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. 2023 Feb 28;5(1):5-14.
doi: 10.35772/ghm.2022.01060.

Specific COVID-19 risk behaviors and the preventive effect of personal protective equipment among healthcare workers in Japan

Reiko Shimbashi  1 , Teiichiro Shiino  2   3 , Akira Ainai  4 , Saya Moriyama  5 , Satoru Arai  1 , Saeko Morino  1 , Sayaka Takanashi  1 , Takeshi Arashiro  1 , Motoi Suzuki  1 , Yukimasa Matsuzawa  1 , Kenichiro Kato  6 , Mitsuru Hasegawa  7 , Rie Koshida  8 , Masami Kitaoka  8 , Takafumi Ueno  9 , Hidefumi Shimizu  10 , Hiroyoshi Yuki  11 , Tomoko Takeda  12 , Fukumi Nakamura-Uchiyama  13 , Kashiya Takasugi  14 , Shun Iida  4 , Tomoe Shimada  15 , Hirofumi Kato  16 , Tsuguto Fujimoto  17 , Naoko Iwata-Yoshikawa  4 , Kaori Sano  4 , Souichi Yamada  16 , Yudai Kuroda  18 , Kazu Okuma  19   20 , Kiyoko Nojima  19 , Noriyo Nagata  4 , Shuetsu Fukushi  16 , Ken Maeda  18 , Yoshimasa Takahashi  5 , Tadaki Suzuki  4 , Makoto Ohnishi  21 , Keiko Tanaka-Taya  1   22
Affiliations

Specific COVID-19 risk behaviors and the preventive effect of personal protective equipment among healthcare workers in Japan

Reiko Shimbashi et al. Glob Health Med. .

Abstract

As coronavirus disease 2019 (COVID-19) outbreaks in healthcare facilities are a serious public health concern, we performed a case-control study to investigate the risk of COVID-19 infection in healthcare workers. We collected data on participants' sociodemographic characteristics, contact behaviors, installation status of personal protective equipment, and polymerase chain reaction testing results. We also collected whole blood and assessed seropositivity using the electrochemiluminescence immunoassay and microneutralization assay. In total, 161 (8.5%) of 1,899 participants were seropositive between August 3 and November 13, 2020. Physical contact (adjusted odds ratio 2.4, 95% confidence interval 1.1-5.6) and aerosol-generating procedures (1.9, 1.1-3.2) were associated with seropositivity. Using goggles (0.2, 0.1-0.5) and N95 masks (0.3, 0.1-0.8) had a preventive effect. Seroprevalence was higher in the outbreak ward (18.6%) than in the COVID-19 dedicated ward (1.4%). Results showed certain specific risk behaviors of COVID-19; proper infection prevention practices reduced these risks.

Keywords: personal protective equipment; risk factors; seroepidemiology.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Study flow diagram. We recruited the study participants voluntarily among healthcare workers working at seven hospitals where outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred between March and August 2020 in Japan. A total of 1,899 participants were included in the analyses, excluding those who were unavailable for epidemiological information or the result of serologic test and those who had contact with SARS-CoV-2 infected persons outside their hospitals.
Figure 2.
Figure 2.
COVID-19 seroprevalence by ward type among healthcare workers in Japan between August and November, 2020. The wards were classified as COVID-19 ward (ward for the treatment of COVID-19 patients), outbreak ward (non-COVID-19 ward where outbreak was detected among staff or in-patients), and non-outbreak ward (non- COVID-19 ward where outbreak was not detected among staff or in-patients). The point estimates (dots) and 95% confidence intervals (lines) of COVID-19 seroprevalence are shown. The COVID-19 ward had the lower seroprevalence than the outbreak ward and similar to the non-outbreak ward.
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