SARS-CoV-2 antibody prevalence by industry, workplace characteristics, and workplace infection prevention and control measures, North Carolina, 2021 to 2022

BackgroundThe COVID-19 pandemic has disproportionately affected workers in certain industries and occupations, and the workplace can be a high risk setting for SARS-CoV-2 transmission. In this study, we measured SARS-CoV-2 antibody prevalence and identified work-related risk factors in a population primarily working at industrial livestock operations. MethodsWe used a multiplex salivary SARS-CoV-2 IgG antibody assay to determine infection-induced antibody prevalence among 236 adult ([≥]18 years) North Carolina residents between February 2021 and August 2022. We used the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS) to classify employed participants industry and compared infection-induced IgG prevalence by participant industry and with the North Carolina general population. We also combined antibody results with reported SARS-CoV-2 molecular test positivity and vaccination history to identify evidence of prior infection. We used logistic regression to estimate odds ratios of prior infection by potential work-related risk factors, adjusting for industry and date. ResultsMost participants (55%) were infection-induced IgG positive, including 71% of animal slaughtering and processing industry workers, which is 1.5 to 4.3 times higher compared to the North Carolina general population, as well as higher than molecularly-confirmed cases and the only other serology study we identified of animal slaughtering and processing workers. Considering questionnaire results in addition to antibodies, the proportion of participants with evidence of prior infection increased slightly, to 61%, including 75% of animal slaughtering and processing workers. Participants with more than 1000 compared to 10 or fewer coworkers at their jobsite had higher odds of prior infection (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] 1.0 to 21.0). ConclusionsThis study contributes evidence of the severe and disproportionate impacts of COVID-19 on animal processing and essential workers and workers in large congregate settings. We also demonstrate the utility of combining non-invasive biomarker and questionnaire data for the study of workplace exposures. Conflict of InterestThe authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Whats important about this paperHigh numbers of COVID-19 outbreaks, cases, and deaths have been reported among livestock industry workers, including Black and Hispanic workers, in the United States. Little is known about SARS-CoV-2 infection as measured by antibody prevalence in this setting. Antibody-based estimates of SARS-CoV-2 infection can capture cases missed by SARS-CoV-2 molecular testing, which is important given limitations in worker access to molecular diagnostic testing. We observed high SARS-CoV-2 infection-induced IgG prevalence in animal slaughtering and processing industry workers (71%) between February 2021 and August 2022, which is 1.5 to 4.3 times higher compared to the North Carolina general population, as well as higher than molecularly-confirmed cases and the only serology study we identified of animal slaughtering and processing workers. We also found higher odds of SARS-CoV-2 infection among participants at worksites with larger compared to smaller numbers of employees.