Evaluating COVID-19 Risk to Essential Workers by Occupational Group: A Case Study in Massachusetts

Abstract

Occupational exposure to SARS-CoV-2 varies by profession, but “essential workers” are often considered in aggregate in COVID-19 models. This aggregation complicates efforts to understand risks to specific types of workers or industries and target interventions, specifically towards non-healthcare workers. We used census tract-resolution American Community Survey data to develop novel essential worker categories among the occupations designated as COVID-19 Essential Services in Massachusetts. Census tract-resolution COVID-19 cases and deaths were provided by the Massachusetts Department of Public Health. We evaluated the association between essential worker categories and cases and deaths over two phases of the pandemic from March 2020 to February 2021 using adjusted mixed-effects negative binomial regression, controlling for other sociodemographic risk factors. We observed elevated COVID-19 case incidence in census tracts in the highest tertile of workers in construction/transportation/buildings maintenance (Phase 1: IRR 1.32 [95% CI 1.22, 1.42]; Phase 2: IRR: 1.19 [1.13, 1.25]), production (Phase 1: IRR: 1.23 [1.15, 1.33]; Phase 2: 1.18 [1.12, 1.24]), and public-facing sales and services occupations (Phase 1: IRR: 1.14 [1.07, 1.21]; Phase 2: IRR: 1.10 [1.06, 1.15]). We found reduced case incidence associated with greater percentage of essential workers able to work from home (Phase 1: IRR: 0.85 [0.78, 0.94]; Phase 2: IRR: 0.83 [0.77, 0.88]). Similar trends exist in the associations between essential worker categories and deaths, though attenuated. Estimating industry-specific risk for essential workers is important in targeting interventions for COVID-19 and other diseases and our categories provide a reproducible and straightforward way to support such efforts.

Machine learning-driven COVID-19 early triage and large-scale testing strategies based on the 2021 Costa Rican Actualidades survey

“…A more balanced approach partitions the population into high-risk and low-risk groups based on their exposure risk, tailoring testing strategies accordingly. The high-risk group includes symptomatic individuals, healthcare workers, and essential workers (Haley et al, 2023). RT-qPCR or similar technologies like RT-LAMP testing is crucial for this group to prevent superspreading events.…”

Capturing the implications of residential segregation for the dynamics of infectious disease transmission

“…Occupational and residential segregation, racial capitalism (1), mass incarceration (2) and other manifestations of social and economic inequity (3) have been definitively shown to drive of racial and socioeconomic inequities in infection, severe disease, and death from a wide variety of infections including SARS-CoV-2 (4,5), seasonal and pandemic influenza (6), tuberculosis (7,8), STIs (9) and many others.…”

COVID‐19 mortality among Massachusetts workers and the association with telework ability, 2020

“…40,41 In the early months of the pandemic, studies found higher rates of COVID-19 in Massachusetts communities with greater percentages of workers in essential services, many of whom were likely unable to telework. 42,43 An analysis by Hawkins et al 22 of Massachusetts death certificate data from March-July 2020 found that COVID-19 ageadjusted mortality rates among workers aged 18-64 years varied by occupation group, with 11 groups having higher than average rates. The authors posited that one potential reason for the elevated rates in some groups was that they were more likely to have to work on-site rather than being able to telework, putting them at risk of occupational exposure.…”