Abstract：
OBJECTIVE: According to current knowledge about legionella transmission, healthcare workers (HCWs) are at an increased risk of exposure. The aim of this research was to systematically review the literature about HCWs\' exposure to legionella and establish whether there is an occupational risk.
METHODS: This was a systematic review and meta-analysis.
METHODS: PubMed, Scopus and Web of Science were searched to identify studies regarding the occupational risk of legionellosis for HCWs. Keywords used in the search were \'Legionella pneumophila\', \'occupational medicine\', \'occupational\' and \'risk\'. Selected studies were reviewed to assess the quality and meta-analysed. Finally, the nine epidemiological principles of Bradford-Hill criteria were used to assess whether legionellosis could be considered an occupational risk for HCWs.
RESULTS: The search strategy retrieved 124 studies, and 10 studies were included in the present review. The overall study quality was low. The pooled odds ratio estimate was 2.45 (95% confidence interval: 1.52-3.96). The assessment using Bradford-Hill criteria showed that only two criteria (plausibility and coherence) were met, which is insufficient to establish an occupational risk.
CONCLUSIONS: This systematic review suggests that there is a higher risk of legionella exposure for HCWs, but there is currently no clinical evidence. Further studies with appropriate study design are needed to determine whether legionella infection is an occupational risk for HCWs.
METHODS: This was a systematic review and meta-analysis.
METHODS: PubMed, Scopus and Web of Science were searched to identify studies regarding the occupational risk of legionellosis for HCWs. Keywords used in the search were \'Legionella pneumophila\', \'occupational medicine\', \'occupational\' and \'risk\'. Selected studies were reviewed to assess the quality and meta-analysed. Finally, the nine epidemiological principles of Bradford-Hill criteria were used to assess whether legionellosis could be considered an occupational risk for HCWs.
RESULTS: The search strategy retrieved 124 studies, and 10 studies were included in the present review. The overall study quality was low. The pooled odds ratio estimate was 2.45 (95% confidence interval: 1.52-3.96). The assessment using Bradford-Hill criteria showed that only two criteria (plausibility and coherence) were met, which is insufficient to establish an occupational risk.
CONCLUSIONS: This systematic review suggests that there is a higher risk of legionella exposure for HCWs, but there is currently no clinical evidence. Further studies with appropriate study design are needed to determine whether legionella infection is an occupational risk for HCWs.
摘要：
目的：根据目前关于军团菌传播的知识，医护人员(HCWs)的暴露风险增加。这项研究的目的是系统地回顾有关HCW暴露于军团菌的文献，并确定是否存在职业风险。
方法：这是一项系统综述和荟萃分析。
方法：PubMed，搜索了Scopus和WebofScience，以确定有关HCW军团菌病职业风险的研究。搜索中使用的关键词是“嗜肺军团菌”，\'职业医学\',\'职业\'和\'风险\'。对选定的研究进行了回顾，以评估质量并进行荟萃分析。最后,Bradford-Hill标准的9项流行病学原则用于评估军团菌病是否可被视为HCW的职业风险.
结果：搜索策略检索了124项研究，本综述包括10项研究。总体研究质量较低。合并比值比估计值为2.45（95％置信区间：1.52-3.96）。使用布拉德福德-希尔标准进行的评估表明，仅满足两个标准（合理性和连贯性），不足以确定职业风险。
结论：本系统评价表明，HCWs接触军团菌的风险更高，但目前没有临床证据.需要进行适当研究设计的进一步研究，以确定军团菌感染是否是HCWs的职业风险。
方法：这是一项系统综述和荟萃分析。
方法：PubMed，搜索了Scopus和WebofScience，以确定有关HCW军团菌病职业风险的研究。搜索中使用的关键词是“嗜肺军团菌”，\'职业医学\',\'职业\'和\'风险\'。对选定的研究进行了回顾，以评估质量并进行荟萃分析。最后,Bradford-Hill标准的9项流行病学原则用于评估军团菌病是否可被视为HCW的职业风险.
结果：搜索策略检索了124项研究，本综述包括10项研究。总体研究质量较低。合并比值比估计值为2.45（95％置信区间：1.52-3.96）。使用布拉德福德-希尔标准进行的评估表明，仅满足两个标准（合理性和连贯性），不足以确定职业风险。
结论：本系统评价表明，HCWs接触军团菌的风险更高，但目前没有临床证据.需要进行适当研究设计的进一步研究，以确定军团菌感染是否是HCWs的职业风险。
