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1. SARS-CoV-2 Testing of 11,884 Healthcare Workers at an Acute NHS Hospital Trust in England: A Retrospective Analysis

Author

Aidan T. Hanrath, Ina Schim van der Loeff, Dennis W. Lendrem, Kenneth F. Baker, David A. Price, Peter McDowall, Kiera McDowall, Susan Cook, Peter Towns, Ulrich Schwab, Adam Evans, Jill Dixon, Jennifer Collins, Shirelle Burton-Fanning, David Saunders, Jayne Harwood, Julie Samuel, Matthias L. Schmid, Lucia Pareja-Cebrian, Ewan Hunter, Elizabeth Murphy, Yusri Taha, Brendan A. I. Payne, and Christopher J. A. Duncan

Subjects
Healthcare workers (HCWs), SARS-CoV-2, COVID-19, nosocomial infection, occupational risk analysis and management, Medicine (General), R5-920
Abstract

Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.

Published
2021
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2. Should long-term symptoms following COVID-19 infection be considered an occupational disease?

Author

Elizabeth Murphy, Peter McDowall, and Kiera McDowall

Subjects
Pediatrics, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Public Health, Environmental and Occupational Health, MEDLINE, Occupational disease, COVID-19, medicine.disease, Term (time), Occupational Diseases, Medicine, Humans, business
Published
2021

3. SARS-CoV-2 Testing of 11,884 Healthcare Workers at an Acute NHS Hospital Trust in England: A Retrospective Analysis

Author

Jennifer Collins, Yusri Taha, Adam Evans, Kiera McDowall, Brendan A I Payne, Christopher J A Duncan, Jill Dixon, Ina Schim van der Loeff, Jayne Harwood, Susan Cook, Lucia Pareja-Cebrian, Kenneth F Baker, David A Price, Peter Towns, Julie Samuel, Elizabeth Murphy, Aidan T Hanrath, Ulrich Schwab, Shirelle Burton-Fanning, David Saunders, Peter McDowall, Matthias Schmid, Ewan Hunter, and Dennis Lendrem

Subjects
lcsh:R5-920, medicine.medical_specialty, SARS-CoV-2, business.industry, Ethnic group, Healthcare workers (HCWs), COVID-19, General Medicine, Brief Research Report, Logistic regression, Asymptomatic, occupational risk analysis and management, Odds, Social deprivation, Informatics, nosocomial infection, Family medicine, Health care, Medicine, Seroconversion, medicine.symptom, lcsh:Medicine (General), business, Qualitative research
Abstract

Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.

Published
2021
Full Text
View/download PDF

4. Medication and employment

Author

Peter McDowall and Caroline Swales

Abstract

Medication allows many people with long-term health conditions to pursue productive employment when they would otherwise be unable to work safely and effectively. However, both short-term and long-term pharmacological treatments can have implications for work. The number of medications taken by individuals has increased; the risk of harm increasing with polypharmacy. The Internet has transformed communications, and practitioners have greater accessibility to updated clinical data with increased communication between specialists. But easier access to data on medication and health conditions for employees has both positive and negative influences. High-profile road traffic fatalities have raised public concerns about the potential adverse effects of medication and of employees not reporting or managing conditions effectively. Occupational health professionals are not regular prescribers. However, they can help to monitor safe use of medications, by observing and recording compliance and adverse effects in relation to workplace health and safety. Greater involvement in employees’ medication management, with onward communication of problems to treating physicians, is required to enable occupational health to participate in medicines optimization.

Published
2019

5. Treatment of allergic rhinitis using mobile technology with real world data: The MASK observational pilot study

Author

Valérie Siroux, Cristiana Stellato, Olivier Vandenplas, Isabella Annesi-Maesano, P V Tomazic, A. Bedbrook, Luís Nogueira-Silva, M. Morais Almeida, Maddalena Illario, Wytske J. Fokkens, Piotr Kuna, Isabelle Bosse, Erik Melén, Joaquim Mullol, G Alexis-Alexandre, Esben Eller, Nikolaos G. Papadopoulos, Pascal Demoly, B. Samolinski, D. Larenas-Linnemann, Carsten Bindslev-Jensen, Peter McDowall, Ana Margarida Pereira, M. Bewick, Josep M. Antó, Torsten Zuberbier, A. Todo Bom, Pedro Carreiro-Martins, R. Murray, A. Yorgancioglu, F. Portejoie, Robyn E O'Hehir, E Murphy, Inger Kull, D. Laune, A. Valiulis, G. Passalacqua, T. Keil, Peter Hellings, M. L. Kowalski, Bilun Gemicioglu, Alvaro A. Cruz, P. Devillier, A. Valero, L. Klimek, Aziz Sheikh, G. De Vries, J. Just, Davide Caimmi, Niels H. Chavannes, K. C. Bergmann, João Fonseca, Erkka Valovirta, J. F. Fontaine, Dermot Ryan, S. Shamai, Massimo Triggiani, Enrica Menditto, Giorgio Walter Canonica, M. Wickman, Jean Bousquet, Sinthia Bosnic-Anticevich, Gabrielle L. Onorato, M. van Eerd, S. Arnavielhe, E Mathieu-Dupas, David Price, Tari Haahtela, O. Spranger, V. Kvedariene, Claus Bachert, R Mösgues, AII - Inflammatory diseases, Ear, Nose and Throat, AII - Amsterdam institute for Infection and Immunity, Other departments, Bousquet, J, Arnavielhe, S, Bedbrook, A, Alexis-Alexandre, G, van Eerd, M, Murray, R, Canonica, G W, Illario, M, Menditto, E, Passalacqua, G, Stellato, C, Triggiani, M, Carreiro-Martins, P, Fonseca, J, Morais Almeida, M, Nogueira-Silva, L, Pereira, A M, Todo Bom, A, Bosse, I, Caimmi, D, Demoly, P, Devillier, P, Fontaine, J F, Just, J, Onorato, G L, Kowalski, M L, Kuna, P, Samolinski, B, Anto, J M, Mullol, J, Valero, A, Tomazic, P V, Bergmann, K C, Keil, T, Klimek, L, Mösgues, R, Shamai, S, Zuberbier, T, Murphy, E, Mcdowall, Peter, Price, D, Ryan, D, Sheikh, A, Chavannes, N H, Fokkens, W J, Kvedariene, V, Valiulis, A, Bachert, C, Hellings, P W, Kull, I, Melén, E, Wickman, M, Bindslev-Jensen, C, Eller, E, Haahtela, T, Valovirta, E, Papadopoulos, N G, Annesi-Maesano, I, Bewick, M, Bosnic-Anticevich, S, Cruz, A A, De Vries, G, Gemicioglu, B, Larenas-Linnemann, D, Laune, D, Mathieu-Dupas, E, O'Hehir, R E, Portejoie, F, Siroux, V, Spranger, O, Vandenplas, O, Yorgancioglu, A, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Foch [Suresnes], 'Federico II' University of Naples Medical School, CHU Montpellier, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Barcelona, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University Hospital of Cologne [Cologne], Department of Computer Science [Haifa], University of Haifa [Haifa], University of Edinburgh, Vilnius University [Vilnius], Ghent University Hospital, University Hospitals Leuven [Leuven], The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], University of Helsinki, The University of Sydney, Heidelberg University, Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), University of Turku, Department of Dermatology, Allergology and Venereology, Clinicum, and HUS Inflammation Center

Subjects
Research design, Male, IMPACT, Pilot Projects, Review, Global Health, law.invention, DOUBLE-BLIND, 0302 clinical medicine, FLUTICASONE, Randomized controlled trial, law, QUALITY-OF-LIFE, HDE ALER, Immunology and Allergy, Medicine, AZELASTINE, 030212 general & internal medicine, Prospective Studies, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, mHealth, Randomized Controlled Trials as Topic, treatment, Disease Management, mobile technology, observational study, rhinitis, Middle Aged, Combined Modality Therapy, Mobile Applications, 3. Good health, rhiniti, Research Design, GUIDED SELF-MANAGEMENT, [SDV.IMM]Life Sciences [q-bio]/Immunology, Over-the-counter, Female, mHealth, mobile technology, observational study, rhinitis, treatment, medicine.drug, Adult, medicine.medical_specialty, Immunology, CONTROLLED-TRIAL, Drug Prescriptions, Medication Adherence, 03 medical and health sciences, Young Adult, Quality of life (healthcare), Journal Article, Humans, Asthma, business.industry, CARE, medicine.disease, Azelastine, Rhinitis, Allergic, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, Physical therapy, ASTHMA, Observational study, business, TRADITIONAL TREATMENT
Abstract

BACKGROUND: Large observational implementation studies are needed to triangulate the findings from randomized control trials (RCTs) as they reflect "real world" everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real life treatment of allergic rhinitis using mobile technology.METHODS: A mobile phone app (Allergy Diary, freely available Google Play and Apple App stores) collects the data of daily visual analogue scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries.RESULTS: A total of 2,871 users filled in 17,091 days of VAS in 2015 and 2016. Medications were reported for 9,634 days. The assessment of days appeared to be more informative than the course of the treatment as, in real life, patients do not necessarily use treatment on a daily basis; rather, they appear to increase treatment use with the loss of symptom control. The Allergy Diary allowed differentiation between treatments within or between classes (intranasal corticosteroid use containing medications and oral H1-antihistamines). The control of days differed between no [best control], single or multiple treatments (worst control).CONCLUSIONS: The present study confirms the usefulness of the Allergy Diary in accessing and assessing everyday use and practice in allergic rhinitis. This pilot observational study uses a very simple assessment (VAS) on a mobile phone, shows novel findings and generates new hypotheses. This article is protected by copyright. All rights reserved.

Published
2018

6. SurveyMonkey®

Author

Peter McDowall and Elizabeth Murphy

Subjects
Public Health, Environmental and Occupational Health
Published
2018

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