# A Pilot Study Exploring the Risk of SARS-CoV-2 Infection Among Employees Handling Healthcare Waste in Selected Healthcare Risk Waste Facilities in Johannesburg, South Africa

## TL;DR

This study explores the risk of SARS-CoV-2 infection among healthcare waste workers in Johannesburg, finding that lack of PPE training and repeated waste handling may increase infection odds.

## Contribution

The study identifies preliminary occupational risk factors for SARS-CoV-2 among healthcare waste handlers in South Africa.

## Key findings

- 21.9% of participants reported a positive test result for SARS-CoV-2.
- Not being trained on PPE use increased the odds of infection.
- Having 3-6 years of experience reduced the odds of infection by 33%.

## Abstract

The SARS-CoV-2 pandemic has increased healthcare waste (HCW) across the globe, giving rise to new challenges such as illegal dumping of medical waste, and an increased risk to hazardous waste exposure such as blood and body fluids that could cause diseases. The study aimed to determine factors associated with SARS-CoV-2 infection among employees handling medical waste in selected healthcare risk waste (HCRW) facilities in Johannesburg, South Africa. The pilot study followed a cross-sectional design, where self-administered questionnaires were used to collect data on occupation-related risk factors for SARS-CoV-2 among HCW handlers working in waste generation, transportation, and final disposal. A total of 33 participants selected from eight HCRW facilities participated in the study. The analysis showed that 21.9% (n = 7) of the HCW handlers who participated in the study reported a positive test result for COVID-19, while 78.1% (n = 26) reported a negative test result for COVID-19. The logistic regression analysis showed that repeated handling of HCW (COR: 1.50, 95% CI: 1.00–2.25) and not having sufficient hand washing facilities (COR: 1.13: 95% CI: 1.04–1.24) increased the odds of SARS-CoV-2 infection; however, these factors were not significant as risks for SARS-CoV-2. In the multivariable analysis, not being trained on personal protective equipment (PPE) use (AOR: 1.25, 95% CI: 1.00–1.58) increased the odds of SARS-CoV-2 infection, while having 3-6 years of experience in medical waste handling significantly lowered the odds of occupation-related SARS-CoV-2 infection by 33% (AOR: 0.67, 95% CI: 0.48–0.95). These preliminary findings show that factors such as the accessibility of handwashing facilities, training on the use of PPE, years of work experience, and repeated contact with medical waste may play a role in modifying the odds of SARS-CoV-2 infection among HCW handlers. A study with a larger sample size is needed to comprehensively quantify occupation related risk factors associated with communicable disease infections among HCW handlers.