A review of infectious disease epidemiology in emergency medical service clinicians

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 occupationallyacquired infections in the EMS workforce. & COPY; 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Automated summary

This review examined the prevalence, incidence, and severity of infections among the emergency medical service (EMS) workforce. The majority of studies focused on SARS-CoV-2 infection, with varying prevalence rates. MRSA and Hepatitis C infections were also reported. Limited studies reported incidence rates. Differences in infection rates were observed between EMS clinicians and firefighters, with higher hospitalization or death rates for SAR-CoV-2 and higher prevalence of Hepatitis C among EMS clinicians. More research is needed to understand the incidence and severity of occupationally-acquired infections in the EMS workforce.