Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study
Eyre DW., Lumley SF., O'Donnell D., Campbell M., Sims E., Lawson E., Warren F., James T., Cox S., Howarth A., Doherty G., Hatch SB., Kavanagh J., Chau KK., Fowler PW., Swann J., Volk D., Yang-Turner F., Stoesser N., Matthews PC., Dudareva M., Davies T., Shaw RH., Peto L., Downs LO., Vogt A., Amini A., Young BC., Drennan PG., Mentzer AJ., Skelly DT., Karpe F., Neville MJ., Andersson M., Brent AJ., Jones N., Martins Ferreira L., Christott T., Marsden BD., Hoosdally S., Cornall R., Crook DW., Stuart DI., Screaton G., Watson AJR., Taylor A., Chetwynd A., Grassam-Rowe A., Mighiu AS., Livingstone A., Killen A., Rigler C., Harries C., East C., Lee C., Mason CJB., Holland C., Thompson C., Hennesey C., Savva C., Kim DS., Harris EWA., McGivern EJ., Qian E., Rothwell E., Back F., Kelly G., Watson G., Howgego G., Chase H., Danbury H., Laurenson-Schafer H., Ward HL., Hendron H., Vorley IC., Tol I., Gunnell J., Ward JLF., Drake J., Wilson JD., Morton J., Dequaire J., O'Byrne K., Motohashi K., Harper K., Ravi K., Millar LJ., Peck LJ., Oliver M., English MR., Kumarendran M., Wedlich M., Ambler O., Deal OT., Sweeney O., Cowie P., Naudé RTW., Young R., Freer R., Scott S., Sussmes S., Peters S., Pattenden S., Waite S., Johnson SA., Kourdov S., Santos-Paulo S., Dimitrov S., Kerneis S., Ahmed-Firani T., King TB., Ritter TG., Foord TH., De Toledo Z., Christie T., Gergely B., Axten D., Simons E-J., Nevard H., Philips J., Szczurkowska J., Patel K., Smit K., Warren L., Morgan L., Smith L., Robles M., McKnight M., Luciw M., Gates M., Sande N., Turford R., Ray R., Rughani S., Mitchell T., Bellinger T., Wharton V., Justice A., Jesuthasan G., Wareing S., Huda Mohamad Fadzillah N., Cann K., Kirton R., Sutton C., Salvagno C., DAmato G., Pill G., Butcher L., Rylance-Knight L., Tabirao M., Moroney R., Wright S., Peto TEA., Holthof B., O'Donnell A-M., Ebner D., Conlon CP., Jeffery K., Walker TM.
We conducted voluntary Covid-19 testing programmes for symptomatic and asymptomatic staff at a UK teaching hospital using naso-/oro-pharyngeal PCR testing and immunoassays for IgG antibodies. 1128/10,034 (11.2%) staff had evidence of Covid-19 at some time. Using questionnaire data provided on potential risk-factors, staff with a confirmed household contact were at greatest risk (adjusted odds ratio [aOR] 4.82 [95%CI 3.45–6.72]). Higher rates of Covid-19 were seen in staff working in Covid-19-facing areas (22.6% vs. 8.6% elsewhere) (aOR 2.47 [1.99–3.08]). Controlling for Covid-19-facing status, risks were heterogenous across the hospital, with higher rates in acute medicine (1.52 [1.07–2.16]) and sporadic outbreaks in areas with few or no Covid-19 patients. Covid-19 intensive care unit staff were relatively protected (0.44 [0.28–0.69]), likely by a bundle of PPE-related measures. Positive results were more likely in Black (1.66 [1.25–2.21]) and Asian (1.51 [1.28–1.77]) staff, independent of role or working location, and in porters and cleaners (2.06 [1.34–3.15]).