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Applying a risk-risk tradeoff economics approach to the occupational health of nurses: 2 economic and microbial risk analysis

Lookup NU author(s): Dr Irene Mussio, Professor Susan ChiltonORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Public health challenges are increasingly complex, and interventions reducing the risk of one health outcome may increase the risk of another. We focus on the increased risk of occupational asthma (OA) for nurses and the decreased risk of occupational infections from contaminated surfaces from intensifying cleaning and disinfection protocols (i.e., during the COVID-19 pandemic). A risk–risk trade-off approach allows for the calculation of tolerable risks. We then determine, through a quantitative microbial risk assessment, critical concentrations of SARS-CoV-2 hygiene standards for surfaces that would achieve those tolerance levels. We find that, on average, in three out of our four scenarios, nurses prefer contracting a respiratory viral illness over OA around 80% of the time. Knowing another person who has contracted a respiratory viral infection (RVI) is negatively related to increasing respiratory viral infection risk. Critical concentrations were <0.01 viral particles/cm2, implying frequent monitoring of viral concentrations on surfaces is needed to ensure risk targets are achieved. When applied to occupational health trade-offs for nurses engaging in cleaning and disinfection, we show that high environmental hygiene standards are needed.


Publication metadata

Author(s): Mussio I, Chilton S, Kent D, Gerald L, Wilson A

Publication type: Article

Publication status: Published

Journal: Risk Analysis

Year: 2025

Pages: epub ahead of print

Online publication date: 23/10/2025

Acceptance date: 29/09/2025

Date deposited: 14/10/2025

ISSN (electronic): 1539-6924

Publisher: Wiley

URL: https://doi.org/10.1111/risa.70122

DOI: 10.1111/risa.70122

ePrints DOI: 10.57711/f91s-2q37

Data Access Statement: Anonymized data are included as a supplementary materials file


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Funding

Funder referenceFunder name
Blood Institute of the National Institutes of Health under Award Number K01HL168014
Southwest 26 Environmental Health Sciences Center (NIEHS P30 ES006694)
University of Arizona Health Sciences Career Development Award

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