506 - Variation in Occupational Activities and Infection Prevention Practices in Healthcare Personnel Based on Exposure to COVID-19 Units

Background: Healthcare personnel (HCP) may be at increased risk for COVID-19, but differences in risk by work activities are poorly defined. Centers for Disease Control and Prevention recommends cohorting hospitalized patients with COVID-19 to reduce in-hospital transmission of SARS-CoV-2, but it is unknown if occupational and non-occupational behaviors differ based on exposure to COVID-19 units.

Methods: We analyzed a subset of HCP from an ongoing CDC-funded SARS-CoV-2 serosurveillance study. HCP were recruited from four Atlanta hospitals of different sizes and patient populations. All HCP completed a baseline REDCap survey. We used logistic regression to compare occupational activities and infection prevention practices among HCP stratified by exposure to COVID-19 units: low (0% of shifts), medium (1-49% of shifts) or high (≥50% of shifts).

Results: Of 211 HCP enrolled (36% emergency department [ED] providers, 35% inpatient RNs, 17% inpatient MDs/APPs, 7% radiology technicians and 6% respiratory therapists [RTs]), the majority (79%) were female and the median age was 35 years. Nearly half of the inpatient MD/APPs (46%) and RNs (47%) and over two-thirds of the RTs (67%) worked primarily in the ICU. Aerosol generating procedures were common among RNs, MD/APPs, and RTs (26-58% performed ≥1), but rare among ED providers (0-13% performed ≥1). Compared to HCP with low exposure to COVID-19 units, those with medium or high exposure spent a similar proportion of shifts directly at the bedside and were about as likely to practice universal masking. Being able to consistently social distance from co-workers was rare (33%); HCP with high exposure to COVID-19 units were less likely to report social distancing in the workplace compared to those with low exposure; however, this was not significantly different (OR 0.6; 95% CI: 0.3, 1.1). Concerns about personal protective equipment in COVID-19 units were similar across levels of exposure (Table 1).Table 1: Occupational activities and infection prevention behaviors of healthcare personnel stratified by level of exposure to COVID-19 units


Conclusion: The proportion of time spent in dedicated COVID-19 units did not appear to influence time HCP spend directly at the bedside or infection prevention practices (social distancing and universal masking) in the workplace. Risk for SARS-CoV-2 infection in HCP may depend more on factors acting at the individual level rather than those related to location of work.