Modeling fomite-mediated SARS-CoV-2 exposure through personal protective equipment doffing in a hospital environment.
Modeling fomite-mediated SARS-CoV-2 exposure through personal protective equipment doffing in a hospital environment.
复制标题
DOI：
10.1111/ina.12938
复制
发表时间：
2022-01
期刊：
影响因子：
5.8
通讯作者：
Noakes CJ
中科院分区：
文献类型：
--
作者：
King MF;Wilson AM;Weir MH;López-García M;Proctor J;Hiwar W;Khan A;Fletcher LA;Sleigh PA;Clifton I;Dancer SJ;Wilcox M;Reynolds KA;Noakes CJ
在SARS-CoV-2阳性患者护理后，脱下个人防护装备(PPE)过程中的自我污染是医护人员(HCW)关注的问题。工作人员可能会因不恰当的手套拆卸而下意识地受到污染；因此，量化这种接触对于安全的工作程序至关重要。使用离散时间马尔可夫链模拟了呼吸科病房的HCW表面接触序列：静脉滴注护理、血压监测和医生查房。使用随机递归关系模拟护理期间病毒RNA在手套上的附着。在模拟中，卫生与公众服务部随后根据不断增加的案件量，在一小部分案件中脱掉了个人防护装备并污染了自己。用参数分析的方法分析了以下因素的影响：(1)病房病人数量的增加；(1)新冠肺炎病例的比例；(2)轮班时间的长短；(3)接触污染个人防护用品的概率。暴露的驱动因素是表面污染和表面接触的数量。结果模拟了大多数考虑的情景中通常较低的病毒暴露，包括100%新冠肺炎阳性病房，尽管这是最高的自我接种剂量可能发生在中位数0.0305病毒(95%可信区间=0-0.6%病毒)。剂量与表面污染高度相关，表明这可能是暴露的一个决定因素。暴露造成的感染风险很难估计，因为它将受到病毒变异和疫苗接种率等因素的影响。
Self‐contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS‐CoV‐2‐positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete‐time Markov chain for: IV‐drip care, blood pressure monitoring, and doctors’ rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID‐19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID‐19 positive wards, although this is where the highest self‐inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0–0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.
登录
查看更多内容
影响因子：
3.8
作者：
Julian, Timothy R.;Canales, Robert A.;Boehm, Alexandria B.
通讯作者：
Boehm, Alexandria B.
影响因子：
11.8
作者：
Bullard, Jared;Dust, Kerry;Poliquin, Guillaume
通讯作者：
Poliquin, Guillaume
DOI：
10.1007/s10096-020-03913-9
发表时间：
2020-04-27
影响因子：
4.5
作者：
La Scola, Bernard;Le Bideau, Marion;Raoult, Didier
通讯作者：
Raoult, Didier
影响因子：
3.7
作者：
Jinadatha C;Villamaria FC;Coppin JD;Dale CR;Williams MD;Whitworth R;Stibich M
通讯作者：
Stibich M
影响因子：
7.4
作者：
King, M. -F.;Noakes, C. J.;Camargo-Valero, M. A.
通讯作者：
Camargo-Valero, M. A.