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

TY - JOUR

T1 - Are Daycare Workers at a Higher Risk of Parvovirus B19 Infection? A Systematic Review and Meta-Analysis

AU - Romero Starke, Karla

AU - Kofahl, Marlen

AU - Freiberg, Alice

AU - Schubert, Melanie

AU - Groß, Mascha Luisa

AU - Schmauder, Stefanie

AU - Hegewald, Janice

AU - Kämpf, Daniel

AU - Stranzinger, Johanna

AU - Nienhaus, Albert

AU - Seidler, Andreas

PY - 2019/4/17

Y1 - 2019/4/17

N2 - 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.

AB - 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.

KW - Journal Article

KW - Review

U2 - 10.3390/ijerph16081392

DO - 10.3390/ijerph16081392

M3 - SCORING: Review article

C2 - 30999694

VL - 16

JO - INT J ENV RES PUB HE

JF - INT J ENV RES PUB HE

SN - 1660-4601

IS - 8

ER -