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An Integrated Model of Infection Risk in a Health‐Care Environment

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  • Mark Nicas
  • Gang Sun

Abstract

Certain respiratory tract infections can be transmitted by hand‐to‐mucous‐membrane contact, inhalation, and/or direct respiratory droplet spray. In a room occupied by a patient with such a transmissible infection, pathogens present on textile and nontextile surfaces, and pathogens present in the air, provide sources of exposure for an attending health‐care worker (HCW); in addition, close contact with the patient when the latter coughs allows for droplet spray exposure. We present an integrated model of pertinent source‐environment‐receptor pathways, and represent physical elements in these pathways as “states” in a discrete‐time Markov chain model. We estimate the rates of transfer at various steps in the pathways, and their relationship to the probability that a pathogen in one state has moved to another state by the end of a specified time interval. Given initial pathogen loads on textile and nontextile surfaces and in room air, we use the model to estimate the expected pathogen dose to a HCW's mucous membranes and respiratory tract. In turn, using a nonthreshold infectious dose model, we relate the expected dose to infection risk. The system is illustrated with a hypothetical but plausible scenario involving a viral pathogen emitted via coughing. We also use the model to show that a biocidal finish on textile surfaces has the potential to substantially reduce infection risk via the hand‐to‐mucous‐membrane exposure pathway.

Suggested Citation

  • Mark Nicas & Gang Sun, 2006. "An Integrated Model of Infection Risk in a Health‐Care Environment," Risk Analysis, John Wiley & Sons, vol. 26(4), pages 1085-1096, August.
    • Handle: RePEc:wly:riskan:v:26:y:2006:i:4:p:1085-1096
    DOI: 10.1111/j.1539-6924.2006.00802.x
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    Cited by:

    1. Baloch, Gohram & Gzara, Fatma & Elhedhli, Samir, 2023. "Risk-based allocation of COVID-19 personal protective equipment under supply shortages," European Journal of Operational Research, Elsevier, vol. 310(3), pages 1085-1100.
    2. Siming You & Man Pun Wan, 2015. "A Risk Assessment Scheme of Infection Transmission Indoors Incorporating the Impact of Resuspension," Risk Analysis, John Wiley & Sons, vol. 35(8), pages 1488-1502, August.
    3. Nan Zhang & Yuguo Li, 2018. "Transmission of Influenza A in a Student Office Based on Realistic Person-to-Person Contact and Surface Touch Behaviour," IJERPH, MDPI, vol. 15(8), pages 1-20, August.
    4. Edward M. Fisher & John D. Noti & William G. Lindsley & Francoise M. Blachere & Ronald E. Shaffer, 2014. "Validation and Application of Models to Predict Facemask Influenza Contamination in Healthcare Settings," Risk Analysis, John Wiley & Sons, vol. 34(8), pages 1423-1434, August.
    5. Lawrence M. Wein & Michael P. Atkinson, 2009. "Assessing Infection Control Measures for Pandemic Influenza," Risk Analysis, John Wiley & Sons, vol. 29(7), pages 949-962, July.
    6. Timothy R. Julian & Robert A. Canales & James O. Leckie & Alexandria B. Boehm, 2009. "A Model of Exposure to Rotavirus from Nondietary Ingestion Iterated by Simulated Intermittent Contacts," Risk Analysis, John Wiley & Sons, vol. 29(5), pages 617-632, May.
    7. Rachael M. Jones & Elodie Adida, 2011. "Influenza Infection Risk and Predominate Exposure Route: Uncertainty Analysis," Risk Analysis, John Wiley & Sons, vol. 31(10), pages 1622-1631, October.
    8. Mark Nicas & Rachael M. Jones, 2009. "Relative Contributions of Four Exposure Pathways to Influenza Infection Risk," Risk Analysis, John Wiley & Sons, vol. 29(9), pages 1292-1303, September.
    9. Rachael M. Jones & Yulin Xia, 2018. "Annual Burden of Occupationally‐Acquired Influenza Infections in Hospitals and Emergency Departments in the United States," Risk Analysis, John Wiley & Sons, vol. 38(3), pages 442-453, March.
    10. Gin Nam Sze‐To & Yang Yang & Joseph K. C. Kwan & Samuel C. T. Yu & Christopher Y. H. Chao, 2014. "Effects of Surface Material, Ventilation, and Human Behavior on Indirect Contact Transmission Risk of Respiratory Infection," Risk Analysis, John Wiley & Sons, vol. 34(5), pages 818-830, May.

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