Association between SARS-CoV-2 infection, exposure risk and mental health among a cohort of essential retail workers in the USA

Occup Environ Med. 2021 Apr;78(4):237-243. doi: 10.1136/oemed-2020-106774. Epub 2020 Oct 30.

Abstract

Objectives: To investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.

Methods: This cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers' personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase PCR (RT-PCR) results, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9).

Results: Among 104 workers tested, 21 (20%) had positive viral assays. Seventy-six per cent positive cases were asymptomatic. Employees with direct customer exposure had an odds of 5.1 (95% CI 1.1 to 24.8) being tested positive for SARS-CoV-2 after adjustments. As to mental health, the prevalence of anxiety and depression (ie, GAD-7 score >4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.3 (95% CI 0.1 to 0.9) and 0.2 (95% CI 0.03 to 0.99) screening positive for anxiety and depression, respectively. Workers commuting by foot, bike or private cars were less likely to screen positive for depression (OR 0.1, 95% CI 0.02 to 0.7).

Conclusions: In this single store sample, we found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct customer exposure were five times more likely to test positive for SARS-CoV-2. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.

Keywords: communicable diseases; health and safety; hygiene / occupational hygiene; occupational health practice; public health.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / psychology
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / prevention & control
  • COVID-19 / transmission
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • Occupational Exposure / statistics & numerical data*
  • Occupational Health
  • Prevalence
  • Risk
  • SARS-CoV-2 / isolation & purification
  • Supermarkets*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Workplace / statistics & numerical data