Yıl 2021, Cilt 11 , Sayı 1, Sayfalar 82 - 85 2021-01-30

Evaluation of the Hand-To-Face Contact Behaviors of Healthcare Workers and Medical Students in the COVID-19 Pandemic
COVID-19 Pandemisinde Sağlık Çalışanları ve Tıp Fakültesi Öğrencilerinin El-Yüz Temas Davranışlarının Değerlendirilmesi

Gülsüm ALKAN [1] , Melike KESER EMİROĞLU [2] , Şadiye Kübra TÜTER ÖZ [3] , Onur URAL [4] , Şua SÜMER [5] , Nazlım AKTUĞ DEMİR [6]


Background: Respiratory viruses such as SARS-CoV-2 spread via different transmission routes. While the droplet path plays the most important role in transmisson, contamination of the mucous membranes with contaminated hands also plays an important role in the spread. Thus, the aim of the present study was to assess the face-touching behaviors of HCWs and intern doctors during the COVID-19 pandemic. Methods: This study was conducted in July 2020 and in the Selcuk University Faculty of Medicine in Konya, Turkey. While 1-hour COVID-19 training was given to healthcare personnel and interns, participants face-touching behavior was monitored through video recording and was tallied with a scoring sheet. Results: A total of 141 intern doctors, 46 assistant doctors, 14 nurses, 10 associate doctors, and eight staff members participated in the study. On average, each of the participants touched their face a mean of 17.2 times (median: 16; range: 0–45) per hour. Of all the face touches, 85.2% (3,228/3,787) involved contact with a face mask, whereas 14.7 % (559/3787) involved contact with the eye mucosa. Intern doctors touched their faces significantly less often with a mean of 13.7 times per hour (P < 0.001), while nurses touched their faces more often with a mean of 28 times per hour (P < 0.001). Although nurses touched their eye mucosa more often than interns and assistant doctors (P < 0,001), their contact with the face mask was significantly less frequent than that of the other participants (P < 0.001). Conclusions: To date, there are no effective vaccines or antiviral drugs for SARS-CoV-2. For the time being, isolation, social distancing measures, and individuals’ protective behaviors are essential for preventing infection. HCWs, medical students, and the broader community should be informed about self-inoculation, which can result from touching one’s mucosa or mask with contaminated hands.
Background: Respiratory viruses such as SARS-CoV-2 spread via different transmission routes. While the droplet path plays the most important role in transmisson, contamination of the mucous membranes with contaminated hands also plays an important role in the spread. Thus, the aim of the present study was to assess the face-touching behaviors of HCWs and intern doctors during the COVID-19 pandemic. Methods: This study was conducted in July 2020 and in the Selcuk University Faculty of Medicine in Konya, Turkey. While 1-hour COVID-19 training was given to healthcare personnel and interns, participants face-touching behavior was monitored through video recording and was tallied with a scoring sheet. Results: A total of 141 intern doctors, 46 assistant doctors, 14 nurses, 10 associate doctors, and eight staff members participated in the study. On average, each of the participants touched their face a mean of 17.2 times (median: 16; range: 0–45) per hour. Of all the face touches, 85.2% (3,228/3,787) involved contact with a face mask, whereas 14.7 % (559/3787) involved contact with the eye mucosa. Intern doctors touched their faces significantly less often with a mean of 13.7 times per hour (P < 0.001), while nurses touched their faces more often with a mean of 28 times per hour (P < 0.001). Although nurses touched their eye mucosa more often than interns and assistant doctors (P < 0,001), their contact with the face mask was significantly less frequent than that of the other participants (P < 0.001). Conclusions: To date, there are no effective vaccines or antiviral drugs for SARS-CoV-2. For the time being, isolation, social distancing measures, and individuals’ protective behaviors are essential for preventing infection. HCWs, medical students, and the broader community should be informed about self-inoculation, which can result from touching one’s mucosa or mask with contaminated hands.
  • 1. Graman PS, Hall CB. Nosocomial viral respiratory infections. Semin Respir Infect. 1989 Dec;4(4):253–60.
  • 2. Kwok YLA, Gralton J, McLaws M-L. Face touching: a frequent habit that has implications for hand hygiene. Am J Infect Control. 2015 Feb;43(2):112–4.
  • 3. Kutter JS, Spronken MI, Fraaij PL, Fouchier RA, Herfst S. Transmission routes of respiratory viruses among humans. Curr Opin Virol. 2018 Feb;28:142–51.
  • 4. Subbarao K, Mahanty S. Respiratory Virus Infections: Understanding COVID-19. Immunity. 2020 Jun;52(6):905–9.
  • 5. Elder NC, Sawyer W, Pallerla H, Khaja S, Blacker M. Hand hygiene and face touching in family medicine offices: a Cincinnati Area Research and Improvement Group (CARInG) network study. J Am Board Fam Med. 2014;27(3):339–46.
  • 6. Kwok A, McLaws M-L. P157: Face-touching: a frequent habit for self-inoculation of transmissible infections? Antimicrob Resist Infect Control [Internet]. 2013;2(1):P157. Available from: https://doi.org/10.1186/2047-2994-2-S1-P157
  • 7. Cai J, Sun W, Huang J, Gamber M, Wu J, He G. Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020. Emerg Infect Dis. 2020 Jun;26(6):1343–5.
  • 8. Zhou Q, Gao Y, Wang X, Liu R, Du P, Wang X, et al. Nosocomial infections among patients with COVID-19, SARS and MERS: a rapid review and meta-analysis. Ann Transl Med. 2020 May;8(10):629.
  • 9. Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020 Aug;56(2):106054.
  • 10. Jayaweera M, Perera H, Gunawardana B, Manatunge J. Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environ Res. 2020 Jun;188:109819.
  • 11. Tao J, Song Z, Yang L, Huang C, Feng A, Man X. Emergency management for preventing and controlling nosocomial infection of the 2019 novel coronavirus: implications for the dermatology department. Vol. 182, The British journal of dermatology. England; 2020. p. 1477–8.
  • 12. West R, Michie S, Rubin GJ, Amlôt R. Applying principles of behaviour change to reduce SARS-CoV-2 transmission. Nat Hum Behav. 2020 May;4(5):451–9.
  • 13. Belser JA, Gustin KM, Katz JM, Maines TR, Tumpey TM. Influenza virus infectivity and virulence following ocular-only aerosol inoculation of ferrets. J Virol. 2014 Sep;88(17):9647–54.
  • 14. Goldmann DA. Transmission of viral respiratory infections in the home. Pediatr Infect Dis J. 2000 Oct;19(10 Suppl):S97-102.
  • 15. MacIntyre CR, Cauchemez S, Dwyer DE, Seale H, Cheung P, Browne G, et al. Face mask use and control of respiratory virus transmission in households. Emerg Infect Dis. 2009 Feb;15(2):233–41.
  • 16. Javid B, Weekes MP, Matheson NJ. Covid-19: should the public wear face masks? Vol. 369, BMJ (Clinical research ed.). England; 2020. p. m1442.
  • 17. Howard J, Huang A, Li Z, Tufekci Z, Zdimal V, Westhuizen H-M van der, et al. Face Mask Against COVID-19: An Evidence Review. Br Med J [Internet]. 2020 Apr 12 [cited 2020 Aug 7];(April):1–8. Available from: www.preprints.org
  • 18. Nicas M, Best D. A study quantifying the hand-to-face contact rate and its potential application to predicting respiratory tract infection. J Occup Environ Hyg. 2008 Jun;5(6):347–52.
  • 19. Macias AE, de la Torre A, Moreno-Espinosa S, Leal PE, Bourlon MT, Ruiz-Palacios GM. Controlling the novel A (H1N1) influenza virus: don’t touch your face! Vol. 73, The Journal of hospital infection. England; 2009. p. 280–1.
  • 20. Grunwald M, Weiss T, Mueller S, Rall L. EEG changes caused by spontaneous facial self-touch may represent emotion regulating processes and working memory maintenance. Brain Res. 2014 Apr;1557:111–26.
Birincil Dil en
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Orcid: 0000-0003-3384-769X
Yazar: Gülsüm ALKAN (Sorumlu Yazar)
Kurum: Selçuk Üniversitesi Tıp Fakültesi Çocuk Enfeksiyon Hastalıkları Bölümü
Ülke: Turkey


Orcid: 0000-0003-1307-0246
Yazar: Melike KESER EMİROĞLU
Kurum: Selçuk Üniversitesi Tıp Fakültesi Çocuk Enfeksiyon Hastalıkları Bölümü
Ülke: Turkey


Orcid: 0000-0002-2473-5672
Yazar: Şadiye Kübra TÜTER ÖZ
Kurum: Selçuk Üniversitesi Tıp Fakültesi Çocuk Enfeksiyon Hastalıkları Bölümü
Ülke: Turkey


Orcid: 0000-0003-1355-7572
Yazar: Onur URAL
Kurum: Selçuk Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı
Ülke: Turkey


Orcid: 0000-0003-3508-7546
Yazar: Şua SÜMER
Kurum: Selçuk Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı
Ülke: Turkey


Orcid: 0000-0002-4703-0827
Yazar: Nazlım AKTUĞ DEMİR
Kurum: Selçuk Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı
Ülke: Turkey


Tarihler

Kabul Tarihi : 23 Aralık 2020
Yayımlanma Tarihi : 30 Ocak 2021

AMA Alkan G , Keser Emiroğlu M , Tüter Öz Ş , Ural O , Sümer Ş , Aktuğ Demir N . Evaluation of the Hand-To-Face Contact Behaviors of Healthcare Workers and Medical Students in the COVID-19 Pandemic. J Contemp Med. 2021; 11(1): 82-85.