A review of infectious disease epidemiology in emergency medical service clinicians

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The emergency medical service (EMS) workforce is at high risk of occupationally-acquired infections. This review synthesized existing literature on the prevalence, incidence, and severity of infections in the EMS workforce. Methods: We searched PubMed, Embase, CINAHL, and SCOPUS from January 1, 2006 to March 15, 2022 for studies in the US that involved EMS clinician or firefighter populations and reported 1 or more health outcomes related to occupationally-acquired infections. Results: Of the 25 studies that met the inclusion criteria, most focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with prevalence rates ranging from 1.1% to 36.2% (median 6.7%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in 4 studies ranged from 1.9% to 6.4%, and the prevalence of Hepatitis C in 1 study was 1.3%. Few studies reported incidence rates. The prevalence or incidence of these infections generally did not differ by age or gender, but 4 studies reported differences by race or ethnicity. In the 4 studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2 (odds ratio 4.23), a higher prevalence of Hepatitis C in another study (odds ratio 1.74), and no significant difference in MRSA colonization in a separate study. Conclusions: More research is needed to better characterize the incidence and severity of occupationally-acquired infections in the EMS workforce.

Original languageEnglish (US)
Pages (from-to)931-937
Number of pages7
JournalAmerican Journal of Infection Control
Volume51
Issue number8
DOIs
StatePublished - Aug 2023

Keywords

  • Firefighters
  • Occupationally-acquired infections
  • Prehospital
  • Systematic review

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Health Policy
  • Epidemiology

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