Occupations Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Vaccination, US Blood Donors, May 2021-December 2021

Melisa M Shah; Bryan R Spencer; Leora R Feldstein; James M Haynes; Tina J Benoit; Sharon H Saydah; Matthew R Groenewold; Susan L Stramer; Jefferson M Jones

doi:10.1093/cid/ciac883

Occupations Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Vaccination, US Blood Donors, May 2021-December 2021

Clin Infect Dis. 2023 Apr 3;76(7):1285-1294. doi: 10.1093/cid/ciac883.

Authors

Melisa M Shah¹, Bryan R Spencer², Leora R Feldstein¹, James M Haynes², Tina J Benoit¹, Sharon H Saydah¹, Matthew R Groenewold³, Susan L Stramer⁴, Jefferson M Jones¹

Affiliations

¹ Centers for Disease Control and Prevention, Epidemiology Task Force, Atlanta, Georgia, USA.
² American Red Cross, Scientific Affairs, Dedham, Massachusetts, USA.
³ Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), Atlanta, Georgia, USA.
⁴ American Red Cross, Scientific Affairs, Gaithersburg, Maryland, USA.

PMID: 36373203
DOI: 10.1093/cid/ciac883

Abstract

Background: 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.

Methods: 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.

Results: 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%).

Conclusions: 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.

Keywords: COVID-19; SARS-CoV-2; occupation; vaccination.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Blood Donors* / statistics & numerical data
COVID-19* / epidemiology
COVID-19* / prevention & control
Case-Control Studies
Food Industry* / statistics & numerical data
Health Personnel* / statistics & numerical data
Humans
Occupations* / statistics & numerical data
Risk Factors
SARS-CoV-2
Surveys and Questionnaires
Vaccination* / statistics & numerical data