Association between SARS-CoV-2 infection, exposure risk and mental health among a cohort of essential retail workers in the USA
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Abstract
To investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.
Methods
This cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers’ personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase PCR (RT-PCR) results, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9).
Results
Among 104 workers tested, 21 (20%) had positive viral assays. Seventy-six per cent positive cases were asymptomatic. Employees with direct customer exposure had an odds of 5.1 (95% CI 1.1 to 24.8) being tested positive for SARS-CoV-2 after adjustments. As to mental health, the prevalence of anxiety and depression (ie, GAD-7 score >4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.3 (95% CI 0.1 to 0.9) and 0.2 (95% CI 0.03 to 0.99) screening positive for anxiety and depression, respectively. Workers commuting by foot, bike or private cars were less likely to screen positive for depression (OR 0.1, 95% CI 0.02 to 0.7).
Conclusions
In this single store sample, we found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct customer exposure were five times more likely to test positive for SARS-CoV-2. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.
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SciScore for 10.1101/2020.06.08.20125120: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our current study has several limitations. First, our limited sample size may prevent identification of certain associations that may require larger statistical power. Second, this is a cross-sectional study and therefore …
SciScore for 10.1101/2020.06.08.20125120: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our current study has several limitations. First, our limited sample size may prevent identification of certain associations that may require larger statistical power. Second, this is a cross-sectional study and therefore causal relationship could not be inferred. At the same time, survey collection was conducted prior to SARS-CoV-2 RT-PCR sampling, suggesting our major findings should be free of reverse causation and any recall bias would be minimized. Third, while a majority of the employees from this retail store were tested at this designated location, some employees received testing at other clinics due to insurance, scheduling and/or location convenience. As this was a city-mandated testing, employees were assigned by the retail headquarter to be tested at this location if they had not received or scheduled to receive SARS-CoV-2 testing. Selection was neither based on their exposure risk nor health outcome and therefore the current study should be free of selection bias. Lastly, since our data collection was largely based on self-reported questionnaire, we incur unavoidable risk of measurement error, misclassification and related information bias. At the same time, our study enjoys several strengths. First, the SARS-CoV-2 RT-PCR assay samples were collected by nasopharyngeal approach which provides the highest test sensitivity among all methods[33] and the outcomes of interest were assessed by validated screening tools including GAD-7 and PHQ-9. The possibility of outco...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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