Why not to pick your nose: Association between nose picking and SARS-CoV-2 incidence, a cohort study in hospital health care workers

PLoS One. 2023 Aug 2;18(8):e0288352. doi: 10.1371/journal.pone.0288352. eCollection 2023.

Abstract

Background: Hospital health care workers (HCW) are at increased risk of contracting SARS-CoV-2. We investigated whether certain behavioral and physical features, e.g. nose picking and wearing glasses, are associated with infection risk.

Aim: To assess the association between nose picking and related behavioral or physical features (nail biting, wearing glasses, and having a beard) and the incidence of SARS-CoV-2-infection.

Methods: In a cohort study among 404 HCW in two university medical centers in the Netherlands, SARS-CoV-2-specific antibodies were prospectively measured during the first phase of the pandemic. For this study HCW received an additional retrospective survey regarding behavioral (e.g. nose picking) and physical features.

Results: In total 219 HCW completed the survey (response rate 52%), and 34/219 (15.5%) became SARS-CoV-2 seropositive during follow-up from March 2020 till October 2020. The majority of HCW (185/219, 84.5%) reported picking their nose at least incidentally, with frequency varying between monthly, weekly and daily. SARS-CoV-2 incidence was higher in nose picking HCW compared to participants who refrained from nose picking (32/185: 17.3% vs. 2/34: 5.9%, OR 3.80, 95% CI 1.05 to 24.52), adjusted for exposure to COVID-19. No association was observed between nail biting, wearing glasses, or having a beard, and the incidence of SARS-CoV-2 infection.

Conclusion: Nose picking among HCW is associated with an increased risk of contracting a SARS-CoV-2 infection. We therefore recommend health care facilities to create more awareness, e.g. by educational sessions or implementing recommendations against nose picking in infection prevention guidelines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / transmission
  • Cohort Studies
  • Eyeglasses
  • Female
  • Habits
  • Hair
  • Health Personnel / statistics & numerical data
  • Hospitals
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nail Biting
  • Nose* / virology

Grants and funding

This work was funded by the Netherlands Organization for Health Research and Development ZonMw (S3 study, grant agreement no. 10430022010023 to M.K.B.) and the Corona Research Fund Amsterdam UMC. The funders were not involved in designing the study, data collection, analysis or interpreting the data, writing the manuscript or the decision to submit the article for publication.