Workplace
Understanding how vaccination practices impact PPE use in first responders, a US occupational group with historically low vaccination rates, 19 can shed insight to potential strategies to improve PPE use and COVID-19 control strategies. Nonethe- less, the relatively small sample size warrants repeated data collection with other fire departments. Further longitudinal research is needed to further investigate long-term immunity to the SARS-CoV-2 virus among first responders, particularly how the use of PPE mitigates rates of infection and how sero- logical antibody testing can inform return to work strategies. Twitter Alberto J Caban-Martinez @DrCabanMartinez and Erin Kobetz @http:// www.twitter.com/K obetzErin Acknowledgements We would like to acknowledge the fire department, the firefighters and local union of the International Association of Fire Firefighters (IAFF) for collaborating in the F-TRACE medical surveillance project. Contributors AJC-M, SBI and EK contributed to the conceptualisation and the design of the work, statistical analysis and interpretation of data and final drafting of the document. AJC-M, KS, MG, AB and PLF contributed to the statistical analysis and interpretation of the data, drafting the document and final approval. AJC-M, NS-S, KS, PLF, AB, MG, SBI and EK contributed to the interpretation of the data, drafting the document and final approval. All authors agree to be held accountable for all aspects of the work related to its accuracy and integrity. Funding Support for this research is, in part, by the State of Florida appropriation # 2382A for Firefighter Cancer Initiative (principal investigator (PI): EK) to the University of Miami (UM) Sylvester Comprehensive Cancer Center; the Federal Emergency Management Administration (FEMA) Grant # EMW-2017-FP-00860 (PI: AJC-M); the State of Florida appropriation #62 for the Medical Training and Simulation Laboratory to the University of Miami Gordon Center for Simulation and Innovation in Medical Education (PI: SBI); and by the National Cancer Institute of the National Institutes of Health under Award Number P30CA240139. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or Federal Emergency Management Agency of the Department of Homeland Security. Competing interests None declared. Patient consent for publication Not required. Ethics approval Review of the study protocol and approval was by the University of Miami Institutional Review Board (#20200537). Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available on reasonable request. Data from this study are available on request by sending an email message to the corresponding author, Dr Alberto Caban-Martinez (a caban@med.m iami.edu). This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise
determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. ORCID iD Alberto J Caban-Martinez http://orcid.org/0 000-0002-5 960-1308 REFERENCES 1 Jernigan DB, CDC COVID-19 Response Team. Update: Public Health Response to the Coronavirus Disease 2019 Outbreak - United States, February 24, 2020. MMWR Morb Mortal Wkly Rep 2020;69:216–9. 2 Gamio L. The workers who face the greatest coronavirus risk. New York Times 2020. 3 Spina S, Marrazzo F, Migliari M, et al . The response of Milan’s emergency medical system to the COVID-19 outbreak in Italy. Lancet 2020;395:e49–50. 4 Goudsmit J. The paramount importance of serological surveys of SARS-CoV-2 infection and immunity. Eur J Epidemiol 2020;35:331–3. 5 Long Q-X, Liu B-Z, Deng H-J, et al . Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med 2020;26:845–8. 6 Patel R, Babady E, Theel ES, et al . Report from the American Society for microbiology COVID-19 international Summit, 23 March 2020: value of diagnostic testing for SARS–CoV-2/COVID-19. MBio 2020;11. 7 Kimball A. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility—King County, Washington, March 2020. MMWR Morbidity and mortality weekly report 2020:69. 8 Bai Y, Yao L, Wei T, et al . Presumed asymptomatic carrier transmission of COVID-19. JAMA 2020;323:1406–7. 9 Ling Z, Xu X, Gan Q, et al . Asymptomatic SARS-CoV-2 infected patients with persistent negative CT findings. Eur J Radiol 2020;126:108956. 10 Harris PA, Taylor R, Thielke R, et al . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–81. 11 NCfH S. National health interview survey questionnaire . Hyattsville, MD: National Center for Health Statistics, 2000. 12 Burke RM. Active monitoring of persons exposed to patients with confirmed COVID-19—United states, January–February 2020. MMWR Morbidity and mortality weekly report 2020:69. 13 Li Z, Yi Y, Luo X, et al . Development and clinical application of a rapid IgM‐IgG combined antibody test for SARS‐CoV‐2 infection diagnosis. J Med Virol 2020. 14 Li Z, Yi Y, Luo X, et al . Development and clinical application of a rapid IgM‐IgG combined antibody test for SARS‐CoV‐2 infection diagnosis 2020. 15 Petherick A. Developing antibody tests for SARS-CoV-2 2020;395:1101–2. 16 Brouwer AF, Delinger RL, Eisenberg MC, et al . Hpv vaccination has not increased sexual activity or accelerated sexual debut in a college-aged cohort of men and women. BMC Public Health 2019;19:821. 17 Meader N, King K, Moe-Byrne T, et al . A systematic review on the clustering and co- occurrence of multiple risk behaviours. BMC Public Health 2016;16:1–9. 18 Strickland JR, Wagan S, Dale AM, et al . Prevalence and perception of risky health behaviors among construction workers. J Occup Environ Med 2017;59:673–8. 19 Caban-Martinez AJ, Lee DJ, Davila EP, et al . Sustained low influenza vaccination rates in US healthcare workers. Prev Med 2010;50:210–2.
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