COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis

Abstract

Workplaces can be high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. The included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, environmental adjustments, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-one studies from healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ~280,000 employees based in Europe, Asia, and North America. Meta-analyses showed that combined IPC measures resulted in lower employee COVID-19 positivity rates (0.2% positivity; 95% CI 0–0.4%) than single measures such as asymptomatic PCR testing (1.7%; 95% CI 0.9–2.9%) and universal masking (24%; 95% CI 3.4–55.5%). Modelling studies showed that combinations of (i) timely and widespread contact tracing and case isolation, (ii) facilitating smaller worker cohorts, and (iii) effective use of PPE can reduce workplace transmission. Comprehensive COVID-19 IPC measures incorporating swift contact tracing and case isolation, PPE, and facility zoning can effectively prevent workplace outbreaks. Masking alone should not be considered sufficient protection from SARS-CoV-2 outbreaks in the workplace.

The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses

“…This unsurprising finding is attributed to more strict infection prevention and control procedures adopted by healthcare settings to mitigate the risk of spreading COVID-19 infections. A systematic review of 61 studies accounting for nearly 300,000 employees, including healthcare workers across 3 continents, showed better infection prevention and control procedures in the workplace would reduce transmission of COVID-19, hence likely resulting in increased workplace safety perceptions [ 26 ].…”

Development and validation of a multi-lingual online questionnaire for surveying the COVID-19 prevention and control measures used in global workplaces

“…Survey items on universal testing, contact tracing, vaccinations, and signage did not fit into the 9-domain model. However – because research shows the ability of universal testing and timely contact tracing to prevent COVID-19 outbreaks [ 6 ]; that the rollout of vaccines plays a crucial part in protecting workers [ 40 ]; and that COVID-19 training should be reinforced by the use of signage placed in strategic locations [ 41 ] – each of these items were considered important for content validity and left in the survey.…”

“…Educators and retail workers felt significantly less protected than healthcare workers, with health care workers reporting the highest average protective score and retail workers the lowest. While IPC response has been widely studied in the healthcare setting [ 6 ], few studies have examined COVID-19 safety amongst retail, transport, and other essential workers. Our finding that 55% (197/359) of non-health care respondents felt unprotected at work, coupled with reports of COVID-19 outbreaks in international bars, building sites, food-processing plants, hotels, shops, and transportation settings [ 4 ], underline the value in studying the COVID-19 safety resources available to geographically and occupationally diverse groups of workers.…”

“…Results from meta-analyses showed that combined IPC measures resulted in lower post-intervention employee COVID-19 positivity rates (0.2% positivity; 95% CI 0,0.4%) than single measures such as asymptomatic PCR testing (1.7%; 95% CI 0.9,2.9%) and universal masking (24%; 95% CI 3.4,55.5%). Specifically, combinations of (1) basic preventive measures (i.e., masking, hand hygiene, and social distancing), (2) surveillance measures, (3) outbreak investigations and response, (4) environmental adjustments, and (5) education initiatives were shown to effectively prevent workplace outbreaks [ 6 ]. These categories became the framework for the development of a survey allowing researchers to measure the level of occupational COVID-19 protection available to workers from diverse geographic and occupational settings.…”

“…Effective measures include swift and thorough contact tracing and case isolation, effective personal protective equipment (PPE), testing, worker bubbles, and improved ventilation and air quality [ 5 – 8 ]. Relying solely on a single control measure like masking is not enough to prevent COVID-19 clusters in high-risk workplace environments [ 6 , 7 ].…”