Covid-19: Protecting Worker Health

At the time of writing (5 March 2020) Coronavirus Disease 2019 (Covid-19) has spread to 76 countries with over 93 000 cases (WHO, 2020a) around the world since it was first identified and described in China on 31 December 2019 (WHO, 2020b). The case fatality rate may be as high as 3.4% and, although the indications are that it is a mild, self-limiting illness for the majority of those infected, it clearly has the potential to cause significant disruption globally. Many countries are moving from the ‘containment’ to the ‘delay’ phase in controlling the outbreak with a recent UK model suggesting a potential peak in June 2020 (Danon et al., 2020). Occupational hygienists have particular skills in understanding exposure to hazards in the workplace and a long history of introducing simple and effective measures that reduce risk to workers’ health. These skills may be able to contribute to protecting the global workforce from Covid-19. Workers involved in healthcare have always had a recognized increase in risk of developing infections present in the community where their patients are drawn. Health care workers are often on the front line dealing with those who are ill and at the most infectious period of a disease, as in the cases of SARS, MERS, and Ebola. Healthcare facilities can therefore act as a focus for infection spreading, giving rise to disease clusters linked to hospitals, social care facilities, and other health locations (Rajakaruna et al., 2017). In the SARS and MERS outbreaks between 2003 and 2015, between 44 and 100% of cases were linked to healthcare settings and healthcare workers made up around a quarter of those infected (Chowell et al., 2015). Other workers involved in providing services to the public may also be at increased risk during particular outbreaks where transmission is through face-to-face or close contact. A recent analysis in the USA has estimated that 10% of the workforce are employed in roles where exposure to disease or infection occurs at least once per week (Baker et al., 2020). Beyond caring and protective service workers, there are a wide range of serviceeconomy workers who may be at risk from a respiratory infection like Covid-19. Shop workers, bus drivers, cleaners, teachers, bank workers and hospitality staff are among the many service-sector employees who will have frequent and close interaction with many people over the course of a shift. Many of these workers will either have physical contact with the public or indirect contact through exchange of money or goods—an exposure route for transmission that is poorly understood (Angelakis et al., 2014). There are also complex societal issues around workers who are ill but feel that they have to work for economic or other reasons, and thereby increase the risks for colleagues and the public. The recent spread of Covid-19 around the globe has led to considerable anxiety and concern among workers Annals of Work Exposures and Health, 2020, 64, No. 5, 461–464 doi: 10.1093/annweh/wxaa033 Advance Access publication 23 March 2020 Editorial