Study of health workers links nose-picking to SARS-CoV-2 infection
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Key takeaways:
- Health care workers who picked their nose were three times as likely to acquire SARS-CoV-2 as those who did not.
- Nail biting, wearing glasses or having a beard were not linked to increased risk for SARS-CoV-2.
Health care workers who pick their nose were around three times more likely to become infected with SARS-CoV-2 than those who did not, a small study conducted at two hospitals in the Netherlands found.
Nose-picking is a relatively common habit, with surveys suggesting as many as 91% of people in the United States acknowledge doing it, according to Ayesha Lavell, PhD, internal medicine physician at Amsterdam University Medical Centers.
Previous studies have suggested that picking or rubbing the nose can be a source of viral colonization, including one that showed Streptococcus pneumoniae could be transmitted from a person’s fingers to the nasal mucosal surface, causing infection.
Additionally, early in the COVID-19 pandemic, as experts advised the public on how to effectively wear a face mask to prevent infection with SARS-CoV-2, they noted that scratching one’s nose behind the mask could defeat the mask’s purpose.
Lavell told Healio that she and her colleagues were curious whether the behavior also affected the potential for disease spread because “it entails literally putting a potentially contaminated finger against the nasal mucosa.”
“Previous research has shown us that nose-picking is associated with nasal carriage of S. aureus bacteria, for example. Therefore, it is surprising, given the amount of literature on SARS-CoV-2, that the relationship between nose-picking and COVID-19 has not been studied before,” Lavell said, “especially since health care workers are at increased risk of contracting SARS-CoV-2.”
Lavell and colleagues recruited 404 health care workers at two university medical centers in the Netherlands from March to October 2020, with 219 participants completing a retrospective survey. During the follow-up period, 34 of those 219 health care workers (15.5%) tested positive for SARS-CoV-2.
Of the health care workers who responded, 84.5% reported picking their nose at least incidentally at frequencies varying from daily to weekly or monthly, and the incidence of SARS-CoV-2 was higher among nose-pickers than those who did not pick their nose (17.3% vs. 5.9%), according to the study.
Conversely, nail biting, wearing glasses or having a beard were not linked to an increased risk for SARS-CoV-2 infection, suggesting direct interaction with the nasal mucosa during nose-picking — as opposed to interaction with saliva when biting nails — increases the risk for infection, the researchers said.
Lavell noted that other researchers have investigated the possible protective effects of saliva against transmission of SARS-CoV-2, but said that she and her colleagues were still surprised that nail biting did not have an association with viral transmission and that the association with nose-picking was so strong.
“It is important that clinicians, hospital administrators and public health officials and people in the general population are aware of the risks of nose-picking behavior and try to refrain from it, especially when in close contact with another person suffering from an upper respiratory tract infection or during a wave of respiratory infectious diseases,” Lavell said.
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