Abstract
There is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission. In this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period). We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals). Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.
Highlights
Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases)
Occupations at risk varied from early outbreak to late outbreak
Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to healthcare worker (HCW)
Summary
Coronavirus disease 2019 (COVID-19) was declared by the World Health Organization (WHO) as a pandemic on March 11, 2020 and its local transmission has been reported in many countries [1]. Work-related transmission is a crucial contributor to infectious disease outbreaks. The characteristics of SARS-CoV-2 virus and its transmission patterns could lead to high transmission rates among workers. Some studies have found similar transmissibility from asymptomatic and symptomatic patients [6,7,8]. These characteristics could lead to a higher probability of workrelated transmission as people with mild symptoms could continue to work, travel or otherwise conduct business and spread the disease to others during work or commuting. It is contingent to better understand the epidemiology of work-related transmission of COVID-19 to implement evidence-based prevention and protection strategies in workplaces
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