Risk of Occupational HPV Exposure Among Medical Trainees: A Call for HPV Vaccination.

Abstract

The global COVID-19 pandemic has brought new scrutiny to aero-sol-generating medical procedures (AGMPs) and the risk that they pose to healthcare workers, namely through the transmission of aerosolized viral particles and viral DNA. As a result, there is now widespread knowl-edge of the risks posed by the SARS-CoV-2 virus and the measures that protect against it, including personal protective equipment and vaccination. However, healthcare workers regularly encounter another virus that is known to be highly contagious in multiple contexts and leads to significant morbidity and mortality. This is the human papillomavirus (HPV), which accounts for up to 79% of all oropharyngeal cancers in the U.S. and is a known cause of respiratory conditions such as recurrent laryngeal papillomatosis. 1-2 While studies into the respiratory transmission of HPV mainly have examined the risk posed by exposure to and inhalation of surgical smoke during procedures such as loop electrosurgical excision pro-cedure and CO2-laser ablation, 3 many non-surgical AGMPs, such as mechanical ventilation and even endotracheal suctioning, have been shown to result in the airborne transmission of other virus-contain-ing aerosols. 4 Although more research is needed to determine the risk of HPV transmission specifically in procedures that are common to general and critical care medicine, the list of known AGMPs includes sputum induction, nebulized or aerosol therapy, high-flow oxygen therapy, non-invasive and manual ventilation, endotracheal intuba-tion and