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Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 27436

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Dr. Antoon De Schryver

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Occupational and Environmental Medicine, Department of Family Medicine & Population Health, University of Antwerpen, 2610 Antwerp, Belgium
Interests: occupational medicine; infectious diseases; epidemiology; occupational infectious agents; prevention; vaccination
Special Issues, Collections and Topics in MDPI journals

Dr. Koen De Schrijver

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Guest Editor

Occupational and Environmental Medicine, Department of Family Medicine & Population Health, University of Antwerpen, 2610 Antwerp, Belgium
Interests: occupational medicine; public health; infectious diseases; epidemiology; vaccination; outbreak management

Dr. Guido François

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Guest Editor

Occupational and Environmental Medicine, Department of Family Medicine & Population Health, University of Antwerpen, 2610 Antwerp, Belgium
Interests: public health; risks; healthcare workers; prevention; population; disease burden

Dr. Helena C. Maltezou

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Guest Editor

Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
Interests: vaccinations; influenza; healthcare personnel; occupational; healthcare-associated infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

During recent years, media coverage has raised public awareness of (re)emerging biological risks, the current pandemic caused by COVID-19 being a recent example. Most of the (re)emerging biological risks also cause new occupational health risks, and therefore occupational infections are not only associated with health workers, but appear as a new and increasing cause of occupational disease, while older risks like measles are re-emerging. The epidemiology of occupational infectious diseases has some special features: workers are both ‘at risk’ and ‘sources of risk’, workers may be immune, a case may be a source without being recognized as a case, there can be a need for urgency, and preventive measures (usually) have a good scientific basis.

Worldwide, an estimated 320,000 employees die annually from work-related infectious diseases. Morbidity from work-related infectious disease is probably much higher, but the true extent of incidence is difficult to establish, as data are lacking.

Undisputedly, work-related infectious disease may result in harm to the health of an individual worker and may impose a high disease burden on a population.

In this Special Issue, we invite all interested researchers to contribute to our understanding of the epidemiology of occupational (re)emerging infections and preventive strategies.

Dr. Antoon De Schryver
Dr. Koen De Schrijver
Dr. Guido François
Dr. Helena C. Maltezou
Guest Editors

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Keywords

epidemiologic studies
infectious diseases
occupational infectious agents
occupational illnesses
occupational exposure
workers/workplaces
biological agents
disease outbreaks
prevention
vaccination

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Published Papers (9 papers)

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9 pages, 318 KiB

Open AccessArticle

Attitudes toward Vaccinations and Vaccination Coverage Rates among Dental Students in Greece

by Helena C. Maltezou, Christos Rahiotis, Maria Tseroni, Phoebus Madianos and Ioannis Tzoutzas

Int. J. Environ. Res. Public Health 2022, 19(5), 2879; https://doi.org/10.3390/ijerph19052879 - 1 Mar 2022

Cited by 9 | Viewed by 2473

Abstract

Our aim was to study attitudes toward vaccinations, full vaccination rates and susceptibility rates against vaccine-preventable diseases among students attending a University Dental School. A total of 134 students were studied. Full vaccination rates were as follows: 56.5% against measles and mumps, 70.6% against rubella, 32.3% against varicella, 44.1% against hepatitis A, 45.9% against hepatitis B, and 87.7% against COVID-19. In the past decade, 63.2% of students had received a booster shot against tetanus–diphtheria, 47.8% against pertussis, and 28.1% against poliomyelitis, while 29.4% of students had been vaccinated against influenza in the past year. Susceptibility rates were 40.4% for measles, 42.4% for mumps, 28.3% for rubella, 32.3% for varicella, 55.3% for hepatitis A, 54.1% for hepatitis B, 36.8% for tetanus–diphtheria, 52.2% for pertussis, and 71.9% for poliomyelitis. Overall, 123 (91.8%) students favored mandatory vaccinations, mainly for all dentists (88.4%), while 11.6% of students favored them only for dentists who provide care to high-risk patients. In conclusion, most dental students favored mandatory vaccinations, yet we found significant vaccination gaps and susceptibility rates against vaccine-preventable diseases. Vaccinations for dental students should be intensified. A national vaccination registry for healthcare personnel including dental students is urgently needed. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

12 pages, 385 KiB

Open AccessArticle

Bacteria Associated with Healthcare-Associated Infections on Environmental Samples Obtained from Two Fire Departments

by Kelli L. Barr, Rodney X. Sturdivant, Denise N. Williams and Debra Harris

Int. J. Environ. Res. Public Health 2021, 18(22), 11885; https://doi.org/10.3390/ijerph182211885 - 12 Nov 2021

Cited by 4 | Viewed by 2501

Abstract

(1) Background: Firefighters spend about 64% of their time responding to medical emergencies and providing medical care without a patient history, which can render them vulnerable to healthcare-associated infections (HAI). Infection prevention, control, and surveillance systems have been instituted at hospitals. However, the prevalence of firefighters’ exposure to HAI is unknown. The objective of this study was to document evidence of HAI on surfaces in fire stations and engines to inform disinfection procedures and identify which pathogens might contribute to occupational exposures. (2) Methods: High-touch or high-use surfaces of two fire departments were sampled during five separate occasions. One fire station from one fire department was sampled over a 4-week period, whereas four fire stations were sampled from a different fire department only once. Sampled surfaces included: entryway floor, washing machine, medical bag, back seat of engine, keyboard of reporting computer, engine console, and uniform pants. (3) Results: Multiple statistical models determined that bacterial contamination was similar between the two fire departments and their stations. Keyboards were the most contaminated surface for all fire stations and departments, E. coli was the most common bacteria detected, and C. difficile was the least detected bacteria. Adjustments for rates of contamination found that contamination rates varied between fire stations. (4) Conclusions: Comprehensive environmental sampling and clinical studies are needed to better understand occupational exposures of firefighters to HAI. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

10 pages, 479 KiB

Open AccessArticle

COVID-19 among Health Workers in Germany—An Update

by Albert Nienhaus

Int. J. Environ. Res. Public Health 2021, 18(17), 9185; https://doi.org/10.3390/ijerph18179185 - 31 Aug 2021

Cited by 14 | Viewed by 2490

Abstract

This is an update of our report on COVID-19 among health and social welfare workers in Germany. Workers’ compensation claims for occupational diseases (OD) are recorded in a standardized database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). We analyzed which workers in the health and welfare sector are most often affected by COVID-19. For the different sectors in healthcare and welfare, the number of full-time workers is known (FTW), allowing for calculation of claim rates by sector. The period for data presentation was extended to 3 May 2021 for this update. The cumulative number of COVID-19 claims increased from 4398 by May 2020 to 84,728 by May 2021. The majority of claims concern nursing homes (39.5%) and hospitals (37.6%). Nursing is the profession most often concerned (68.8%). Relative to the number of workers, the claim rate is highest for hospitals (41.3/1000 FTW). Seventy-seven workers died (0.09%) and three hundred and seventy-five (0.4%) were hospitalized. A total of 65,693 (77.5%) claims were assessed, and for 81.4% of these claims, the OD was confirmed. The number of health and welfare workers affected by COVID-19 is high. With most HW vaccinated by now in Germany, within the next few weeks or months, the number of new cases should decrease. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

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12 pages, 11963 KiB

Open AccessArticle

Indoor Air Quality Evaluation Using Mechanical Ventilation and Portable Air Purifiers in an Academic Dentistry Clinic during the COVID-19 Pandemic in Greece

by Ioannis Tzoutzas, Helena C. Maltezou, Nikolaos Barmparesos, Panagiotis Tasios, Chrysanthi Efthymiou, Margarita Niki Assimakopoulos, Maria Tseroni, Rengina Vorou, Fotios Tzermpos, Maria Antoniadou, Vassilios Panis and Phoebus Madianos

Int. J. Environ. Res. Public Health 2021, 18(16), 8886; https://doi.org/10.3390/ijerph18168886 - 23 Aug 2021

Cited by 26 | Viewed by 4517

Abstract

The coronavirus disease 2019 (COVID-19), which is mainly transmitted through droplets without overlooking other sources of transmission, rendered attention on the air quality in indoor areas and more specifically in healthcare settings. The improvement of indoor air quality (IAQ) is ensured by frequent changes of the air that must be carried out in healthcare areas and with assistance from special devices that undertake the filtration of the air and its purification through special filters and lamps. In this research, the performance of air purifiers is assessed in terms of the limitation of PM_2.5, PM₁₀, VOCs and CO₂ in a postgraduate clinic of the Dentistry School of the National and Kapodistrian University of Athens in parallel with mechanical ventilation. Our findings indicate that the use of mechanical ventilation plays a key role on the results, retaining good IAQ levels within the clinic and that air purifiers show a positive impact on IAQ by mainly reducing the levels of PM_2.5 and secondly of TVOC. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

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6 pages, 329 KiB

Open AccessArticle

Estimated SARS-CoV-2 Infection and Seroprevalence in Firefighters from a Northeastern Brazilian State: A Cross-Sectional Study

by Lysandro P. Borges, Laranda C. Nascimento, Luana Heimfarth, Daniela R. V. Souza, Aline F. Martins, José M. de Rezende Neto, Kezia A. dos Santos, Igor L. S. Matos, Grazielly B. da Invenção, Brenda M. Oliveira, Aryanne A. Santos, Nicolas A. A. Souza, Pamela C. de Jesus, Cliomar A. dos Santos, Marco A. O. Goes, Mércia S. F. de Souza and Adriana G. Guimarães

Int. J. Environ. Res. Public Health 2021, 18(15), 8148; https://doi.org/10.3390/ijerph18158148 - 1 Aug 2021

Cited by 3 | Viewed by 2134

Abstract

The new coronavirus has been affecting health worldwide and essential service workers are continually exposed to this infectious agent, increasing the chance of infection and the development of the disease. Thus, this study aimed to estimate the frequency of infection and seroprevalence for SARS-CoV-2 in military firefighters in a city in Northeastern Brazil in January 2021. An observational cross-sectional study was carried out with 123 firefighters who answered a brief questionnaire to collect socio-epidemiological data and underwent RT-PCR and immunofluorescence test (IgM and IgG). The results found reveal a positive seroprevalence, with a high rate of infection in this class of workers, since they are essential service professionals who are exposed to risk due to their working hours, in addition to sharing some spaces and work materials. Besides, there were significant associations between positivity for IgG and IgM, as well as for positive RT-PCR prior to the study and the presence of IgG, with odd ratios of 3.04 and 4.9, respectively. These findings reinforce the need for immunization in this category, whose line of service hinders the adoption of distancing measures, since in many situations physical contact is inevitable. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

9 pages, 297 KiB

Open AccessArticle

Latent Tuberculosis Infection among Health Workers in Germany—A Retrospective Study on Progression Risk and Use of Preventive Therapy

by Nika Zielinski, Johanna Stranzinger, Hajo Zeeb, Jan Felix Kersten and Albert Nienhaus

Int. J. Environ. Res. Public Health 2021, 18(13), 7053; https://doi.org/10.3390/ijerph18137053 - 1 Jul 2021

Cited by 8 | Viewed by 2876

Abstract

Despite the decline in tuberculosis incidence (TB) in Germany, health workers (HW) are at greater risk of becoming infected with Mycobacterium tuberculosis. To date, little is known about the risk of progression of latent tuberculosis infections (LTBI) and the use of Tuberculosis Preventive Therapy (TPT) among HW. Routine data from the German Statutory Institution for Accident Insurance and Prevention for Health and Welfare Services (BGW) were analysed and a retrospective survey was conducted. A self-administered questionnaire was sent to 1711 HW who had received recognition of an LTBI as an occupational disease between the years 2009 and 2018. The response rate was 42.3% after correcting for those with no actual address (20.4%). We included 575 HW in the data analysis of the retrospective survey. The cumulative incidence of progression, the incidence density and the associated 95% confidence interval (95% CI) were calculated. Three progressive cases were identified in the analysis of the routine data. In the survey cohort, three HW developed TB during the observation period of 5.4 years on average (standard deviation: 2.8 years; interquartile range: 5.0 years). The cumulative TB incidence was 0.52% in the survey group (95% CI: 0.14% to 1.65%). The incidence density was 0.97 cases per 1000 person years (95% CI: 0.25 to 3.10). One-third of the respondents underwent TPT. Significant differences were observed between age and activity groups in the use of TPT, but not between the genders, year of diagnosis or the reason for performing the screening. The data indicate that the risk of progression of an LTBI is low for HW. However, one-third of the HW had undergone TPT. Information about the expected progression risk is important so that it can be weighed against the risk of side effects of TPT. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

14 pages, 602 KiB

Open AccessArticle

COVID-19 Vaccination: Status and Willingness to Be Vaccinated among Employees in Health and Welfare Care in Germany

by Agnessa Kozak and Albert Nienhaus

Int. J. Environ. Res. Public Health 2021, 18(13), 6688; https://doi.org/10.3390/ijerph18136688 - 22 Jun 2021

Cited by 22 | Viewed by 3458

Abstract

Healthcare workers are at particular risk due to their occupational exposure to SARS-CoV-2. Therefore, they belong to the top priority group for vaccination. However, earlier studies show that nursing staff in particular are hesitant to be inoculated. This study presents the current picture with regard to vaccination status, willingness, vaccine preference, and reasons for or against a COVID-19 vaccination among health and welfare workers. An online survey was conducted between 4 March and 10 April 2021 among professional associations and providers of health and social services. Data sets of n = 3401 participants were analyzed. Of these, 62% stated that they had already been vaccinated at least once. A further 22% wanted to be vaccinated, while 6.6% were still hesitant and 9% refused to be vaccinated. Preference was given to predominantly mRNA-based vaccines. Altogether, there was a high vaccination rate and a great willingness to be vaccinated (>80%) across all professional groups and fields of work. Among nursing staff, the total figure was 83.5%. The percentage was highest in geriatric care at 87.5%. Contrary to findings of earlier surveys, vaccination willingness has risen in all professional groups during the course of the vaccination campaign in Germany. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

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16 pages, 749 KiB

Open AccessArticle

Validity and Reliability of Self-Assessment Tool for Risk Prioritization Following Exposure to Tuberculosis in a Hospital Setting

by Piyapong Sirinapakul, Naesinee Chaiear and Phanumas Krisorn

Int. J. Environ. Res. Public Health 2021, 18(8), 3981; https://doi.org/10.3390/ijerph18083981 - 9 Apr 2021

Cited by 1 | Viewed by 2572

Abstract

The Modified Self-Assessment (MSA) and Present Self-Assessment (PSA) forms are questionnaires used to prioritize the risk of infection of health workers exposed to tuberculosis (TB) in Srinagarind Hospital in Thailand. As MSA was developed from PSA, the validity and reliability of MSA need to be assessed. The research aim is to examine the content validity of MSA and to assess the respective reliability of MSA and PSA vis-à-vis expert opinion. Seven experts determined the content validity index (CVI) of MSA. MSA and PSA were used to prioritize the TB contact of 108 subjects, and we compared the result with the risk assessed by the experts. The respective Kappa agreements between MSA and PSA and the experts were used to assess reliability. The result of the content validity index revealed that MSA had I-CVI > 0.83 for all questions and an S-CVI/Ave above 0.90 for all factors. The Kappa agreement of contact priority between MSA and the experts was 0.80; it was 0.58 between PSA and the experts. MSA can, thus, be used to prioritize contact with tuberculosis in Srinagarind Hospital. MSA is a valid risk communication tool for aerosol-generating procedures. Further study should be conducted in other hospitals, and the number of participants should be increased in order to come to a concrete result. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

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9 pages, 333 KiB

Open AccessPerspective

Influenza Vaccination Programs for Healthcare Personnel: Organizational Issues and Beyond

by Helena C. Maltezou, Eleni Ioannidou, Koen De Schrijver, Guido François and Antoon De Schryver

Int. J. Environ. Res. Public Health 2021, 18(21), 11122; https://doi.org/10.3390/ijerph182111122 - 22 Oct 2021

Cited by 10 | Viewed by 2317

Abstract

Healthcare personnel (HCP) are a high priority group for influenza vaccination aiming to protect them but also to protect vulnerable patients and healthcare services from healthcare-associated influenza and HCP absenteeism. Multi-component influenza vaccination programs targeting behavioral, organizational, and administrative barriers are critical, if influenza vaccination rates among HCP are to be raised on a sustained basis. Mandatory influenza vaccination policy is the only single intervention that can achieve high and sustainable vaccination rates in HCP in short term. In this article, we provide an overview of issues pertaining to influenza vaccination of HCP, with an emphasis on organizational issues of influenza vaccination programs. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology 2020: The Importance of (Re)Emerging Occupational Infectious Agents)

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