medigraphic.com
ISSN 1561-3054 (Electronic)

2021, Number 3

<< Back Next >>

Rev Cubana Med Trop 2021; 73 (3)

Infection control in occupational COVID-19 prevention among healthcare workers

Ramos LSS, Tafur QKT, Pinedo CC, Cardenas JAR

Language: Spanish
References: 64
Page: 1-21
PDF size: 473.51 Kb.


ABSTRACT

The COVID-19 pandemic affects healthcare workers as well. Reports are available of the susceptibility of these workers during daily practice. The policies in place and the implementation of three infection control measures: administrative, environmental and related to respiratory protection, require great involvement of all healthcare professionals, from decision-makers to the personnel in direct contact with infected patients. This is the reason why teamwork is decisive for the success of these strategies. It should be pointed out that each health institution will have different infection control needs, but the main administrative measures in all of them are the formation of an infection control team and the implementation of risk assessment actions. The key environmental measure is the disinfection of surfaces and environments. It is therefore necessary to foster an appropriate distribution of spaces facilitating cross-ventilation with the aid of natural or mechanical ventilation, besides the possibility of using germicidal UV light for environmental disinfection. With respect to respiratory protection, it is indispensable to have access to the protection equipment required by the level of risk to which the health personnel are exposed. Application of these strategies in the current context of occupational COVID-19 transmission, will make it possible to reinforce the capacities already installed in health systems clearly affected by the pandemic.


REFERENCES

  1. Zhang W, Wang K, Yin L, Zhao W, Xue Q, Peng M, et al. Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. Psychother Psychosom. 2020;89(4):242-50. Doi: https://doi.org/10.1159/000507639.

  2. Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020. Doi: https://doi.org/ 10.1016/j.bbi.2020.04.049.

  3. World Health Organization. Coronavirus Disease 2019 (COVID-19). Situation Report 82 [Internet]. WHO. 2020 [acceso: 28/05/2020]. Disponible en: Disponible en: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200411-sitrep-82-covid-19.pdf?sfvrsn=74a5d15_2.

  4. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. Doi: https://doi.org/10.1001/jama.2020.1585.

  5. Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk factors of healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis. 2020. Doi: https://doi.org/10.1093/cid/ciaa287.

  6. Heinzerling A, Stuckey MJ, Scheuer T, Xu K, Perkins KM, Resseger H, et al. Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient - Solano County, California, February 2020. MMWR. 2020;69(15):472-6. Doi: https://doi.org/10.15585/mmwr.mm6915e5.

  7. Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 Novel Coronavirus Diseases (COVID-19)-China, 2020. China CDC Weekly. 2020;2. Doi: https://doi.org/10.3760/cma.j.issn.0254-6450.2020.02.003.

  8. Jin YH, Huang Q, Wang YY, Zeng XT, Luo LS, Pan ZY, et al. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey. Mil Med Res. 2020;7(1):24. Doi: https://doi.org/10.1186/s40779-020-00254-8.

  9. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw open. 2020;3(3):e203976. Doi: https://doi.org/10.1001/jamanetworkopen.2020.3976.

  10. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7. Doi: https://doi.org/10.1056/NEJMc2004973.

  11. World Health Organization. Transmission of SARS-CoV-2 - implications for infection prevention precautions: Scientific brief 09 July 2020 [Internet]. WHO. 2020 [acceso: 11/11/2020]. Disponible en: Disponible en: https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions.

  12. World Health Organization. Infection prevention and control during health care when COVID-19 is suspected. Interim guidance 19 March 2020 [Internet]. WHO. 2020 [acceso: 28/11/2020]. Disponible en: Disponible en: https://apps.who.int/iris/rest/bitstreams/1272420/retrieve.

  13. European Centre for Disease Prevention and Control. Infection prevention and control for COVID-19 in healthcare settings. Third update. 13 May 2020 [Internet]. ECDC Technical Report. Stockholm; 2020. [acceso: 28/05/2020]. Disponible en: Disponible en: https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-covid-19-healthcare-settings.

  14. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) : Interim infection prevention and control recommendations for healthcare personnel during Coronavirus Disease 2019 (COVID-19) pandemic. Updated July 15, 2020 [Internet]. CDC. 2020 [acceso: 20/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.

  15. World Health Organization. Minimum requirements for infection prevention and control programmes [Internet]. WHO. Geneva: World Health Organization; 2019 [acceso: 28/05/2020]. Disponible en: Disponible en: https://www.who.int/infection-prevention/publications/min-req-IPC-manual/en/.

  16. Centers for Disease Control and Prevention. Infection control in healthcare personnel: Infrastructure and routine practices for occupational infection prevention and control services. Updated: October 25, 2019. CDC; 2019. [acceso: 05/06/2020]. Disponible en: Disponible en: https://www.cdc.gov/infectioncontrol/pdf/guidelines/infection-control-HCP-H.pdf.

  17. World Health Organization. Severe Acute Respiratory Infection (SARI) Treatment facility design. Training Modules. WHO. 2020. [acceso: 06/06/2020]. Disponible en: Disponible en: https://openwho.org/courses/SARI-facilities.

  18. Bauchner H, Fontanarosa PB, Livingston EH. Conserving Supply of Personal Protective Equipment-A Call for Ideas. JAMA. 2020;323(19):1911. Doi: https://doi.org/10.1001/jama.2020.4770.

  19. Livingston E, Desai A, Berkwits M. Sourcing personal protective equipment during the COVID-19 pandemic. JAMA - J Am Med Assoc. 2020;2019:E1-3. Doi: https://doi.org/10.1001/jama.2020.5317.

  20. Atkinson J, Chartier Y, Pessoa-silva CL, Jensen P, Li Y, Seto W-H. Natural ventilation for infection control in health-care settings. WHO Publication/Guidelines. Geneva, 2009[acceso: 2/06/2020]. Disponible en: Disponible en: https://www.who.int/water_sanitation_health/publications/natural_ventilation/en/.

  21. Peters AW, Chawla KS, Turnbull ZA. Transforming ORs into ICUs. N Engl J Med. 2020;382(19):e52. Doi: https://doi.org/10.1056/NEJMc2010853.

  22. Yager PH, Whalen KA, Cummings BM. Repurposing a pediatric ICU for adults. N Engl J Med. 2020;e80. Doi: https://doi.org/10.1056/nejmc2014819.

  23. Meselson M. Droplets and aerosols in the transmission of SARS-CoV-2. N Engl J Med. 2020;2009324. Doi: https://doi.org/10.1056/nejmc2009324.

  24. Lewis D. Is the coronavirus airborne? Experts can’t agree. Nature. 2020;580(7802):175-175. Doi: https://doi.org/10.1038/d41586-020-00974-w.

  25. Morawska L, Cao J. Airborne transmission of SARS-CoV-2: The world should face the reality. Environ Int. 2020;139:105730. Doi: https://doi.org/10.1016/j.envint.2020.105730.

  26. World Health Organization. Infection Prevention and Control (IPC) for Novel Coronavirus (COVID-19). Training module. WHO. 2020. [acceso: 05/06/2020]. Disponible en: Disponible en: https://openwho.org/courses/COVID-19-IPC-EN.

  27. Somsen GA, van Rijn C, Kooij S, Bem RA, Bonn D. Small droplet aerosols in poorly ventilated spaces and SARS-CoV-2 transmission. Lancet Respir Med. 2020;2600(20):9-10. Doi: https://doi.org/10.1016/S2213-2600(20)30245-9.

  28. Morawska L, Johnson GR, Ristovski ZD, Hargreaves M, Mengersen K, Corbett S, et al. Size distribution and sites of origin of droplets expelled from the human respiratory tract during expiratory activities. J Aerosol Sci. 2009;40(3):256-69. Doi: https://doi.org/10.1016/j.jaerosci.2008.11.002.

  29. World Health Organization. WHO Policy on TB Infection Control in health-care facilities, congregate settings and households. WHO. 2009[acceso: 05/06/2020]. Disponible en:Disponible en:https://apps.who.int/iris/bitstream/handle/10665/44148/9789241598323_eng.pdf?sequence=1&isAllowed=y.

  30. Sehulster LM, Chinn RYW, Arduino MJ, Carpenter J, Donlan R, Ashford D, et al. Guidelines for environmental infection control in health-care facilities. Recommendations from CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Updated: July 2019 [Internet]. CDC. 2003 [acceso: 05/06/2020]. Disponible en: Disponible en: https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf.

  31. Walker CM, Ko G. Effect of ultraviolet germicidal irradiation on viral aerosols. Environ Sci Technol. 2007;41(15):5460-5. Doi: https://doi.org/10.1021/es070056u.

  32. Welch D, Buonanno M, Grilj V, Shuryak I, Crickmore C, Bigelow AW, et al. Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases. Sci Rep. 2018;8(1):1-7. Doi: https://doi.org/10.1038/s41598-018-21058-w.

  33. Tseng CC, Li CS. Inactivation of virus-containing aerosols by ultraviolet germicidal irradiation. Aerosol Sci Technol. 2005;39(12):1136-42. Doi: https://doi.org/10.1080/02786820500428575.

  34. Nardell EA, Nathavitharana RR. Airborne spread of SARS-CoV-2 and a potential role for air disinfection. JAMA. 2020. Doi: https://doi.org/10.1001/jama.2020.7603.

  35. Mphaphlele M, Dharmadhikari AS, Jensen PA, Rudnick SN, Van Reenen TH, Pagano MA, et al. Institutional tuberculosis transmission: Controlled trial of upper room ultraviolet air disinfection: A basis for new dosing guidelines. Am J Respir Crit Care Med. 2015;192(4):477-84. Doi: https://doi.org/10.1164/rccm.201501-0060OC.

  36. Nardell E, Vincent R, Sliney DH. Upper-room ultraviolet germicidal irradiation (UVGI) for air disinfection: A symposium in print. Photochem Photobiol. 2013;89(4):764-9. Doi: https://doi.org/10.1111/php.12098.

  37. Rudnick SN, McDevitt JJ, Hunt GM, Stawnychy MT, Vincent RL, Brickner PW. Influence of ceiling fan’s speed and direction on efficacy of upperroom, ultraviolet germicidal irradiation: Experimental. Build Environ. 2015;92:756-63. Doi: https://doi.org/10.1016/j.buildenv.2014.03.025.

  38. Rahman SF, Rudnick SN, Milonova SP, McDevitt JJ, Nardell EA. Influence of bioaerosol source location and ceiling fan direction on Eggcrate Upper-room Ultraviolet Germicidal Irradiation. Br J Appl Sci Technol. 2014;4(26):3856-61. Doi: https://doi.org/10.9734/BJAST/2014/11762.

  39. Nardell EA. Indoor environmental control of tuberculosis and other airborne infections. Indoor Air. 2016;26(1):79-87. Doi: https://doi.org/ 10.1111/ina.12232.

  40. Ye G, Lin H, Chen S, Wang S, Zeng Z, Wang W, et al. Environmental contamination of SARS-CoV-2 in healthcare premises. J Infect. 2020. Doi: https://doi.org/10.1016/j.jinf.2020.04.034.

  41. Wu S, Wang Y, Jin X, Tian J, Liu J, Mao Y. Environmental contamination by SARS-CoV-2 in a designated hospital for coronavirus disease 2019. Am J Infect Control. 2020. Doi: https://doi.org/10.1016/j.ajic.2020.05.003.

  42. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246-51. Doi: https://doi.org/10.1016/j.jhin.2020.01.022.

  43. Ren SY, Wang WB, Hao YG, Zhang HR, Wang ZC, Chen YL, et al. Stability and infectivity of coronaviruses in inanimate environments. World J Clin Cases. 2020;8(8):1391-9. Doi: https://doi.org/10.12998/WJCC.V8.I8.1391.

  44. Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY, et al. Air, surface environmental, and personal protective equipment contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323(16):1610-2. Doi: https://doi.org/10.1001/jama.2020.3227.

  45. Fiorillo L, Cervino G, Matarese M, D’amico C, Surace G, Paduano V, et al. COVID-19 surface persistence: A recent data summary and its importance for medical and dental settings. Int J Environ Res Public Health. 2020;17(9). Doi: https://doi.org/10.3390/ijerph17093132.

  46. World Health Organization. Advice on the use of masks in the context of COVID-19: interim guidance 5 June 2020 [Internet]. WHO. 2020 [acceso: 08/06/2020]. Disponible en: Disponible en: https://apps.who.int/iris/handle/10665/332293.

  47. Chinese Center for Disease Control and Prevention. Guidelines for personal protection of specific groups from COVID-19. China CDC Weekly. 2020;2(19):341-3. Doi: https://doi.org/10.46234/ccdcw2020.087.

  48. World Health Organization. Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care [Internet]. WHO. Geneva: World Health Organization ; 2014 [acceso: 28/05/2020]. Disponible en: Disponible en: http://apps.who.int/iris/bitstream/10665/112656/1/9789241507134_eng.pdf?ua=1.

  49. European Centre for Disease Prevention and Control. Personal protective equipment (PPE) needs in healthcare settings for the care of patients with suspected or confirmed novel coronavirus (2019-nCoV). February 2020 [Internet]. Stockholm: ECDC Technical Report; 2020 [acceso: 05/05/2020]. Disponible en: Disponible en: https://www.ecdc.europa.eu/en/publications-data/personal-protective-equipment-ppe-needs-healthcare-settings-care-patients.

  50. Derrick JL, Chan YF, Gomersall CD, Lui SF. Predictive value of the user seal check in determining half-face respirator fit. J Hosp Infect. 2005;59(2):152-5. Doi: https://doi.org/10.1016/j.jhin.2004.09.009.

  51. European Centre for Disease Prevention and Control. Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. February 2020 [Internet]. ECDC Technical Report. Stockholm: ECDC; 2020 [acceso: 05/06/2020]. Disponible en: Disponible en: https://www.ecdc.europa.eu/en/publications-data/guidance-wearing-and-removing-personal-protective-equipment-healthcare-settings.

  52. World Health Organization. COVID-19: How to put on and take off personal protective equipment (PPE). Posters. 22 Apr 2020 [Internet]. WHO. 2020[acceso: 04/06/2020]. Disponible en: Disponible en: https://www.who.int/csr/resources/publications/putontakeoffPPE/en/.

  53. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19 ) Using Personal Protective Equipment ( PPE ). Updated July 14, 2020 [Internet]. CDC. 2020 [acceso:10/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html.

  54. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Optimizing supply of PPE and other equipment during shortages. Updates July 16, 2020 [Internet]. CDC. 2020 [acceso: 19/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.

  55. The National Institute for Occupational Safety and Health (NIOSH). Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings [Internet]. CDC. Centers for Disease Control and Prevention; 2020 [acceso: 21/05/2020]. Disponible en: Disponible en: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html.

  56. Fisher EM, Shaffer RE. Considerations for recommending extended use and limited reuse of filtering facepiece respirators in health care settings. J Occup Environ Hyg. 2014;11(8):115-28. Doi: https://doi.org/10.1080/15459624.2014.902954.

  57. Food and Drug Administration. Coronavirus Disease 2019 (COVID-19) Emergency Use Authorizations for Medical Devices | FDA [Internet]. FDA. 2020 [acceso: 20/07/2020]. Disponible en: Disponible en: https://www.fda.gov/medical-devices/emergency-use-authorizations-medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices.

  58. Centers for Disease Control and Prevention. COVID-19 Decontamination and reuse of filtering facepiece respirators. Updated April 30, 2020 [Internet]. CDC. 2020 [acceso: 10/06/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html.

  59. Polkinghorne A, Branley J. Evidence for decontamination of single-use filtering facepiece respirators. J Hosp Infect. 2020;105(4):663-9. Doi: https://doi.org/10.1016/j.jhin.2020.05.032.

  60. Lindsley WG, Martin SB, Thewlis RE, Sarkisian K, Nwoko JO, Mead KR, et al. Effects of Ultraviolet Germicidal Irradiation (UVGI) on N95 Respirator Filtration Performance and Structural Integrity. J Occup Environ Hyg. 2015;12(8):509-17. Doi: https://doi.org/10.1080/15459624.2015.1018518.

  61. Cramer A, Tian E, Galanek M, Lamere E, Li J, Gupta R, et al. Assessment of the Qualitative Fit Test and Quantitative Single-Pass Filtration Efficiency of disposable N95 masks following gamma irradiation. JAMA Netw open. 2020;3(5):e209961. Doi: https://doi.org/10.1001/jamanetworkopen.2020.9961.

  62. Centers for Disease Control and Prevention. Coronavirus Disease 2019 ( COVID-19 ) Considerations for release of stockpiled N95s beyond the manufacturer-designated shelf life. Updated July 20, 2020 [Internet]. CDC. 2020 [acceso: 20/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/release-stockpiled-N95.html.

  63. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) - Considerations for optimizing the supply of Powered Air-Purifying Respirators (PAPRs). For Healthcare Practitioners (HCP). Updated April 19, 2020 [Internet]. CDC. 2020 [acceso: 19/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/powered-air-purifying-respirators-strategy.html.

  64. Centers for Disease Control and Prevention. Coronavirus Disease 201 (COVID-19). Elastometric respirators:Strategies during conventional and surge demande Situations. Conventional, contingency, and crisis strategies, Updated April 20, 2020 [Internet]. CDC. 2020 [acceso: 19/07/2020]. Disponible en: Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/elastomeric-respirators-strategy/index.html.




2020     |     www.medigraphic.com