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Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study.
Occup Environ Med. 2020 12; 77(12):857-861.OE

Abstract

OBJECTIVES

We estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak.

METHODS

A cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined point-of-care lateral flow immunoassay among frontline firefighters/paramedics collected over a 2-day period, 16-17 April 2020. Fire department personnel were emailed a survey link assessing COVID-19 symptoms and work exposures the day prior to the scheduled drive-through antibody testing at a designated fire station. Off-duty and on-duty firefighter/paramedic personnel drove through the fire station/training facility in their personal vehicles or on-duty engine/rescue trucks for SARS-CoV-2 antibody testing.

RESULTS

Among the 203 firefighters/paramedics that make up the fire department workforce, 18 firefighters/paramedics (8.9%) tested positive for SARS-CoV-2 antibodies, of which 8 firefighters/paramedics (3.9%) were IgG positive only, 8 (3.9%) were IgM positive only and 2 (0.1%) were IgG/IgM positive. The positive predictive value (PPV) of the serological test is estimated to be 33.2% and the negative predictive value is 99.3%. The average number of COVID-19 case contacts (ie, within 6 feet of an infected person (laboratory-confirmed or probable COVID-19 patient) for ≥15 min) experienced by firefighters/paramedics was higher for those with positive serology compared with those with negative (13.3 cases vs 7.31 cases; p=0.022). None of the antibody positive firefighters/paramedics reported receipt of the annual influenza vaccine compared with firefighters/paramedics who tested negative for SARS-CoV-2 antibodies (0.0% vs 21.0%; p=0.027).

CONCLUSION

Rapid SARS-CoV-2 IgM-IgG antibody testing documented early-stage and late-stage infection in a firefighter workforce providing insight to a broader medical surveillance project on return to work for firefighters/paramedics. Given the relatively low PPV of the serological test used in this study back in April 2020, caution should be used in interpreting test results.

Authors+Show Affiliations

Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA acaban@med.miami.edu. Sylvester Comprehensive Cancer Center, Miami, Florida, USA.Sylvester Comprehensive Cancer Center, Miami, Florida, USA. Medicine, University of Miami School of Medicine, Miami, Florida, USA.Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA.Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA.Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA.Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA. Sylvester Comprehensive Cancer Center, Miami, Florida, USA. Medicine, University of Miami School of Medicine, Miami, Florida, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32764107

Citation

Caban-Martinez, Alberto J., et al. "Epidemiology of SARS-CoV-2 Antibodies Among Firefighters/paramedics of a US Fire Department: a Cross-sectional Study." Occupational and Environmental Medicine, vol. 77, no. 12, 2020, pp. 857-861.
Caban-Martinez AJ, Schaefer-Solle N, Santiago K, et al. Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study. Occup Environ Med. 2020;77(12):857-861.
Caban-Martinez, A. J., Schaefer-Solle, N., Santiago, K., Louzado-Feliciano, P., Brotons, A., Gonzalez, M., Issenberg, S. B., & Kobetz, E. (2020). Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study. Occupational and Environmental Medicine, 77(12), 857-861. https://doi.org/10.1136/oemed-2020-106676
Caban-Martinez AJ, et al. Epidemiology of SARS-CoV-2 Antibodies Among Firefighters/paramedics of a US Fire Department: a Cross-sectional Study. Occup Environ Med. 2020;77(12):857-861. PubMed PMID: 32764107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study. AU - Caban-Martinez,Alberto J, AU - Schaefer-Solle,Natasha, AU - Santiago,Katerina, AU - Louzado-Feliciano,Paola, AU - Brotons,Angel, AU - Gonzalez,Marco, AU - Issenberg,S Barry, AU - Kobetz,Erin, Y1 - 2020/08/06/ PY - 2020/05/07/received PY - 2020/07/12/revised PY - 2020/07/20/accepted PY - 2020/8/9/pubmed PY - 2020/11/27/medline PY - 2020/8/9/entrez KW - biological monitoring KW - communicable diseases KW - epidemiology KW - health and safety KW - virology SP - 857 EP - 861 JF - Occupational and environmental medicine JO - Occup Environ Med VL - 77 IS - 12 N2 - OBJECTIVES: We estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak. METHODS: A cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined point-of-care lateral flow immunoassay among frontline firefighters/paramedics collected over a 2-day period, 16-17 April 2020. Fire department personnel were emailed a survey link assessing COVID-19 symptoms and work exposures the day prior to the scheduled drive-through antibody testing at a designated fire station. Off-duty and on-duty firefighter/paramedic personnel drove through the fire station/training facility in their personal vehicles or on-duty engine/rescue trucks for SARS-CoV-2 antibody testing. RESULTS: Among the 203 firefighters/paramedics that make up the fire department workforce, 18 firefighters/paramedics (8.9%) tested positive for SARS-CoV-2 antibodies, of which 8 firefighters/paramedics (3.9%) were IgG positive only, 8 (3.9%) were IgM positive only and 2 (0.1%) were IgG/IgM positive. The positive predictive value (PPV) of the serological test is estimated to be 33.2% and the negative predictive value is 99.3%. The average number of COVID-19 case contacts (ie, within 6 feet of an infected person (laboratory-confirmed or probable COVID-19 patient) for ≥15 min) experienced by firefighters/paramedics was higher for those with positive serology compared with those with negative (13.3 cases vs 7.31 cases; p=0.022). None of the antibody positive firefighters/paramedics reported receipt of the annual influenza vaccine compared with firefighters/paramedics who tested negative for SARS-CoV-2 antibodies (0.0% vs 21.0%; p=0.027). CONCLUSION: Rapid SARS-CoV-2 IgM-IgG antibody testing documented early-stage and late-stage infection in a firefighter workforce providing insight to a broader medical surveillance project on return to work for firefighters/paramedics. Given the relatively low PPV of the serological test used in this study back in April 2020, caution should be used in interpreting test results. SN - 1470-7926 UR - https://www.unboundmedicine.com/medline/citation/32764107/Epidemiology_of_SARS_CoV_2_antibodies_among_firefighters/paramedics_of_a_US_fire_department:_a_cross_sectional_study_ L2 - https://oem.bmj.com/lookup/pmidlookup?view=long&pmid=32764107 DB - PRIME DP - Unbound Medicine ER -