Frontline workers in healthcare settings and other essential workers continue to gain attention regarding their elevated risk of COVID-19, but a recent study from the University of Texas at Austin COVID-19 Modeling Consortium found that construction workers have a much higher risk of hospitalization from coronavirus than non-construction workers.

Data analysis on hospitalizations in Austin from mid-March through mid-August revealed that construction workers were five times as likely to be hospitalized with the virus as workers in other fields. An earlier CDC study reported that those in construction ranked second in frequency of workplace outbreaks in Utah.

The explanation for the elevated numbers in this sector is most likely due to the fact that construction workers stayed on the job despite stay-at-home orders or other community-wide mitigation measures and that the work puts them in close proximity to others. Employer practices and demographic factors may have also contributed.

In Texas, COVID-19 has disproportionately affected Hispanics, who account for about 40% of the state's population but 56% of its COVID-19 fatalities, according to the latest data from the Texas Department of State Health Services. In addition, Hispanics represent a disproportionate percentage of construction workers in central Texas and across the U.S. While 17.6% of all U.S. workers are Hispanic or Latino, 30% of construction workers are Hispanic or Latino, according to the U.S. Bureau of Labor Statistics.

Many of these workers are uninsured and in close contact with people who have limited access to healthcare. They have more of the underlying health conditions that have been linked to severe cases of COVID-19 than the general population and they, as well as others in their homes, are more likely to continue going to work when they do not feel well because of pressures to earn money.

"These workers face many overlapping risks and are being exposed at a time when less vulnerable populations are able to stay home," said Lauren Ancel Meyers, a professor of integrative biology and director of the consortium.

The study authors noted that employers and governments can act to lessen the risk. Steps such as encouraging mask-wearing and social distancing, offering workers paid sick leave and other incentives to stay home when they are sick or have had known exposure, and worksite-based surveillance COVID-19 testing along with contact tracing and isolation of cases would help prevent the spread.

The results of the study matched the consortium’s predictions from an earlier study done at the request of the City of Austin.

"From mid-March to mid-August, the elevated risk of COVID hospitalization among construction workers matched our model predictions almost to a T," said Remy Pasco, a graduate student in the Meyers lab. "The rise in COVID-19 hospitalizations among construction workers suggest that the virus has been spreading at work sites, and more should be done to protect the health and safety of the workers."

The model also suggests that continuing construction work, deemed essential and permissible by Texas Gov. Greg Abbott on March 31, would increase hospitalizations in the general population as well. Without higher levels of contact tracing, however, that conclusion is difficult to measure and validate.

The results of the study are published in JAMA Network Open.

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