR2, TLR4 genes, TLR2 expression level on peripheral blood monocytes, peripheral blood cytokine profile (IL-1β, IL-10, IL-6, IFNγ, platelet activation marker) and SARS-CoV-2-specific humoral immune response in medical workers (MW) at a temporary infectious disease hospital in early and late COVID-19 convalescence. Materials and methods. immunologic, cytofluorimetric and molecular-genetic research methods were applied. Adaptive immune response in medical workers — COVID-19 convalescent subjects. Results. Early post-COVID-19 convalescence period in MW was linked to higher TLR2 monocyte expression; the mean fluorescence intensity was significantly elevated by 1.5-fold compared to control group. Late convalescence period (7 months post-COVID-19) was characterized by lowered serum IFNγ level. A decline in IFNγ production was significant: decreased by 82-fold in MR that was markedly stronger compared to control group (59 times). The imbalance of cytokines controlling antiviral innate and adaptive immune response was revealed in MW with identified combination of polymorphisms rs5743708 and rs4986790 in TLR2, TLR4 genes with the rate not exceeding 6.7%. It was found that 7 months after COVID-19 there was a markedly decreased IFNγ, IL-1β and IL-10 levels. The studies indicate both altered innate and adaptive immune mechanisms and a need to optimize therapeutic and prophylactic measures aimed at increasing patient-intrinsic resistance, protection of respiratory tract mucosal barriers and identification of genetic predictors of defects in innate and adaptive immune response in medical workers — COVID-19 convalescent subjects.

Measuring Immunoglobulin Titers Among Healthcare Workers After Hepatitis B Vaccination: A Cross-Sectional Study in Kuwait.

Introduction Hepatitis B virus (HBV) is a highly infectious disease affecting the liver, causing life-threatening acute and chronic hepatitis. It poses a significant global public health burden and is a major occupational risk for healthcare workers (HCWs) due to transmission through blood and blood products. Given their increased risk compared to the general population, vaccination is crucial in limiting the spread of HBV and protecting HCWs. This study aims to measure the anti-HBs titers of HCWs in the Farwaniyah Health District in Kuwait after completing three doses of the HBV vaccine. Methods This cross-sectional study was conducted in the Farwaniyah Health District of Kuwait between May and July 2023. We collected data from 556 participants from various departments, including physicians, nurses, and laboratory technicians, chosen through simple random sampling. Inclusion criteria included the completion of three doses of the HBV vaccine (Engerix-B recombinant vaccine, GlaxoSmithKline Biologicals, Brentford, UK). Demographic data were collected, and blood samples were tested for hepatitis B surface antigen antibody titers using fourth-generation enzyme-linked immunosorbent assay. Participants were categorized based on sex, age, specialty, and time since the last vaccine dose. The chi-square test and Fisher's exact test assessed differences in categorical variables, with a p-value of <0.05 considered statistically significant. Results The study included 556 participants, with 304 (54.7%) women and 252 (45.3%) men. Participants were assigned into two age groups: 294 (52.9%) were 18 to 40 years oldand the remainder (262) were over 40. Most participants were nursing staff (n=392; 70.5%), followed by physicians (n=110; 19.7%) and technicians (n=54; 9.7%). A high proportion (n=340; 61.2%) received their last vaccine dose within the last five years. Overall, 375 (67.4%) HCWs developed sufficient anti-HBs titers of ≥100 mIU/mLwhile 181 (32.6%) had levels below 100 mIU/mL. Age between 18 and 40 years and receiving the vaccine within the last five years were significantly associated with protective titer levels, while sex was not. Nurses had significantly higher immunity levels compared to doctors and technicians. Conclusions HCWs in the Farwaniyah area of Kuwait generally responded positively to the HBV vaccine. Younger HCWs and those who received the vaccine more recently were more likely to have a protective immune response. Nurses demonstrated higher rates of seroconversion compared to doctors and technicians. These results suggest that HBV vaccination programs should prioritize timely booster doses, especially for older HCWs and those vaccinated longago. Monitoring antibody levels is crucial to ensure ongoing protection, particularly in high-risk groups such as nurses. Implementing these measures can enhance the effectiveness of HBV vaccination programs, reduce HBV incidence among HCWs, and contribute to a safer healthcare environment. Post-vaccination testing is essential to ensure the safety of all HCWs against HBV.

Central nervous system tumours and occupational ionising radiation exposure: a nested case–control study among the ORICAMs cohort of healthcare workers in France

ObjectiveThis study aimed at investigating the relationship between occupational exposure to external ionising radiation and central nervous system (CNS) tumours mortality in healthcare workers working in France.Design and settingThe Occupational...

Key aspects of occupational risks for healthcare workers

At present, the greatest challenge associated with risks in healthcare is the lack of research on occupational diseases associated with healthcare workers’ activities. Despite all achievements of the modern medicine and use of high-tech equipment, occupational health risks remain high in healthcare organizations. Few available literature sources assume that the level of actual occupational morbidity among healthcare workers is considerably higher than the official figures. This does not allow us to fully assess its prevalence. No unified approaches to investigating morbidity among healthcare workers have been developed yet. Analysis of available literature sources has revealed that most studies with their focus on peculiarities of working conditions and health of healthcare workers as well as associated risk factors are rather fragmentary and do not fully encompass all relevant aspects. At present, there is no unified organizational system for occupational safety that includes, among other things, scientific study of the issue. It is advisable to create a concept of occupational health risks in order to provide effective substantiation for selecting managerial decisions on regulation of effects produced by risk factors on personnel employed by healthcare organizations. The methodology for occupational health risk analysis is eligible for becoming an instrument that can ensure an effective policy aimed at protecting and promoting health of healthcare workers.

The Epidemiology of Needlestick and Sharp Injuries Among Healthcare Workers in a Secondary Care Hospital in Saudi Arabia: A Retrospective Study.

Introduction Needlestick and sharp injuries (NSI) continue to pose a significant risk for healthcare workers (HCWs) at their workplace. The incidence rate of NSI in hospitals depends on multiple risk factors. This study aimed to analyze the epidemiological characteristics of NSI among HCWs and the risk factors influencing NSI rates and to provide further direction for NSI prevention in secondary care hospitals. Methods This study included all the NSI cases reported by HCWs in King Abdul Aziz Hospital, Makkah from 2005 to 2017. All the cases were recorded in the Exposure Prevention Information Network (EPINet™)database (International Healthcare Worker Safety Center, University of Virginia, Charlottesville, USA). The study was executed by using data loaded in the EPINet™Program, the hospital electronic recording system Medica Plus, and analyzed by the StatisticalPackage for the Social Sciences program (SPSS Inc. Released 2007. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). Results During the period of study, 524 NSI cases were reported. The mean incidence rate per 100 occupied beds with 95% CI was 25.43 (22.05-28.81) and a statistically insignificant decline in NSI incidence rate was observed from 2005 to 2017. The maximal annual incidence rate (35.63 per 100 occupied beds) was registered in 2010 and the minimal value (14.84 per 100 occupied beds) in 2013. Injuries were mainly reported in patient rooms/wards (30.2%) and most frequently by nurses (56.1%). The mean of incident reporting within 24 hours was 74.0, 95% CI (67.19-80.73). This rate showed a statistically significant (p=0.01) increasing trend of 5.0% per annum. The mean of identified source patients - 83.5, 95% CI (79.13- 87.23) - possessed an annual 2.1% rise during 2005-2017 which was statistically insignificant (p=0.7). Cases occurred after the use/before disposal of items in 45.0% of cases and during the use of items in 44.7%. Hollow-bore needles caused injuries in 46.5% of incidents. Blood sample taking - 23.2% and IV or arterial line insertion/removal/manipulation (19.1%) - presented exposure-prone procedures posing the highest risk. Conclusions The results of this study revealed a high rate of NSI in the hospital. NSI rate in hospitals was impacted by a group of related risk factors, particularly, the location of risk (patient room/ward, intensive care unit (ICU), and emergency room (ER) depending on job intensity, the kind and frequency of exposure-prone procedures (blood sample taking, IV or arterial line insertion/removal/manipulation) and handling of hollow-bore and solid needle connected to the main healthcare professional group at risk (nurses). Future direction in NSI prevention requires a complex approach of continuous staff education along with the usage of devices with safety features.

Completion of three-dose hepatitis B vaccination cycle and associated factors among health care workers in the Greater Accra Region of Ghana.

Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.

Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue?

BackgroundNeedle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study.MethodsAn online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany.ResultsThe response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs.ConclusionWe assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.

Assessment of COVID-19 infection Risk, thermal Comfort, and energy efficiency in negative pressure isolation wards with varied ventilation modes

Negative pressure isolation wards (NPIWs) play a crucial role in providing care to COVID-19 patients during a pandemic. However, the exhalation of patients releases aerosols containing pathogens, posing a potential infection risk for healthcare workers (HCWs). While robust ventilation systems within NPIWs can help mitigate this risk, they may also lead to increased energy consumption and reduced thermal comfort for patients. Therefore, it is imperative to strike a delicate balance between HCW safety, patient comfort, and energy efficiency when optimizing airflow within NPIWs. This study introduces TARGETING, a novel index designed to assess the efficiency of aerosols removal of ventilation systems in NPIWs. The primary goal of TARGETING is to enhance the precision of ventilation systems, consequently reducing the required air changes per hour (ACH) and minimizing energy consumption. The research delves into the impact of various supply air parameters, including ACH and temperature, as well as different ventilation modes. Through a comprehensive evaluation utilizing an array of metrics such as the Air Diffusion Performance Index (ADPI), Predicted Mean Vote (PMV), TARGETING, infection risk assessment, and energy consumption estimation measured by cooling load (Lcool), this study employs an Analytic Hierarchy Process to assess the aforementioned indices. The findings highlight that air curtain ventilation (ACV) emerges as the most favorable choice, delivering comprehensive benefits, including an infection risk of less than 0.03%, an ADPI score of 90.2%, a PMV close to zero, TARGETING at 1.3, and energy savings ranging from 35.1% to 57.3%.

Assessment of Knowledge, Attitude and Practices among Healthcare Professionals Regarding Hepatitis B Infection and Vaccination in a Tertiary Care Hospital

Background: Hepatitis B infection is an occupational risk for Healthcare workers (HCWs).[3] They have a greaterrisk of acquiring HBV infection due to exposure to blood or bodily fluids. Compared to the general population, therisk is four times higher for this group of professionals. The present study was carried out to know the vaccinationstatus of Hepatitis B; assess knowledge and attitude towards Hepatitis B vaccination; and to assess the awarenessabout Hepatitis B infection among health care professionals.Methods and Materials: A cross sectional study was conducted in the MY Hospital, Indore for a period of 6months after getting approval from institutional ethics committee. The sample size of 210 healthcare professionalswas selected using simple random sampling technique. The data was collected by using a pre-designed, validatedsemi-structured questionnaire. Data collected through the questionnaires were coded, entered into a database andanalysed using a statistical software SPSS version 25(trial version).Results: 63.81% of HCWs knew about HBV infection. 43.81% were aware about its spread through saliva. 77.36%doctors, 74.78% nurses and 80.95% of the other health care workers never used PPE while handling blood andbody fluids. All the doctors, 54.78% nurses and 21.43 of others knew about the HBV vaccine (p-value&lt;0.00001).88.68% doctors and 41.27% nurses and only 33.33% of the other staff knew that there were three doses of HBVvaccine. Majority of the doctors (83.02%) and nurses (53.04%) had received HBV vaccine, while 69.05% of otherhealth care workers did not receive any dose of HBV vaccine.Conclusion: The study shows that complete knowledge regarding the hepatitis B infection, its mode of transmission,preventive measures and screening is still lacking among the health care workers. Although doctors seem to be themost knowledgeable, there is a need to improve the knowledge and practices among the other workers as well.

Influence of talking behavior of infected patients and the associated exposure risk in a ventilated negative-pressure ward

Negative-pressure isolation ward is a primary choice in preventing the spread of outbreaks and safeguarding patient recovery. Inside the ward, patients with respiratory diseases generate virus-carrying bioaerosols through breathing and talking, posing a very high risk of infection to healthcare workers. In this paper, we used numerical simulation to compare the effects of different respiratory behaviors, such as normal breathing, prolonged talking, short talking, and alternating talking, on the spatial and temporal distribution of aerosols in a ward, and to study the risk of infection for healthcare workers. It was found that a short period of time in which a patient talked in a ward increased aerosol concentrations by four orders of magnitude compared to normal breathing. In the ward with the ventilation of up-supply, or the one with side-supply, the impacts of aerosol generation from talking accounted for 62.4% and 42.6% of the total time, respectively. The overall infection risk in wards designed with side-supply ventilation was lower. Patient talking time changes did not affect high-risk areas. However, when healthcare worker and patient talked alternately, the aerosol impact time was slightly extended. In addition, the aerosols produced by talking were mainly deposited on the beds and floors, leading to higher exposure risk for healthcare workers during direct contact with beds. It is hoped that the results of this study can be used as the data basis for the study of aerosol pollution control strategies in medical scenarios, and provide useful suggestions for reducing the risk of infection.

Cardiovascular risk and the COVID-19 pandemic: a retrospective observational study in a population of healthcare professionals

Abstract Background To contain the spread of COVID-19, many countries imposed several restrictive measures, leading to radical changes in daily life behaviors. Social isolation, stress, the fear of being infected by SARS-CoV-2 and economic crisis could have generate unhealthy habits such as eating junk food, sedentary lifestyle and increased alcohol and tobacco consumption, that could have a serious impact on individual cardiovascular (CV) risk [1, 2, 3]. Healthcare workers experienced additional stress due to the increased risk of contagion, possibly leading to an increase in unhealthy habits [4]. Currently, there is no data in literature about the potential effect of these lifestyle changes on the CV risk of healthcare workers during the pandemic. Purpose In our study, we investigated how the CV risk has changed during the pandemic in a healthy population of healthcare workers, calculating the SCORE-2, a new algorithm to estimate 10-year risk of CV disease in apparently healthy people aged 40-69 years, described in 2021 by European Society of Cardiology (ESC) guidelines [5]. Methods We included healthy healthcare workers, aged &amp;gt;40 years with at least one complete medical examination with anamnestic and laboratory data in the 12 months preceding the lockdown (T0, from 10/03/2019 to 09/03/2020) and two more annual medical assessments during the pandemic period (T1, from 10/03/2020 to 09/03/2021 and T2, from 10/03/2021 to 09/03/2022). From records, we investigated the presence of main CV risk factors as outlined by ESC guidelines [5], stratifying individuals in low-moderate, high and very high risk for fatal and non-fatal CV disease at 10 years according to the SCORE-2 [5]. An analysis by subgroups was also conducted (sportspeople vs sedentary subjects). Results We included 264 consecutive participants, the average age was 47.1 +/- 5.9 years (72% female, 28% men). The main characteristics at T0, T1 and T2 of the population are summarized in Picture 1. We found a significant increase in the average CV risk, according to SCORE-2, during the follow-up in our healthy population, with a shift from a mean low-moderate risk profile (T0: 2.35%; T1: 2.49%) to a mean high-risk profile at T2 (2.80%) (Picture 2 A). In the population of physically active subjects the SCORE-2 ranged from 2.22% at T0 to 2,25% at T1 and 2,45% at T2. Whereas, in sedentary subjects the baseline SCORE-2 was 2.38%, increasing to 2,55% at T1 and reaching 2,88% at T2 (Picture 2 B). Furthermore, in our population a significant increase in total cholesterol, LDL and HDL cholesterol, glycemia, BMI, PAD and smoking habit was observed (Picture 1). Conclusions Since 2019, we observed an increase in CV risk profile in a healthy population of healthcare workers, particularly in sedentary subjects, highlighting the need to reassess SCORE-2 every year to promptly treat high-risk subjects, according to the latest Guidelines.

Influenza vaccination rates among healthcare workers: a systematic review and meta-analysis investigating influencing factors.

Healthcare workers risk of exposure to the influenza virus in their work, is a high-risk group for flu infections. Thus WHO recommends prioritizing flu vaccination for them-an approach adopted by >40 countries and/or regions worldwide. Cross-sectional studies on influenza vaccination rates among healthcare workers were collected from PubMed, EMBASE, CNKI, and CBM databases from inception to February 26, 2023. Influenza vaccination rates and relevant data for multiple logistic regression analysis, such as odds ratios (OR) and 95% confidence intervals (CI), were extracted. A total of 92 studies comprising 125 vaccination data points from 26 countries were included in the analysis. The meta-analysis revealed that the overall vaccination rate among healthcare workers was 41.7%. Further analysis indicated that the vaccination rate was 46.9% or 35.6% in low income or high income countries. Vaccination rates in the Americas, the Middle East, Oceania, Europe, Asia, and Africa were 67.1, 51.3, 48.7, 42.5, 28.5, and 6.5%, respectively. Influencing factors were age, length of service, education, department, occupation, awareness of the risk of influenza, and/or vaccines. The global influenza vaccination rate among healthcare workers is low, and comprehensive measures are needed to promote influenza vaccination among this population. www.inplysy.com, identifier: 202350051.