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Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA.
BMJ Open. 2020 10 21; 10(10):e042752.BO

Abstract

OBJECTIVE

The COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA.

DESIGN

We conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out).

SETTING

The questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey.

PARTICIPANTS

Using a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey.

PRIMARY OUTCOME

Prevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms.

RESULTS

Participants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71).

CONCLUSION

HCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being.

Links

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Authors+Show Affiliations

Firew T
Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA tsionfirew@gmail.com. Office of the Minister, Ethiopia Ministry of Health, Addis Ababa, Ethiopia.
Sano ED
Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Lee JW
Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA. Department of Emergnecy Medicine, Mount Sinai Medical Center, New York, New York, USA.
Flores S
Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Lang K
School of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Salman K
General Public Health, Columbia University Mailman School of Public Health, New York, New York, USA.
Greene MC
Global Mental Health Program, New York State Psychiatric Institute, New York, New York, USA. Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA.
Chang BP
Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.

MeSH

AdultBetacoronavirusBurnout, ProfessionalCOVID-19Coronavirus InfectionsCross-Sectional StudiesFemaleHealth PersonnelHumansMaleMental HealthPandemicsPneumonia, ViralPrevalencePsychological DistressSARS-CoV-2Surveys and QuestionnairesUnited States

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

33087382

Citation

Firew, Tsion, et al. "Protecting the Front Line: a Cross-sectional Survey Analysis of the Occupational Factors Contributing to Healthcare Workers' Infection and Psychological Distress During the COVID-19 Pandemic in the USA." BMJ Open, vol. 10, no. 10, 2020, pp. e042752.
Firew T, Sano ED, Lee JW, et al. Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA. BMJ Open. 2020;10(10):e042752.
Firew, T., Sano, E. D., Lee, J. W., Flores, S., Lang, K., Salman, K., Greene, M. C., & Chang, B. P. (2020). Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA. BMJ Open, 10(10), e042752. https://doi.org/10.1136/bmjopen-2020-042752
Firew T, et al. Protecting the Front Line: a Cross-sectional Survey Analysis of the Occupational Factors Contributing to Healthcare Workers' Infection and Psychological Distress During the COVID-19 Pandemic in the USA. BMJ Open. 2020 10 21;10(10):e042752. PubMed PMID: 33087382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA. AU - Firew,Tsion, AU - Sano,Ellen D, AU - Lee,Jonathan W, AU - Flores,Stefan, AU - Lang,Kendrick, AU - Salman,Kiran, AU - Greene,M Claire, AU - Chang,Bernard P, Y1 - 2020/10/21/ PY - 2020/10/22/entrez PY - 2020/10/23/pubmed PY - 2020/11/6/medline KW - COVID-19 KW - anxiety disorders KW - epidemiology KW - occupational & industrial medicine KW - public health SP - e042752 EP - e042752 JF - BMJ open JO - BMJ Open VL - 10 IS - 10 N2 - OBJECTIVE: The COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA. DESIGN: We conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out). SETTING: The questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey. PARTICIPANTS: Using a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey. PRIMARY OUTCOME: Prevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms. RESULTS: Participants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71). CONCLUSION: HCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/33087382/Protecting_the_front_line:_a_cross_sectional_survey_analysis_of_the_occupational_factors_contributing_to_healthcare_workers'_infection_and_psychological_distress_during_the_COVID_19_pandemic_in_the_USA_ DB - PRIME DP - Unbound Medicine ER -