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., Oxford University Hospitals Staff Testing Group None., Peto TE., 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]).