A narrative review of occupational and community acquired infections among healthcare workers including exposure routes risk factors and infection prevention and control strategies from 2015 to 2025

Abstract

Healthcare workers (HCWs) face infection risks through patient care, specimen processing, sharps, contaminated environments, and exposures outside healthcare settings. Vulnerability was illustrated during COVID-19, when the World Health Organization estimated that 80,000–180,000 health and care workers could have died from COVID-19 between January 2020 and May 2021. This narrative review examines role-specific exposure pathways, barriers to adherence to infection prevention and control (IPC) measures, and strategies for reducing occupational and community-acquired infections among HCWs. English-language sources published during 2015–2025 were identified through targeted database and public-health-agency searches, last updated 30 June 2026. Evidence was organized thematically by HCW role, transmission route, barrier, and preventive intervention. Occupational risk was concentrated in aerosol-generating procedures, dental drilling, airway management, specimen centrifugation, direct contact with lesions or body fluids, sharps injuries, and contaminated equipment or surfaces. Recurrent barriers included inadequate training, personal protective equipment (PPE) shortages or poor fit, workload, staffing deficiencies, emergency time pressure, weak safety culture, and inconsistent institutional enforcement, with resource limitations especially influential in low- and middle-income settings. Community respiratory and household exposures may cause workforce infection and contribute to subsequent transmission within healthcare settings. Effective protection therefore requires standard precautions, transmission-based precautions, vaccination, safe sharps systems, engineering and environmental controls, adequate staffing, continuous competency-based training, and leadership accountability. Protecting HCWs should be treated as both an occupational-health obligation and a patient-safety strategy; interventions should be adapted to task-specific risks and local resources rather than relying on PPE alone. Different HCW groups have distinct exposure profiles, including physicians (and surgeons), dentists, pharmacists, anesthesia professionals, laboratory personnel, radiology technicians, nurses, midwives, medical waste handlers, and other support and administrative staff. Protection is described as risk-based PPE selection (gloves, masks or respirators, gowns or aprons, and eye protection) combined with IPC measures such as hand hygiene, environmental cleaning and disinfection, safe sharps handling, and biomedical waste management. Barriers to PPE and IPC adherence include limited awareness and training, misconceptions about PPE, heavy workload and staffing constraints, emergencies, and shortages or poor-quality PPE. Transmission is described as direct (respiratory aerosols and droplets, skin contact, sharps, mucosal exposure, and ingestion) and indirect through contaminated objects (fomites) in the clinical environment as well as exposure of HCWs to a wide variety of infections outside the medical setting.