Highlights
- •There is limited available evidence on EMS providers’ exposure and infection.
- •COVID-19 is the most common infectious disease studied among EMS providers.
- •Few studies showed infection differences between age, race, gender, or work characteristics.
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.
Key Words
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Article info
Publication history
Published online: December 09, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding/support: This report is based on research conducted by the Johns Hopkins University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 75Q80120D00003) with support from the National Highway Traffic Safety Administration (NHTSA). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ or NHTSA. Therefore, no statement in this report should be construed as an official position of AHRQ, the U.S. Department of Health and Human Services, NHTSA or the U.S. Department of Transportation.
Conflicts of interest: None to report.
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
