What is the risk to workers in the United States?
The risks from SARS-CoV-2, the virus that causes Coronavirus Disease 2019 (COVID-19), for workers depends on how extensively the virus spreads between people; the severity of resulting illness; pre-existing medical conditions workers may have; and the medical or other measures available to control the impact of the virus and the relative success of these measures. The U.S. Centers for Disease Control and Prevention (CDC) provides detailed information about this topic.
According to the CDC, certain people, including older adults and those with underlying conditions such as heart or lung disease or diabetes, are at higher risk for developing more serious complications from COVID-19.
Classifying Risk of Worker Exposure to SARS-CoV-2
Worker risk of occupational exposure to SARS-CoV-2 during a pandemic may depend in part on the industry type and the need for contact within 6 feet of people known to be, or suspected of being, infected with SARS-CoV-2. Other factors, such as conditions in communities where employees live and work, their activities outside of work (including travel to COVID-19-affected areas), and individual health conditions, may also affect workers’ risk of getting COVID-19 and/or developing complications from the illness.
OSHA has divided job tasks into four risk exposure levels: very high, high, medium, and lower risk, as shown in the occupational risk pyramid, below. The four exposure risk levels represent the probable distribution of risk. Most American workers will likely fall in the lower exposure risk (caution) or medium exposure risk levels
Lower Exposure Risk (Caution)
Jobs that do not require contact with people known to be, or suspected of being, infected with SARS-CoV-2. Workers in this category have minimal occupational contact with the public and other coworkers. Examples include:
- Remote workers (i.e., those working from home during the pandemic).
- Office workers who do not have frequent close contact with coworkers, customers, or the public.
- Manufacturing and industrial facility workers who do not have frequent close contact with coworkers, customers, or the public.
- Healthcare workers providing only telemedicine services.
- Long-distance truck drivers.
Medium Exposure Risk
Jobs that require frequent/close contact with people who may be infected, but who are not known to have or suspected of having COVID-19. Workers in this category include:
- Those who may have frequent contact with travelers who return from international locations with widespread COVID-19 transmission.
- Those who may have contact with the general public (e.g., in schools, high population density work environments, and some high-volume retail settings).
High Exposure Risk
Jobs with a high potential for exposure to known or suspected sources of SARS-CoV-2. Workers in this category include:
- Healthcare delivery and support staff (hospital staff who must enter patients’ rooms) exposed to known or suspected COVID-19 patients.
- Medical transport workers (ambulance vehicle operators) moving known or suspected COVID-19 patients in enclosed vehicles.
- Mortuary workers involved in preparing bodies for burial or cremation of people known to have, or suspected of having, COVID-19 at the time of death.
Very High Exposure Risk
Jobs with a very high potential for exposure to known or suspected sources of SARS-CoV-2 during specific medical, postmortem, or laboratory procedures. Workers in this category include:
- Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or suspected COVID-19 patients.
- Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19 patients (e.g., manipulating cultures from known or suspected COVID-19 patients).
- Morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or are suspected of having, COVID-19 at the time of their death.
Job Duties Affect Workers’ Exposure Risk Levels
As workers’ job duties change or they perform different tasks in the course of their duties, they may move from one exposure risk level to another. Additional examples of workers who may have increased risk of exposure to SARS-CoV-2 include those in:
- Other types of healthcare positions (including pre-hospital and medical transport workers, allied medical care professionals, and support staff)
- Emergency response (e.g., emergency medical services workers, firefighters, and law enforcement officers)
- Other postmortem care positions (e.g., funeral directors)
- Research or production laboratory workers
- Airline operations
- Retail operations, particularly those in critical and/or high-customer-volume environments
- Border protection and transportation security
- Correctional facility operations
- Solid waste and wastewater management
- Environmental (i.e., janitorial) services
- In-home repair services
- Travel to areas where the virus is spreading
- Pastoral, social, or public health workers in jobs requiring contact with community members who may spread the virus
- Transit and delivery drivers, depending on their degree of close contacts with the public
This list is not intended to be comprehensive, and employers should always rely on thorough hazard assessments to identify if and when their workers are at increased risk of exposure to the virus on the job.
How Does COVID-19 Spread?
Although the pandemic possibly originated from humans exposed to infected animals, SARS-CoV-2—like other coronaviruses—spreads between people and cause COVID-19. The CDC acknowledges that at this time, there is no evidence that companion animals, including pets, can spread COVID-19 to people or that they might be a source of infection in the United States.
According to the CDC, person-to-person transmission occurs during close (within 6 feet) contact with a person with COVID-19, primarily from respiratory droplets produced when an infected person coughs or sneezes. These droplets, particularly when aerosolized, can be deposited in the mouth, nose, or eyes of nearby people or be inhaled into the lungs. Airborne transmission from person-to-person over long distances (including as a result of evaporating droplets that leave behind infectious particles known as droplet nuclei) is believed to be unlikely.
People can also become infected with SARS-CoV-2 by touching surfaces or objects contaminated with the virus, and then touching their mouths, noses, or eyes. Current evidence suggests that novel coronavirus may remain viable for hours to days on a variety of surfaces. Frequent cleaning of visibly dirty and high-touch surfaces, followed by disinfection, can help prevent SARS-CoV-2 and other respiratory pathogens (germs) from spreading in workplaces.
Person-to-person spread is likely to continue to occur under current pandemic conditions.
There is still more to learn about the transmissibility, severity, and other features associated with SARS-CoV-2.
Identifying Potential Risks and Sources of Exposure
OSHA requires employers to assess occupational hazards to which their workers may be exposed. Some OSHA standards, such as those for personal protective equipment (PPE) (29 CFR 1910.132) and respiratory protection (29 CFR 1910.134), include these types of requirements.
In assessing potential hazards, employers should consider if and when their workers may encounter someone infected with SARS-CoV-2 in the course of their duties. Employers should also determine if workers could be exposed to environments (e.g., work sites) or materials (e.g., laboratory samples, waste) contaminated with the virus.
Depending on the work setting, employers may also rely on the identification of sick individuals who have signs, symptoms, and/or a history of travel to COVID-19-affected areas, to help identify exposure risks for workers and implement appropriate control measures. It is also possible that someone may have been in close contact (within about 6 feet) with someone with COVID-19 in their community and, thus, may have had exposure. The Control and Prevention page provides guidance for controlling risks for worker exposures.
The CDC provides information about risk assessment for COVID-19.