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    Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands

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    Author
    Wilson, Amanda M
    Reynolds, Kelly A
    Verhougstraete, Marc P
    Canales, Robert A
    Affiliation
    Univ Arizona, Dept Community Environm & Policy, Mel & Enid Zuckerman Coll Publ Hlth
    Issue Date
    2019-08-01
    Keywords
    Bacteriophage
    exposure simulation
    healthcare
    
    Metadata
    Show full item record
    Publisher
    WILEY
    Citation
    Wilson, A. M., Reynolds, K. A., Verhougstraete, M. P. and Canales, R. A. (2019), Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands. Risk Analysis, 39: 1812-1824. doi:10.1111/risa.13281
    Journal
    RISK ANALYSIS
    Rights
    © 2019 Society for Risk Analysis
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Understanding healthcare viral disease transmission and the effect of infection control interventions will inform current and future infection control protocols. In this study, a model was developed to predict virus concentration on nurses' hands using data from a bacteriophage tracer study conducted in Tucson, Arizona, in an urgent care facility. Surfaces were swabbed 2 hours, 3.5 hours, and 6 hours postseeding to measure virus spread over time. To estimate the full viral load that would have been present on hands without sampling, virus concentrations were summed across time points for 3.5- and 6-hour measurements. A stochastic discrete event model was developed to predict virus concentrations on nurses' hands, given a distribution of virus concentrations on surfaces and expected frequencies of hand-to-surface and orifice contacts and handwashing. Box plots and statistical hypothesis testing were used to compare the model-predicted and experimentally measured virus concentrations on nurses' hands. The model was validated with the experimental bacteriophage tracer data because the distribution for model-predicted virus concentrations on hands captured all observed value ranges, and interquartile ranges for model and experimental values overlapped for all comparison time points. Wilcoxon rank sum tests showed no significant differences in distributions of model-predicted and experimentally measured virus concentrations on hands. However, limitations in the tracer study indicate that more data are needed to instill more confidence in this validation. Next model development steps include addressing viral concentrations that would be found naturally in healthcare environments and measuring the risk reductions predicted for various infection control interventions.
    Note
    12 month embargo; published online: 13 February 2019
    ISSN
    0272-4332
    PubMed ID
    30759318
    DOI
    10.1111/risa.13281
    Version
    Final accepted manuscript
    Sponsors
    GOJO Industries, Inc.; Western Alliance to Expand Student Opportunities (WAESO) Louis Stokes Alliance for Minority Participation (LSAMP) Bridge to Doctorate (BD) National Science Foundation (NSF) [1608928]
    ae974a485f413a2113503eed53cd6c53
    10.1111/risa.13281
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