Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

  1. Carol Y. Rao
  2. Tashina Robinson
  3. Karin Huster
  4. Rebecca L. Laws
  5. Ryan Keating
  6. Farrell A. Tobolowsky
  7. Temet M. McMichael
  8. Elysia Gonzales
  9. Emily Mosites

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Abstract

To describe the work environment and COVID-19 mitigation measures for homeless shelter workers and assess occupational risk factors for COVID-19.

Methods

Between June 9-August 10, 2020, we conducted a self-administered survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia. We calculated frequencies for work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models to produce unadjusted prevalence ratios (PR) to assess risk factors for SARS-CoV-2 infection.

Results

Of the 106 respondents, 43.4% reported frequent close contact with clients; 75% were worried about work-related SARS-CoV-2 infections; 15% reported testing positive. Close contact with clients was associated with testing positive for SARS-CoV-2 (PR 3.97, 95%CI 1.06, 14.93).

Conclusions

Homeless shelter workers may be at risk of being exposed to individuals with COVID-19 during the course of their work. Frequent close contact with clients was associated with SARS-CoV-2 infection. Protecting these critical essential workers by implementing mitigation measures and prioritizing for COVID-19 vaccination is imperative during the pandemic.

Article activity feed

  1. Version published to 10.1371/journal.pone.0253108
  2. Version published to 10.1101/2021.02.22.21251646v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.02.22.21251646: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Study data were collected and managed using REDCap electronic data capture tools hosted at CDC.
    REDCap
    suggested: (REDCap, RRID:SCR_003445)

    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:
    This study is subject to several limitations. The questionnaire was online and self-administered where there may have been selection bias and recall bias when reporting exposures, symptoms, and timing of testing. There were small number of positives which limited our ability to conduct more robust analyses to evaluate potential occupational risk factors associated with testing positive (Table 4). The respondents were a self-selected convenience sample where response rate was not able to be estimated. It is possible that workers who were more concerned with COVID-19 participated in the survey. In our sample, 15% of respondents reported testing positive compared to 4.3% of a universal testing database.5 In addition, homeless shelter workers from multi-facility networks in large cities were invited to participate.; thus, this sample may not be representative of all homeless shelter workers in the United States. This is the first study that describes the work environment of homeless shelter workers in the context of COVID-19. We found that surveyed homeless shelter workers reported frequent close contact with clients; this was associated with having a positive test for SARS-CoV-2, while wearing masks and maintaining social distance at work were protective. Shelter management should continue to follow public health recommendations11 by reinforcing mitigation measures in the workplace and training staff routinely on mitigation measures. Homeless shelter workers are essential worker...

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.02.22.21251646v1 on medRxiv