Risk factors for SARS-CoV-2 infection among farmworkers in Monterey County, California

Abstract

Importance: Essential workers in agriculture and food production have been severely affected by the ongoing COVID-19 pandemic. Objective: To identify risk factors associated with SARS-CoV-2 shedding and antibody response in farmworkers in California. Design: This cross-sectional study collected survey data and determined current SARS-CoV-2 shedding and seropositivity among 1,107 farmworkers in California's Salinas Valley from 16 July to 30 November 2020. Setting: Farmworkers receiving transcription-mediated amplification (TMA) tests for SARS-CoV-2 infection at federally qualified community clinics and community sites were invited to participate in our study. Participants: Individuals were eligible if they were not pregnant, were 18 years old or older, had conducted farm work since the pandemic started, and were proficient in English or Spanish. Exposures: Sociodemographic, household, community, and workplace characteristics. Main Outcome(s) and Measure(s): Current (as indicated by TMA positivity) and historical (as indicated by IgG seropositivity) SARS-CoV-2 infection. Results: Most farmworkers enrolled in the study were born in Mexico, had primary school or lower levels of educational attainment, and were overweight or obese. Current SARS-CoV-2 shedding was associated in multivariable analyses with attained only primary or lower educational levels (RR=1.32; 95% CI: 0.99-1.76), speaking an indigenous language at home (RR=1.30; 0.97-1.73), working in the fields (RR=1.60; 1.03-2.50), and exposure to known or suspected COVID-19 case at home (RR=2.98; 2.06-4.32) or in the workplace (RR=1.59; 1.18-2.14). Antibody detection was associated with residential exposures including living in crowded housing (RR=1.23; 0.98-1.53), with children (RR=1.40; 1.1-1.76) or unrelated roommates (RR=1.40; 1.19-1.64), and with a known or suspected COVID-19 case (RR=1.59; 1.13-2.24). Those who were obese (RR=1.65; 1.01-2.70) or diabetic (RR=1.31; 0.98-1.75) were also more likely to be seropositive. Farmworkers who lived in rural areas other than Greenfield (RR=0.58; 0.47-0.71), worked indoors (RR=0.68; 0.61-0.77), or whose employer provided them with information on how to protect themselves at work (RR=0.59; 0.40-0.86) had lower risk of prior infection.

COVID-19 among the Pakistani immigrant population in Northern Europe––Incidence and possible causes for infection

“…Crowded housing has been shown to be a contributing factor to infection rates, and people who live in crowded conditions have higher infection rates than people with the same ethnic background who do not live in crowded conditions ( Habib et al, 2009 , Mora et al, 2021 ). When Indseth et al adjusted for crowded conditions, however, immigrants from Pakistan were still overrepresented ( Indseth et al, 2021 ).…”

Extreme Heat and COVID-19: A Dual Burden for Farmworkers

“…Farmworkers have experienced a comparably higher rate of COVID-19 infections relative to the general population. For example, in Monterrey County, California the observed rate of positive test results for Latino/a farm workers was 22% while that of the rest of the county population was 6% in November-December 2020 ( 11 , 12 ). Additionally, it is not possible to carry out this form of agricultural labor remotely or virtually, making farmworkers more susceptible to infections in the workplace.…”

“…Figure 1 presents a conceptual framework of the pathways by which COVID-19 can exacerbate heat-health Issues. These essential workers are already more vulnerable than the general population to the effects of heat due to potential pre-existing illness, lack of health care, and lack of coping resources ( 10 , 11 ). COVID-19 precautions may exacerbate the vulnerabilities due to less use of cooling resources (e.g., cooled or shady spaces that require individuals to gather) and may disallow the use of community water supplies (e.g., no shared cooler to fill bottles).…”