Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study
David W. Eyre, Sheila Lumley, Denise O’Donnell, Mark Campbell, Elizabeth Sims, Elaine Lawson, Fiona C Warren, Tim James, Stuart Cox, Alison Howarth, George Doherty, Stephanie B. Hatch, James Kavanagh, Kevin Chau, Philip W. Fowler, Jeremy Swann, Denis Volk, Fan Yang-Turner, Nicole Stoesser, Philippa C. Matthews, Maria Dudareva, T. J. Davies, R. H. Shaw, Leon Peto, Louise Downs, Alexander Vogt, Ali Amini, Bernadette Young, Philip G. Drennan, Alexander J. Mentzer, Donal Skelly, Fredrik Karpe, Matt J. Neville, Monique Andersson, Andrew Brent, Nicola Jones, Lucas Martins Ferreira, Thomas Christott, Brian D. Marsden, Sarah Hoosdally, Richard J. Cornall, Derrick W. Crook, David I. Stuart, Gavin Screaton, Adam Watson, A Taylor, Alan Chetwynd, Alexander Grassam-Rowe, Alexandra Mighiu, Angus Livingstone, Annabel Killen, Caitlin Rigler, Callum Harries, Cameron East, Charlotte Lee, Chris Mason, Christian Holland, Connor Thompson, Conor Hennesey, Constantinos Savva, David Kim, Edward Harris, Euan J McGivern, Evelyn Qian, Evie Rothwell, Francesca Back, Gabriella Kelly, Gareth Watson, Gregory Howgego, Hannah Chase, Hannah Danbury, Hannah Laurenson-Schafer, Harry Ward, Holly Hendron, Imogen C Vorley, Isabel Tol, James Gunnell, Jocelyn Ward, Jonathan Drake, Joseph D. Wilson, Joshua Morton, Julie Dequaire, Katherine O’Byrne, Kenzo Motohashi, Kirsty Harper, Krupa Ravi, Lancelot Jamie Millar, Liam J Peck, Madeleine Oliver, Marcus Rex English, Mary Kumarendran, Matthew Wedlich, Olivia Ambler, Oscar Deal, Owen Sweeney, Philip Cowie, Rebecca te Water Naudé, Rebecca Young, Rosie Freer, Samuel Scott
Abstract
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]).