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<br />Table 3 Characteristics of retail essential employees in a single grocery store in Massachusetts, USA presented for SARS-CoV-2, the virus causing
<br />COVID-19, RT -PCR assay testing by Patient Health Questionnaire -9 (PHQ-9) screening score for depression
<br />Age, mean (SD)
<br />Female, n (%)
<br />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 />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 />Commuting to work by foot, bike or private car
<br />PPE knowledge score, median (IQR)
<br />COVID-19 perception score, median (IQR)
<br />At least mild depression (PHQ- No or minimal depression
<br />9 score >4) (N=8) (PHQ-9 score <4) (N=91) P value
<br />40.3 (10.5)
<br />49.7 (14.2)
<br />0.070
<br />6(75.0%)
<br />41 (45.1%)
<br />0.145*
<br />3(37.5%)
<br />21 (23.1%)
<br />0.397*
<br />2(25.0%)
<br />6(6.6%)
<br />0.125*
<br />2(25.0%)
<br />11 (12.1%)
<br />0.282*
<br />5(62.5%)
<br />19(20.9%)
<br />0.019*
<br />6(75.0%)
<br />58(63.7%)
<br />0.712*
<br />7(87.5%)
<br />61 (67.0%)
<br />0.429*
<br />2(25.0%)
<br />66(72.5%)
<br />0.010*
<br />6(75.0%)
<br />71 (78.0%)
<br />0.667*
<br />7(87.5%)
<br />85(93.4%)
<br />0.409*
<br />4(50.0%)
<br />74(81.3%)
<br />0.133*
<br />4(50.0%)
<br />81 (89.0%)
<br />0.013*
<br />14.5 (14-15)
<br />15(14-15)
<br />0.885#
<br />13(12-14)
<br />12(11-15)
<br />0.402#
<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.
<br />These are in contrast to positions mainly dealing with consumer goods or the environment, such as stocker, backroom, receiving and maintenance.
<br />tStatistics derived from Wilcoxon rank sum test with continuity correction.
<br />PPE, personal protective equipment; RT -PCR, reverse transcriptase PCR.
<br />DISCUSSION
<br />Our current study presents multiple valuable COVID-19-related
<br />associations in a group of essential workers during the pandemic.
<br />First, the infection rate of 20% positive SARS-CoV-2 RT -PCR
<br />assay results at this grocery retail store was significantly higher
<br />than the surrounding communities. In addition, most of these
<br />employees were asymptomatic at time of testing. After IPW
<br />adjustments, employees with direct exposure to customers
<br />had more than five times increased odds to have a positive
<br />SARS-CoV-2 RT -PCR assay result. We also found the ability to
<br />practice social distancing at workplace was inversely correlated
<br />to workers' anxiety and depression status. Lastly, having a
<br />confirmed SARS-CoV-2 exposure history in past 14 days and
<br />commuting to work by public transportation or shared rides was
<br />strongly associated with depressive mood. To the best of our
<br />knowledge, this study is the first to report the above associations
<br />in a cohort of grocery retail essential employees.
<br />There is limited research discussing non -HCWs essential
<br />workers in this pandemic, particularly retail employees and
<br />their exposure to customers.9 The SARS-CoV-2 infection rate
<br />among these retail employees was significantly higher than of the
<br />local community around similar time period, which was 0.9%-
<br />1.3%.23 Previous studies on HCWs suggested COVID-19 infec-
<br />tions among HCWs were consistent with community exposure
<br />rather than work-related exposure, with the prevalence ranging
<br />from 0% to 14%.13 14 In fact, a pioneering study conducted in the
<br />Table 4 Crude and inverse probability weighting (IPW) adjusted ORs of positive SARS-CoV-2 (the virus causing COVID-19) RT -PCR assay, positive
<br />Generalised Anxiety Disorder Titem scale (GAD -7) and positive Patient Health Questionnaire -9 (PHQ-9) screenings by key risk factors among retail
<br />essential employees in a single grocery store in Massachusetts, USA
<br />Positive SARS-CoV-2 RT -PCR assay
<br />Job positions with direct customer exposure at store*
<br />Cigarette smoker
<br />Positive GAD -7 screening (GAD -7 >4)
<br />Ability to practice social distancing consistently at work
<br />Positive PHQ-9 screening (PHQ-9 score >4)
<br />Self-reported exposure to SARS-CoV-2-positive individual(s) in the past 14
<br />days
<br />Ability to practice social distancing consistently at work
<br />Truncated IPW
<br />Crude OR (95% Cl) IPW adjusted OR (95% Cl) adjusted OR (95% Cl)
<br />6.2 (1.6 to 40.6)
<br />5.1 (1.1 to 24.8)t
<br />5.3 (1.1 to 25.6)t
<br />0.1 (0.01 to 0.6)
<br />0.2 (0.02 to 1.4)t
<br />0.2 (0.02 to 1.3)t
<br />0.3 (0.1 to 0.7)
<br />0.3 (0.1 to 0.9)§
<br />0.3 (0.1 to 0.8)§
<br />6.3 (1.4 to 33.1)
<br />5.0 0.0 to 25.1)§
<br />5.0 (1.0 to 24.9)§
<br />0.1 (0.02 to 0.6)
<br />0.2 (0.03 to 0.99)§
<br />0.2 (0.03 to 0.9)§
<br />Commute to work by foot, bike or private car 0.1 (0.03 to 0.6) 0.1 (0.02 to 0.7)§ 0.1 (0.03 to 0.7)§
<br />*Direct customer exposure positions include cashier, front end associate, sales associate, fresh food associate, cart attendant, janitorial crew, supervisor and manager of all levels.
<br />These are in contrast to positions mainly dealing with consumer goods or the environment, such as stocker, backroom, receiving and maintenance.
<br />tIPW adjusting for age, gender, smoking and SARS-CoV-2 community prevalence in workers' residential cities.
<br />tIPW adjusting for age, gender, job positions with direct customer exposure, and SARS-CoV-2 community prevalence of workers' residential cities.
<br />§IPW adjusting for age, gender, smoking, customer -facing jobs, SARS-CoV-2 community prevalence of workers' residential cities and self-reported history of anxiety and/or
<br />depression.
<br />RT -PCR, reverse transcriptase PCR; Truncated IPW, IPW with extreme weights (below 5th and above 95th percentile) truncated.
<br />Lan F -Y, et al. Occup Environ Med 2021;78:237-243. doi: 10. 1 136/oemed-2020-106774 241
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