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V. -
<br />Social
<br />. -
<br />Social distancing, PPE usage, COVID-19 prevention knowledge
<br />score and COVID-19 pandemic perception score
<br />Participants answered a Likert scale, from never (one) to always
<br />(five), for four questions that assessed employee's practice of
<br />social distancing and PPE use. Participants answered another
<br />Likert scale with six statements, from completely disagree (one)
<br />to completely agree (five), which captured the workers' knowl-
<br />edge on PPE and self-perceptions toward COVID-19 pandemic.
<br />Both employee's PPE knowledge and COVID-19 perception
<br />were then tabulated to a score ranging from 3 to 15. A complete
<br />list of questions is included in Online -Only Supplement 1.
<br />Customer exposure categorisation
<br />Employees' job position was classified into two categories: those
<br />with significant face-to-face, direct exposure to customers and
<br />those without significant customer exposure. Employees with
<br />direct customer exposure include cashier, front end associate,
<br />sales associate, fresh food associate, cart attendant, janitorial
<br />crew, supervisor and manager of all levels. Those without direct
<br />customer exposure include stocker, backroom, receiving and
<br />maintenance.
<br />Study participants
<br />The COVID-19 testing was conducted as part of a city -mandated
<br />group testing, independent to this research. The existing medical
<br />records collected for the city testing were de -identified at the
<br />primary clinical site prior to analysis. Therefore, the study of
<br />de -identified data received a non -human research determination
<br />by the Management Sciences for Health (SC#0012020).
<br />Statistical analysis
<br />We performed univariate analyses to compare the workers' char-
<br />acteristics by their SARS-CoV-2 RT -PCR testing results, anxiety
<br />and depression status. For binary variables, Pearson's x2 test with
<br />Yates' continuity correction was performed, while for variables
<br />with at least one cell count less than five, Fisher's exact test
<br />was conducted instead. As to continuous variables, data were
<br />examined by Q -Q plots and determined if they followed normal
<br />distribution beforehand. Then we performed parametric t-test or
<br />non -parametric Wilcoxon rank sum test, as appropriate.
<br />Logistic regression models and models adjusting for potential
<br />confounders were further built. Due to the small sample size and
<br />event numbers, we used the inverse probability weighting (IPW)
<br />method to avoid inflated SEs of the parameter estimates. 22 The
<br />IPW was calculated based on the selected variables determined
<br />from the univariate analyses results. Extreme weights (below the
<br />5th and above the 95th percentile) were truncated as an addi-
<br />tional sensitivity analysis. ORs with 95% CIs were presented.
<br />We performed secondary sensitivity analysis according to
<br />employees' job titles. Employees' job position(s) were initially
<br />categorised into positions with greater direct customer exposure
<br />versus those without. In the sensitivity analysis, we categorised
<br />the jobs into supervisory positions vs non -supervisory positions.
<br />All p values reported are two -tailed. A p value <0.05 was
<br />considered statistically significant. We used R software (V.3.6.3)
<br />to conduct statistical analyses.
<br />RESULTS
<br />In table 1, we presented the characteristics of all tested employees
<br />stratified by SARS-CoV-2 RT -PCR assay results. Among the 104
<br />Table 1 Characteristics of retail essential employees in a single grocery store in Massachusetts, USA by SARS-CoV-2 (the virus causing COVID-19)
<br />RT -PCR assay testing results
<br />Age, mean (SD)
<br />Female, n N
<br />Non -Caucasian, n (%)
<br />Cigarette smoker, n (%)
<br />Daily alcohol consumption, n (%)
<br />Marijuana use, n (%)
<br />Self-reported exposure to SARS-CoV-2-positive individual(s) in the past 14 days, n (%)
<br />Job positions with direct customer exposure at storet, n (%)
<br />Full-time employment status, n (%)
<br />Residential area SARS-CoV-2 prevalence (per 100 000), geometric mean (geometric SD)
<br />Ability to practice social distancing consistently at work, count (%)
<br />Using gloves consistently at work, count (%)
<br />Wearing face mask consistently at work, count (%)
<br />Wearing face mask consistently outside of work, count (%)
<br />Commute to work by foot, bike or private car
<br />PPE knowledge score, median (IQR)
<br />COVID-19 perception score, median (IQR)
<br />GAD -7 score, median (IQR)
<br />PHQ-9 score, median (IQR)
<br />Employee has an assigned primary care provider, n (%)
<br />Requested mental health support on survey, n (%)
<br />Positive SARS-CoV-2 RT- Negative SARS-CoV-2
<br />Overall PCR assay RT -PCR assay
<br />(N=104) (N=21) (N=83) Pvalue
<br />49.0 (14.1)
<br />49.2 (14.4)
<br />49.0 (14.2)
<br />0.954
<br />49(47.1%)
<br />11 (52.4%)
<br />38(45.8%)
<br />0.767
<br />64(61.5%)
<br />14(66.7%)
<br />50(60.2%)
<br />0.283
<br />25(24.0%)
<br />1 (4.8%)
<br />24(28.9%)
<br />0.022*
<br />8(7.7%)
<br />0
<br />8(9.6%)
<br />0.354*
<br />1403.5%)
<br />2 (9.5%)
<br />12(14.5%)
<br />0.730*
<br />24(23.1%)
<br />4(19.0%)
<br />20(24.1%)
<br />0.776*
<br />68(65.4%)
<br />19(90.5%)
<br />49(59.0%)
<br />0.009*
<br />73(70.2%)
<br />16(76.2%)
<br />57(68.7%)
<br />0.685
<br />1106.0 (1.5)
<br />1292.8 (1.63)
<br />1063.2 (1.4)
<br />0.179#
<br />69(66.3%)
<br />13 (61.9%)
<br />56(67.5%)
<br />0.930
<br />80(76.9%)
<br />19(90.5%)
<br />61 (73.5%)
<br />0.068*
<br />95(91.3%)
<br />20(95.2%)
<br />75(90.4%)
<br />0.596*
<br />81 (77.9%)
<br />18(85.7%)
<br />63(75.9%)
<br />0.348*
<br />90(86.5%)
<br />19(90.5%)
<br />71 (85.5%)
<br />0.730*
<br />15(14-15)
<br />15(14-15)
<br />15(14-15)
<br />0.966 t
<br />12 (11-15)
<br />13(11-15)
<br />12(11-14)
<br />0.510 t
<br />0(0-4)
<br />1 (0-4.5)
<br />0 (0-4)
<br />0.660#
<br />0(0-2)
<br />00-1)
<br />0(0-2)
<br />0.733#
<br />77(74.0%)
<br />17(81.0%)
<br />60(72.3%)
<br />0.584*
<br />14(13.5%)
<br />3(14.3%)
<br />11 (13.3%)
<br />0.999*
<br />*Statistics derived from Fisher's exact test.
<br />tDirect customer exposure positions include cashier, front end associate, sales associate, fresh food associate, cart attendant, janitorial crew, supervisor and manager of all levels. These are in
<br />contrast to positions mainly dealing with consumer goods or the environment, such as stocker, backroom, receiving and maintenance.
<br />#Statistics derived from Wilcoxon rank sum test with continuity correction.
<br />GAD -7, Generalised Anxiety Disorder 7 -item scale; PHQ-9, Patient Health Questionnaire -9; PPE, personal protective equipment.
<br />Lan F -Y, et al. Occup Environ Med 2021;78:237-243. doi:10.1136/oemed-2020-106774 239
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