TY - JOUR
T1 - Healthcare personnel exposure in an emergency department during influenza season
AU - Rule, Ana M.
AU - Apau, Otis
AU - Ahrenholz, Steven H.
AU - Brueck, Scott E.
AU - Lindsley, William G.
AU - de Perio, Marie A.
AU - Noti, John D.
AU - Shaffer, Ronald E.
AU - Rothman, Richard
AU - Grigorovitch, Alina
AU - Noorbakhsh, Bahar
AU - Beezhold, Donald H.
AU - Yorio, Patrick L.
AU - Perl, Trish M.
AU - Fisher, Edward M.
N1 - Funding Information:
This research was funded by the Centers for Disease Control and Prevention and in part by BARDA 1 IDSEP130014-01-00 and NIH HHSN272201400007C. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to thank the staff of the Johns Hopkins Hospital adult emergency department and the ResPECT team and investigators for their help and support in this study. Dr. Rothman is supported in part by BARDA 1 IDSEP130014-01-00 and NIH HHSN272201400007C. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. Mention of any company, product, policy, of the inclusion of any reference does not constitute endorsement by NIOSH. We would also like to thank our reviewers, Dr. Raymond Roberge, Dr. Lewis Radonovich, Michael Bergman, and Judi Coyne.
Publisher Copyright:
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2018/8
Y1 - 2018/8
N2 - Introduction Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care. Methods Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction. Results Influenza was identified in 42% (53/125) of personal bioaerosol samples, 43% (28/ 96) of room bioaerosol samples, 76% (23/30) of pooled surface samples, and 25% (3/12) of the filtering facepiece respirators analyzed. Influenza copy numbers were greater in personal bioaerosol samples (17 to 631 copies) compared to room bioaerosol samples (16 to 323 copies). Regression analysis suggested that the amount of influenza in personal samples was approximately 2.3 times the amount in room samples (Wald χ2 = 16.21, p<0.001). Conclusions Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.
AB - Introduction Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care. Methods Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction. Results Influenza was identified in 42% (53/125) of personal bioaerosol samples, 43% (28/ 96) of room bioaerosol samples, 76% (23/30) of pooled surface samples, and 25% (3/12) of the filtering facepiece respirators analyzed. Influenza copy numbers were greater in personal bioaerosol samples (17 to 631 copies) compared to room bioaerosol samples (16 to 323 copies). Regression analysis suggested that the amount of influenza in personal samples was approximately 2.3 times the amount in room samples (Wald χ2 = 16.21, p<0.001). Conclusions Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.
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U2 - 10.1371/journal.pone.0203223
DO - 10.1371/journal.pone.0203223
M3 - Article
C2 - 30169507
AN - SCOPUS:85053001533
SN - 1932-6203
VL - 13
JO - PLoS One
JF - PLoS One
IS - 8
M1 - e0203223
ER -