Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study
- University of Oxford, United Kingdom
- Oxford University Hospitals, United Kingdom
- Nuffield Department of Medicine, University of Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, United Kingdom
- Oxford University, United Kingdom
- Target Discovery Institute, University of Oxford, United Kingdom
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]).
Data availability
The data studied are available from the Infections in Oxfordshire Research Database (https://oxfordbrc.nihr.ac.uk/research-themes-overview/antimicrobial-resistance-and-modernising-microbiology/infections-in-oxfordshire-research-database-iord/), subject to an application and research proposal meeting the ethical and governance requirements of the Database. For further details on how to apply for access to the data and for a research proposal template please email iord@ndm.ox.ac.uk.
Article and author information
Author details
Bernadette C Young
Philip George Drennan
Alexander J Mentzer
Funding
UK Government: Department of Health and Social Care
- David W Eyre
- Sheila F Lumley
- Denise O'Donnell
- Mark Campbell
- Elizabeth Sims
- Elaine Lawson
- Fiona Warren
- Tim James
- Stuart Cox
- Alison Howarth
- George Doherty
- Stephanie B Hatch
- James Kavanagh
- Kevin K Chau
- Philip W Fowler
- Jeremy Swann
- Denis Volk
- Fan Yang-Turner
- Nicole Stoesser
- Philippa C Matthews
- Maria Dudareva
- Timothy Davies
- Robert H Shaw
- Leon Peto
- Louise O Downs
- Alexander Vogt
- Ali Amini
- Bernadette C Young
- Philip George Drennan
- Alexander J Mentzer
- Donal T Skelly
- Fredrik Karpe
- Matt J Neville
- Monique Andersson
- Andrew J Brent
- Nicola Jones
- Lucas Martins Ferreira
- Thomas Christott
- Brian D Marsden
- Sarah Hoosdally
- Richard Cornall
- Derrick W Crook
- David I Stuart
- Gavin Screaton
- Timothy EA Peto
- Bruno Holthof
- Anne-Marie O'Donnell
- Daniel Ebner
- Christopher P Conlon
- Katie Jeffery
- Timothy M Walker
Wellcome Trust Clinical Research Training Fellow (216417/Z/19/Z)
- Ali Amini
NIHR Clinical Lecturer
- Bernadette C Young
Structural Genomics Consortium
- Lucas Martins Ferreira
- Thomas Christott
- Brian D Marsden
Kennedy Trust for Rheumatology Research
- Brian D Marsden
Wellcome Trust Senior Investigator
- Gavin Screaton
Schmidt Foundation
- Gavin Screaton
Wellcome Trust Career Development Fellow (214560/Z/18/Z)
- Timothy M Walker
National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance (HPRU-2012-10041)
- David W Eyre
- Sheila F Lumley
- Denise O'Donnell
- Mark Campbell
- Elizabeth Sims
- Elaine Lawson
- Fiona Warren
- Tim James
- Stuart Cox
- Alison Howarth
- George Doherty
- Stephanie B Hatch
- James Kavanagh
- Kevin K Chau
- Philip W Fowler
- Jeremy Swann
- Denis Volk
- Fan Yang-Turner
- Nicole Stoesser
- Philippa C Matthews
- Maria Dudareva
- Timothy Davies
- Robert H Shaw
- Leon Peto
- Louise O Downs
- Alexander Vogt
- Ali Amini
- Bernadette C Young
- Philip George Drennan
- Alexander J Mentzer
- Donal T Skelly
- Fredrik Karpe
- Matt J Neville
- Monique Andersson
- Andrew J Brent
- Nicola Jones
- Lucas Martins Ferreira
- Thomas Christott
- Brian D Marsden
- Sarah Hoosdally
- Richard Cornall
- Derrick W Crook
- David I Stuart
- Gavin Screaton
- Timothy EA Peto
- Bruno Holthof
- Anne-Marie O'Donnell
- Daniel Ebner
- Christopher P Conlon
- Katie Jeffery
- Timothy M Walker
Robertson Foundation
- David W Eyre
NIHR Oxford BRC Senior Fellow
- David W Eyre
- Philippa C Matthews
Wellcome Trust Clinical Research Fellow
- Sheila F Lumley
Medical Research Council (MR/N00065X/1)
- David I Stuart
Wellcome Trust Intermediate Fellowship (110110/Z/15/Z)
- Philippa C Matthews
NIHR Doctoral Research Fellow
- Maria Dudareva
Medical Research Foundation (MRF-145-004-TPG-AVISO)
- Kevin K Chau
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: All asymptomatic staff data collection and testing were part of enhanced hospital infection prevention and control measures instituted by the UK Department of Health and Social Care (DHSC). Deidentified data from staff testing and patients were obtained from the Infections in Oxfordshire Research Database (IORD) which has generic Research Ethics Committee, Health Research Authority and Confidentiality Advisory Group approvals (19/SC/0403, ECC5-017(A)/2009). De-identified patient data extracted included admission and discharge dates, ward location and positive Covid-19 test results.
Copyright
© 2020, Eyre et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study
eLife 9:e60675.
https://doi.org/10.7554/eLife.60675
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Several areas of the world suffer a notably high incidence of Shiga toxin-producing Escherichia coli. To assess the impact of persistent cross-species transmission systems on the epidemiology of E. coli O157:H7 in Alberta, Canada, we sequenced and assembled E. coli O157:H7 isolates originating from collocated cattle and human populations, 2007–2015. We constructed a timed phylogeny using BEAST2 using a structured coalescent model. We then extended the tree with human isolates through 2019 to assess the long-term disease impact of locally persistent lineages. During 2007–2015, we estimated that 88.5% of human lineages arose from cattle lineages. We identified 11 persistent lineages local to Alberta, which were associated with 38.0% (95% CI 29.3%, 47.3%) of human isolates. During the later period, six locally persistent lineages continued to be associated with human illness, including 74.7% (95% CI 68.3%, 80.3%) of reported cases in 2018 and 2019. Our study identified multiple locally evolving lineages transmitted between cattle and humans persistently associated with E. coli O157:H7 illnesses for up to 13 y. Locally persistent lineages may be a principal cause of the high incidence of E. coli O157:H7 in locations such as Alberta and provide opportunities for focused control efforts.
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Background: The role of circulating metabolites on child development is understudied. We investigated associations between children's serum metabolome and early childhood development (ECD).
Methods: Untargeted metabolomics was performed on serum samples of 5,004 children aged 6-59 months, a subset of participants from the Brazilian National Survey on Child Nutrition (ENANI-2019). ECD was assessed using the Survey of Well-being of Young Children's milestones questionnaire. The graded response model was used to estimate developmental age. Developmental quotient (DQ) was calculated as the developmental age divided by chronological age. Partial least square regression selected metabolites with a variable importance projection ≥ 1. The interaction between significant metabolites and the child's age was tested.
Results: Twenty-eight top-ranked metabolites were included in linear regression models adjusted for the child's nutritional status, diet quality, and infant age. Cresol sulfate (β = -0.07; adjusted-p < 0.001), hippuric acid (β = -0.06; adjusted-p < 0.001), phenylacetylglutamine (β = -0.06; adjusted-p < 0.001), and trimethylamine-N-oxide (β = -0.05; adjusted-p = 0.002) showed inverse associations with DQ. We observed opposite directions in the association of DQ for creatinine (for children aged -1 SD: β = -0.05; p =0.01; +1 SD: β = 0.05; p =0.02) and methylhistidine (-1 SD: β = - 0.04; p =0.04; +1 SD: β = 0.04; p =0.03).
Conclusion: Serum biomarkers, including dietary and microbial-derived metabolites involved in the gut-brain axis, may potentially be used to track children at risk for developmental delays.
Funding: Supported by the Brazilian Ministry of Health and the Brazilian National Research Council.
