P2/N95 fit testing and the risk of COVID-19 in Healthcare Workers.

Autor: Collis B; Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia. Electronic address: brennan.collis@nh.org.au., Tacey M; Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia; Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia., McGrath C; Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia., Madigan V; Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia., Kainer M; Department of Infectious Diseases, Western Health, 176 Furlong Road, St. Albans, Victoria, 3021, Australia., Tramontana A; Department of Infectious Diseases, Western Health, 176 Furlong Road, St. Albans, Victoria, 3021, Australia., Aboltins C; Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia; Northern Clinical School, The University of Melbourne, 185 Cooper Street, Epping, Victoria, 3076, Australia.
Jazyk: angličtina
Zdroj: Infection, disease & health [Infect Dis Health] 2024 Feb; Vol. 29 (1), pp. 8-14. Date of Electronic Publication: 2023 Aug 10.
DOI: 10.1016/j.idh.2023.07.005
Abstrakt: Background: Guidelines recommend healthcare workers (HCWs) undertake fit testing of P2/N95 respirators to mitigate the risk of infectious aerosols, however few studies have assessed whether fit testing reduces COVID-19 infection.
Methods: A retrospective cohort study was conducted amongst HCWs across two tertiary health services in Melbourne, Australia during a period of low community transmission. Institution-wide quantitative fit testing and detailed questionnaires assessing COVID-19 acquisition risk factors were undertaken from September 2020. HCWs diagnosed with COVID-19 in the period prior to the fit testing program (February 1st - August 31st 2020) were matched on a 1:3 ratio to HCWs who had not been diagnosed with COVID-19. Risk factors for COVID-19 acquisition, including fit testing outcome, were compared between groups.
Results: A total of 1571 HCWs took part in fit testing programs. Seventy-two (4.6%) were diagnosed with COVID-19 within the study period. Younger age, nursing staff, close contact with a COVID-19 case, and working longer periods in wards with COVID-19 patients, were associated with COVID-19 infection. After matching for intensity of occupational exposure to infectious aerosols, close contact was the only independent variable associated with COVID-19 infection (OR 3.50, 95% CI:1.65-7.44, p = 0.001). Adequate fit test for the respirator predominately worn before the fit testing period was not associated with COVID-19 (OR 1.08, 95% CI:0.59-1.98, p = 0.815).
Conclusion: After controlling for intensity of occupational exposure to infectious aerosols, P2/N95 respirator fit testing was not associated with reduced risk of COVID-19 infection. The utility of widespread fit testing to reduce HCW COVID-19 infections should be reconsidered.
(Copyright © 2023 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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