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Sciaudone M, Cutshaw MK, McClean CM, Lacayo R, Kharabora O, Murray K, Strohminger S, Zivanovich MM, Gurnett R, Markmann AJ, Salgado EM, Bhowmik DR, Castro-Arroyo E, Boyce RM, Aiello AE, Richardson D, Juliano JJ, Bowman NM. Seroepidemiology and risk factors for SARS-CoV-2 infection among household members of food processing and farm workers in North Carolina. IJID Reg 2023; 7:164-169. [PMID: 37034427 PMCID: PMC10032047 DOI: 10.1016/j.ijregi.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Background Racial and ethnic minorities have borne a disproportionate burden from coronavirus disease 2019 (COVID-19). Certain essential occupations, including food processing and farm work, employ large numbers of Hispanic migrant workers and have been shown to carry an especially high risk of infection. Methods This observational cohort study measured the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and assessed the risk factors for seropositivity among food processing and farm workers, and members of their households, in North Carolina, USA. Participants completed questionnaires, blood samples were collected, and an enzyme-linked immunosorbent assay was used to assess SARS-CoV-2 seropositivity. Univariate and multi-variate analyses were undertaken to identify risk factors associated with seropositivity, using generalized estimating equations to account for household clustering. Findings Among the 218 participants, 94.5% were Hispanic, and SARS-CoV-2 seropositivity was 50.0%. Most seropositive individuals did not report a history of illness compatible with COVID-19. Attending church, having a prior history of COVID-19, having a seropositive household member, and speaking Spanish as one's primary language were associated with SARS-CoV-2 seropositivity, while preventive behaviours were not. Interpretation These findings underscore the substantial burden of COVID-19 among a population of mostly Hispanic essential workers and their households in rural North Carolina. This study contributes to a large body of evidence showing that Hispanic Americans have suffered a disproportionate burden of COVID-19. This study also highlights the epidemiologic importance of viral transmission within the household.
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Affiliation(s)
- Michael Sciaudone
- Department of Medicine, Section of Infectious Diseases, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Center for Intelligent Molecular Diagnostics, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | | | - Roberto Lacayo
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Oksana Kharabora
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Katherine Murray
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Stephen Strohminger
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Miriana Moreno Zivanovich
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rachel Gurnett
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Alena J. Markmann
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Emperatriz Morales Salgado
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - D. Ryan Bhowmik
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Edwin Castro-Arroyo
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ross M. Boyce
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Allison E. Aiello
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - David Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California – Irvine, Irvine, California, USA
| | - Jonathan J. Juliano
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Natalie M. Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Klein MD, Sciaudone M, Richardson D, Lacayo R, McClean CM, Kharabora O, Murray K, Zivanovich MM, Strohminger S, Gurnett R, Markmann AJ, Bhowmik DR, Salgado EM, Castro-Arroyo E, Aiello AE, Boyce RM, Juliano JJ, Bowman NM. SARS-CoV-2 seroprevalence and risk factors among meat packing, produce processing, and farm workers. PLOS Glob Public Health 2022; 2:e0000619. [PMID: 36962464 PMCID: PMC10022315 DOI: 10.1371/journal.pgph.0000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
Meat packing, produce processing, and farm workers are known to have an elevated risk of COVID-19, but occupational risk factors in this population are unclear. We performed an observational cohort study of meat packing, produce processing, and farm workers in North Carolina in fall 2020. Blood, saliva, and nasal turbinate samples were collected to assess for SARS-CoV-2 seropositivity. Risk factors for SARS-CoV-2 seropositivity were investigated using chi-square tests, two-sample t-tests, and adjusted risk ratio analyses. Among 118 enrolled workers, the baseline SARS-CoV-2 seroprevalence was 50.0%. Meat packing plant workers had the highest SARS-CoV-2 seroprevalence (64.6%), followed by farm workers (45.0%) and produce processing workers (10.0%), despite similar sociodemographic characteristics. Compared to SARS-CoV-2 seronegative workers, seropositive workers were more likely to work in loud environments that necessitated yelling to communicate (RR: 1.83, 95% CI: 1.25-2.69), work in cold environments (RR: 1.58, 95% CI: 1.12-2.24), or continue working despite developing symptoms at work (RR: 1.63, 95% CI: 1.14-2.32). After adjusting for age and working despite symptoms, high occupational noise levels were associated with a 1.72 times higher risk of SARS-CoV-2 seropositivity (95% CI: 1.16-2.55). Half of food processing workers showed evidence of past SARS-CoV-2 infection, a prevalence five times higher than most of the United States population at the time of the study. Work environments with loud ambient noise may pose elevated risks for SARS-CoV-2 transmission. Our findings also highlight the disproportionate burden of COVID-19 among underserved and economically disadvantaged Latinx communities in the United States.
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Affiliation(s)
- Melissa D. Klein
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Michael Sciaudone
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - David Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Roberto Lacayo
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Colleen M. McClean
- School of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Oksana Kharabora
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Katherine Murray
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Miriana Moreno Zivanovich
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Stephen Strohminger
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Rachel Gurnett
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Alena J. Markmann
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - D. Ryan Bhowmik
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Emperatriz Morales Salgado
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Edwin Castro-Arroyo
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Allison E. Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Ross M. Boyce
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jonathan J. Juliano
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Natalie M. Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
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