Black and Hispanic people experience a higher risk for COVID-19 and severe illness, influenced by factors such as discrimination, housing, and healthcare access and utilization. Now, a new study in the American Journal of Preventive Medicine, published by Elsevier, identifies specific job categories that put workers at risk because they require working in close contact with others. Some of these jobs have a disproportionately high number of Black or Hispanic workers. The findings should be used to inform workplace interventions to reduce the risk for these particularly vulnerable communities.

Researchers used data from the Occupational Information Network (O*NET) and the Bureau of Labor Statistics (BLS) to classify the occupations of all US workers into six categories for risk of COVID-19 exposure at work: low, medium, or high proximity work indoors; and low, medium, or high proximity work outdoors. They studied the distribution of workers by occupation in the higher risk categories (medium or high proximity indoors and high proximity outdoors) and determined where Black and Hispanic workers were overrepresented.

Information on 772 detailed occupations and 144,525,054 workers was examined. Researchers found that a high proportion of US workers may be at greater risk for exposure to COVID-19 because their occupations involve either high proximity to others indoors or outdoors (25.2 percent, 36.5 million people) or medium proximity work indoors (48.0 percent, 69.6 million workers).

A higher proportion of Black workers perform high proximity indoor work compared to all workers (27.5 percent vs 22.1 percent). In contrast, Hispanic workers had higher representation in outdoor work categories: 5.0 percent Hispanic vs 3.1 percent all workers in high proximity outdoor work and 7.0 percent vs 5.3 percent in medium proximity outdoor work.

Black workers were overrepresented in 103 of the 772 occupations. Eighty of those occupations were in the proximity and indoor/outdoor categories at higher risk for exposure and included 34.7 percent of all Black workers. Hispanic workers were overrepresented in 124 of the 772 occupations. Seventy-six of these occupations were in higher risk categories and included 21.5 percent of all Hispanic workers.

The authors highlighted the most populous occupations in each of the three higher risk exposure categories where Black or Hispanic workers were overrepresented. The indoor high proximity occupations for Black workers were Home Health Aides, Nursing Assistants, and Personal Care Aides, while for Hispanic workers they were Restaurant Cooks, Medical Assistants, and Dining Room/Cafeteria Attendants and Bartender Helpers. The outdoor high proximity occupations had many fewer Black than Hispanic workers.

In this category large numbers of Hispanic workers were Landscaping and Groundskeeping Workers, Carpenters, and Cement Masons and Concrete Finishers. Looking at indoor medium proximity work, Laborers and Freight, Stock and Material Movers included large numbers of both Black and Hispanic workers. Additionally, large numbers of Black workers were Cashiers and Stock Clerks/Order Fillers, while large numbers of Hispanic workers were Hand Packers/Packagers and Food Preparation workers.

Prevention strategies should consider worksite conditions, and communication messages should be tailored to the languages and preferred media of the workforce.

Although there are recommendations for keeping a distance of at least six feet between people to minimize the spread of SARS-CoV-2, such social distancing may not be possible in indoor and outdoor occupations that require high physical proximity to perform work tasks.

"Efforts to control the spread of the virus that causes COVID-19 are still needed in all aspects of our lives, including at work. Becoming complacent in wearing a mask, physical distancing, and other prevention efforts during the rollout of the vaccine could have unfortunate consequences not only for ourselves, but also for our family members, co-workers, and friends," cautioned Dr. Cox-Ganser and Dr. Henneberger.

"We all have a role to play, including getting the COVID-19 vaccine when it is offered."