Objectives To compare the impact of occupational exposures to SARS-CoV-2 positive patients and SARS-CoV-2 positive coworkers, by comparing the frequency of occupational exposure incidents and the rate of healthcare personnel (HCP) who developed a positive PCR test for SARS-COV-2 after occupational exposure to the two different types of infectious individuals.
Methods A retrospective analysis of all confirmed higher risk occupational exposure incidents that occurred in HCP from 20 March 2020 to 31 December 2020 at a large multisite US academic medical centre. Comparisons between groups for source type were performed using unpaired Student’s t-test for continuous variables and the χ2 test for categorical variables, regression analysis was conducted to assess the associations between source type and risk of positive COVID-19 test after occupational exposure.
Results In total, 2253 confirmed medium or high-risk occupational exposures occurred during the study period. 57% were exposures from coworker sources. Each source individual exposed a mean of 2.6 (95% CI 2.3 to 2.9) HCP; during postexposure surveillance, 4.5% of exposed HCP tested positive within 14 days. A coworker source on average exposed 2.2 (95% CI 2.01 to 2.4) other HCP and infected 0.14 (95% CI 0.1 to 0.17) HCP, while patient sources exposed a mean of 3.4 (95% CI 2.6 to 4.2) HCP but only infected 0.07 (95% CI 0.04 to 0.11) HCP. The multivariate analysis demonstrated that exposure to a coworker source carried a higher risk of testing positive compared with exposure to a patient source (OR 3.22; 95% CI 1.72 to 6.04).
Conclusion Occupational exposures to coworker sources were not only more frequent but also associated with triple the risk of developing COVID-19 infection, compared with exposures to patient sources.
- Healthcare personnel
- Occupational exposures
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
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Contributors WF contributed to the planning of the study, data collection, interpretation of data, manuscript writing, and submitted the study. LB contributed to the conception of the study protocol and IRB submission, data interpretation and manuscript writing. VS contributed to the study question, data collection, and manuscript writing. ZW analysed the data and revised the manuscript method and statistical section. CH contributed to the data collection and revised the manuscript critically for important intellectual content. MS contributed substantially to the study planning, conception of the study protocol and IRB submission, data interpretation and manuscript writing. WF, LB and MS had full access to all of the data in the study and takes responsibility as guarantors for the integrity and accuracy of the data and the overall content.
Funding This work was supported by the Division of Public Health, Infectious Diseases and Occupational Medicine at Mayo Clinic, Rochester.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.