Virus Exposure of Healthcare Workers in Healthcare Settings

Introduction Healthcare workers are at risk for contracting viral respiratory infections while providing care to patients with infectious diseases, therefore, understanding the infection risk posed by common respiratory viruses is very important to prevent occupationally-acquired infections among healthcare workers in the future. Method Healthcare activities for 52 patients with viral respiratory infections were observed in an acute care hospital. Pathogens were measured in the air a fixed location in the patient room, and in the breathing zone of healthcare workers using the NIOSH 2-stage cyclone samplers. Environmental surfaces were sampled using pre-moistened Copan swabs at the beginning and at the end of the experiment. Personal protective equipment worn by healthcare worker participants were swabbed with the Copan swabs. Environmental contact patterns of healthcare workers and patients were recorded. Personal protective equipment doffing practices of healthcare workers were also observed. Results Virus was present in 43% of stationary air samples, with a mean virus concentration of 7737 copies/m3, and 22% of the personal breathing zone air samples, with a mean virus concentration of 3 x 106 copies/m3. The presence of virus in stationary air samples was associated with the patient receiving five or more visits from healthcare worker during the 3-hour observation period. Virus was commonly found on environmental surfaces at the beginning and at the end of the 3-hour observation period. The presence of virus on some surfaces was correlated with the number of contacts with that surface by healthcare workers, including telephone, the IV pole, the exterior bed control panel. Virus was found on the gloves, facemask, gowns, personal stethoscope of healthcare workers. In addition, virus was found on the bare hands, face and scrubs of healthcare workers. We found that deviations from the recommended personal protective equipment doffing protocol are common. Conclusion Overall, our findings indicate that healthcare workers are exposed to respiratory viruses through multiple routes, including inhalation and contact. There is a substantial need to improve doffing practices of healthcare worker, but these were not specifically linked to virus exposure in this study.