Occupational COVID-19 exposure among health care workers in obstetric unit in a Central Government Hospital in India: initial experience

Authors

  • Neha Pruthi Tondon Department of Obstetrics and Gynecology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
  • Renuka Malik Department of Obstetrics and Gynecology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
  • Kanika Kumari Department of Obstetrics and Gynecology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
  • Anjali Singh Department of Obstetrics and Gynecology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20212949

Keywords:

Health care workers in obstetric ward, COVID-19 exposure, Positivity rate

Abstract

Background: Health care workers (HCW) are the frontline warriors who are at a high risk of acquiring the COVID-19. HCW in obstetrical department are at high-risk due to their close proximity with the patient for examination, giving treatment and in delivery. The objectives of this study were to evaluate the positivity rate of COVID-19 in the initial 3 months of pandemic in health care personnel working in obstetric unit in a tertiary care hospital.

Methods: Prospective cohort study was conducted in department of obstetrics and gynecology at tertiary care hospital in Delhi from 10 April to 10 June 2020. Predesigned questionnaire was used to record data of HCWs exposed to COVID-19 patients.

Results: In a period of 3 months (April-June 2020), 152 health care workers were exposed to 30 COVID-19 patients.  Out of this, 10 HCW were found to be positive on testing, showing a positivity rate of 6.58%. Positivity ratio was 6:3:1 among nurses, auxiliary workers and doctors respectively. Labor room was area of high infection as 80% of HCW were infected in the labor room .80% HCW acquired infection during patient care in hospital and 20% were infected in contact with asymptomatic COVID-19 positive HCW.

Conclusions: Positivity rate in obstetric department is comparable to that of general population. Appropriate infection prevention measures like use of PPE, handwashing and maintain safe distance from the patient is the key to prevention of infection. Gloves and N95 masks have been shown to provide superior protection as compared to triple layer masks. Nursing staff and auxiliary workers should be reinforced the importance of use of PPE, hand hygiene and physical distancing.

References

Huang C, Wang Y, Li X, Ren L, Zhao J, Ho Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. 2020;92(4):401-2.

Hui DS, Azhar IE, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264-6.

Andrews MA, Areekal B, Rajesh KR, Krishnan J, Suryakala R, Krishnan B, et al. First confirmed case of COVID-19 infection in India: A case report. Indian J Med Res. 2020;151:490-2.

Mahajan P, Kaushal J. Epidemic Trend of COVID-19 Transmission in India During Lockdown-1 Phase. J Community Health. 2020;45(6):1291-300.

Xiao J, Fang M, Chen Q, He B. SARS, MERS and COVID-19 among healthcare workers: a narrative review. J Infect Public Health. 2020;13:843-8.

Lapolla P, Mingoli A, Lee R. Deaths from COVID-19 in healthcare workers in Italy-What can we learn? Infect Control Hosp Epidemiol. 2021;42(3):364-5.

Keeley AJ, Evans C, Colton H, Ankcorn M, Cope A, State A, Bennett T, Giri P, de Silva TI, Raza M. Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Euro Surveill. 2020;25(14):2000433.

European centre for disease prevention and cotrol. Rapid risk assessment: Coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK – eighth update. 2020.

Lai X, Wang M, Qin C, Li T, Ran L, Chen D, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Network Open. 2020;3(5):209666.

Zhou P, Huang Z, Xiao Y, Huang X, Fan XG. Protecting Chinese healthcare workers while combating the 2019 novel coronavirus. Infect Control Hosp Epidemiol. 2020;41(6):745-6.

Wang J, Zhou M, Liu F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020;105(1):100-1.

Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk Factors of Healthcare Workers With Coronavirus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis. 2020;71(16):2218-21.

Tran K, Cimon K, Severn M, Pessoa SCL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. 2012;7(4):35797.

Jensen D, Duffin J, Lam YM, Webb KA, Simpson JA, Davies GA, Wolfe LA, et al. Physiological mechanisms of hyperventilation during human pregnancy. Respir Physiol Neurobiol. 2008;161(1):76-86.

Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res. 2020;151(5):459-67.

Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, Mehta RS, Warner ET, Sikavi DR, Lo CH, Kwon S, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):475-83.

Tostmann A, Bradley J, Bousema T, Yiek WK, Holwerda M, Bleeker RC, et al. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Euro Surveill. 2020;25(16):2000508.

Zabarsky TF, Bhullar D, Silva SY, Mana TSC, Ertle MT, Navas ME, et al. What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection?. Am J Infect Control. 2021;49(3):392-5.

Mhango M, Dzobo M, Chitungo I, Dzinamarira T. COVID-19 Risk Factors Among Health Workers: A Rapid Review. Saf Health Work. 2020;11(3):262-5.

WHO. Rational use of personal protective equipment (‎PPE)‎ for coronavirus disease (‎COVID-19)‎: interim guidance, 2020. Available at: https://apps.who.int/ iris/handle/10331498. Accessed on 12 June 2021.

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Published

2021-07-26

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Original Research Articles