美国社区队列中基本工作人员感染 SARS-CoV-2 的风险。
Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States.
机构信息
Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States.
Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
出版信息
Front Public Health. 2022 May 17;10:878208. doi: 10.3389/fpubh.2022.878208. eCollection 2022.
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 and June 19, 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.
目的
本文旨在确定与职业类型和工作场所条件相关的 SARS-CoV-2 感染风险因素。识别这些风险因素对于增强工作场所安全和为基本工作人员制定应急准备计划具有重要意义。
方法
我们对 2020 年 3 月 18 日至 6 月 19 日期间在大波士顿地区的一个社区 SARS-CoV-2 检测点进行了回顾性分析，对象为 14 至 65 岁的个体。采集鼻咽拭子标本、医学审查和自我管理问卷，并通过实时逆转录聚合酶链反应（RT-PCR）确定 SARS-CoV-2 感染情况。通过图表审查从每个个体的回复中提取经医学记录验证的工作分类、面向客户和工作模式，并由持照临床医生进行验证。职业模式由职业医学医生根据预设标准进行编码，并通过逻辑回归和逆概率加权进行分析。
结果
在最终分析的 780 名个体中，从事医疗保健相关工作的个体感染 SARS-CoV-2 的风险增加了四倍（调整后的 OR：4.00，95%CI：1.45-11.02）。与非面向客户的职位相比，从事面向客户工作的个体 SARS-CoV-2 RT-PCR 检测结果呈阳性的风险增加了两倍（调整后的 OR：1.97，95%CI：1.12-3.45）。
结论
在这项美国社区人群的大流行初期研究中，从事医疗保健行业或面向客户的职业的个体感染 SARS-CoV-2 的风险显著增加。需要进一步研究以确定随着人群免疫力的增强和 SARS-CoV-2 毒力的减弱，这些相关性是否会持续存在。
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