Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States

Chih-Fu Wei; Fan-Yun Lan; Yu-Tien Hsu; Nina Lowery; Lauren Dibona; Ream Akkeh; Stefanos N Kales; Justin Yang

doi:10.3389/fpubh.2022.878208

Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States

Front Public Health. 2022 May 17:10:878208. doi: 10.3389/fpubh.2022.878208. eCollection 2022.

Authors

Chih-Fu Wei¹, Fan-Yun Lan^{1

2

3}, Yu-Tien Hsu⁴, Nina Lowery⁵, Lauren Dibona⁵, Ream Akkeh⁵, Stefanos N Kales^{1

3}, Justin Yang^{1

5

6

7}

Affiliations

¹ Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.
² Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States.
⁴ Department of Social and Behavioral Science, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.
⁵ Manet Community Health Center, Quincy, MA, United States.
⁶ Department of Employee and Occupational Health, Atrius Health, Boston, MA, United States.
⁷ Department of General Internal Medicine, Boston University School of Medicine, Boston, MA, United States.

Abstract

Objectives: The objective of this paper is to identify the risk factors for SARS-CoV-2 infection that are related to occupation type as well as workplace conditions. Identifying such risk factors could have noteworthy implications in workplace safety enhancement and emergency preparedness planning for essential workers.

Methods: We conducted a retrospective analysis of visits at a community-based SARS-CoV-2 testing site in the greater Boston area between March 18^th and June 19^th, 2020, for individuals between 14 and 65 years of age. Nasopharyngeal swab specimen, medical review, and self-administered questionnaire were obtained, and SARS-CoV-2 infection was determined with real-time, reverse transcriptase-polymerase chain reaction (RT-PCR). Medical record-verified job classification, customer-facing, and work patterns were extracted from each individual's response through chart review and validated by licensed clinicians. The occupational patterns were coded by occupational medicine physicians with pre-specified criteria and were analyzed with logistic regression and inverse probability weighting.

Results: Among the 780 individuals included in the final analysis, working in healthcare-related jobs was associated with a four-fold increase in risk of SARS-CoV-2 infection (Adjusted OR: 4.00, 95% CI: 1.45-11.02). Individuals with customer-facing jobs had a two times risk increase (Adjusted OR: 1.97, 95% CI: 1.12-3.45) in having a positive SARS-CoV-2 RT-PCR assay result compared to participants with non-customer facing positions.

Conclusions: In this U.S. community-based population during the initial wave of the pandemic, a significant increase in risk of SARS-CoV-2 infection was observed in those employed in the healthcare sector or with customer-facing positions. Further research is warranted to determine if these correlations continued with the buildup of population immunity together with the attenuation of SARS-CoV-2 virulence.

Keywords: COVID-19; Public Health Surveillance; communicable diseases; healthcare workers; occupational health.

MeSH terms

COVID-19 Testing
COVID-19* / epidemiology
Humans
Pandemics
Retrospective Studies
SARS-CoV-2
United States / epidemiology