Centers for Disease Control and Prevention, Epidemiology Task Force, Atlanta, Georgia, USA.
American Red Cross, Scientific Affairs, Dedham, Massachusetts, USA.
Clin Infect Dis. 2023 Apr 3;76(7):1285-1294. doi: 10.1093/cid/ciac883.
There are limited data on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States by occupation. We identified occupations at higher risk for prior SARS-CoV-2 infection as defined by the presence of infection-induced antibodies among US blood donors.
Using a nested case-control study design, blood donors during May-December 2021 with anti-nucleocapsid (anti-N) testing were sent an electronic survey on employment status, vaccination, and occupation. The association between previous SARS-CoV-2 infection and occupation-specific in-person work was estimated using multivariable logistic regression adjusting for sex, age, month of donation, race and ethnicity, education, vaccination, and telework.
Among 85 986 included survey respondents, 9504 (11.1%) were anti-N reactive. Healthcare support (20.3%), protective service (19.9%), and food preparation and serving related occupations (19.7%) had the highest proportion of prior infection. After adjustment, prior SARS-CoV-2 infection was associated with healthcare practitioners (adjusted odds ratio [aOR], 2.10; 95% confidence interval [CI], 1.74-2.54) and healthcare support (aOR, 1.82; 95% CI, 1.39-2.40) occupations compared with computer and mathematical occupations as the referent group. Lack of coronavirus disease 2019 vaccination (aOR, 16.13; 95% CI, 15.01-17.34) and never teleworking (aOR, 1.17; 95% CI, 1.05-1.30) were also independently associated with prior SARS-CoV-2 infection. Construction and extraction occupations had the highest proportion of unvaccinated workers (30.5%).
Workers in healthcare, protective services, and food preparation had the highest prevalence of prior SARS-CoV-2 infection. Occupational risks for SARS-CoV-2 infection remained after adjusting for vaccination, telework, and demographic factors. These findings underscore the need for mitigation measures and personal protection in healthcare settings and other workplaces.
关于美国职业与严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染风险的数据有限。我们通过美国献血者中存在感染诱导抗体的情况，确定了感染风险更高的职业。
使用巢式病例对照研究设计，在 2021 年 5 月至 12 月期间进行抗核衣壳（抗-N）检测的献血者，会收到一份关于就业状况、疫苗接种和职业的电子调查。使用多变量逻辑回归，根据性别、年龄、献血月份、种族和民族、教育程度、疫苗接种情况和远程工作情况，调整了先前 SARS-CoV-2 感染与特定岗位工作的关联。
在 85986 名纳入的调查受访者中，有 9504 人（11.1%）抗-N 呈阳性。医疗支持（20.3%）、保护服务（19.9%）和食品制备与服务相关职业（19.7%）的既往感染比例最高。调整后，与计算机和数学职业相比，SARS-CoV-2 感染与医疗保健从业者（调整后的优势比[aOR]，2.10；95%置信区间[CI]，1.74-2.54）和医疗支持（aOR，1.82；95%CI，1.39-2.40）职业相关。未接种 2019 年冠状病毒病疫苗（aOR，16.13；95%CI，15.01-17.34）和从未远程工作（aOR，1.17；95%CI，1.05-1.30）也与先前的 SARS-CoV-2 感染独立相关。建筑和开采职业的未接种疫苗者比例最高（30.5%）。
医疗保健、保护服务和食品制备相关职业的 SARS-CoV-2 既往感染率最高。在调整了疫苗接种、远程工作和人口统计学因素后，SARS-CoV-2 感染的职业风险仍然存在。这些发现强调了在医疗保健环境和其他工作场所采取缓解措施和个人保护的必要性。
