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Int. J. Environ. Res. Public Health 2019, 16(8), 1392; https://doi.org/10.3390/ijerph16081392

Are Daycare Workers at a Higher Risk of Parvovirus B19 Infection? A Systematic Review and Meta-Analysis

1
Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
2
Section Occupational Health, Basic Principles of Prevention and Rehabilitation, Institution for Statutory Social Accident Insurance and Prevention in the Health Care and Welfare Services (BGW), 22089 Hamburg, Germany
3
Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
*
Author to whom correspondence should be addressed.
Received: 27 March 2019 / Revised: 13 April 2019 / Accepted: 15 April 2019 / Published: 17 April 2019
(This article belongs to the Section Occupational Safety and Health)
PDF [659 KB, uploaded 17 April 2019]

Abstract

Objective: In this systematic review, we aimed to summarize the evidence on the association between being a daycare educator working with children and the possible increased risk of parvovirus B19 infection compared to the general population. Methods: The Medline and Embase databases were searched using a defined search to find studies published since 2000. Two reviewers evaluated the search hits using predefined inclusion and exclusion criteria. The resulting studies were extracted and were assessed in eight domains of bias. A pooled relative risk (RR) of parvovirus infection for daycare workers compared to the general population was calculated. Results: After evaluating the 7781 search hits and manual search, four methodologically-adequate studies were identified: three cross-sectional studies and one retrospective cohort study. Of the three studies investigating the risk of infection, one evaluated parvovirus B19 seroconversion rates for daycare workers. There was an indication for an increased risk for daycare workers compared to the unexposed population (RR = 1.12, 95% CI 0.98–1.27) using prevalence estimators. Furthermore, daycare workers had a higher seroconversion rate compared to the unexposed population (RR = 2.63, 95% 1.27–5.45) in the low risk of bias study. Conclusions: Our findings suggest a higher risk of parvovirus B19 infection for daycare workers compared to an unexposed comparison population, which necessitate preventative efforts. Considering the underestimation of the occupational seroconversion risk by prevalence-based estimators, parvovirus B19 infections among daycare workers might mostly be occupationally acquired.
Keywords: parvovirus B19; fifth disease; daycare workers; daycare; kindergarten teachers; occupational risk; occupational disease parvovirus B19; fifth disease; daycare workers; daycare; kindergarten teachers; occupational risk; occupational disease
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Romero Starke, K.; Kofahl, M.; Freiberg, A.; Schubert, M.; Groß, M.L.; Schmauder, S.; Hegewald, J.; Kämpf, D.; Stranzinger, J.; Nienhaus, A.; Seidler, A. Are Daycare Workers at a Higher Risk of Parvovirus B19 Infection? A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2019, 16, 1392.

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