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Agricultural workers in meatpacking plants presenting to an emergency department with suspected COVID‐19 infection are disproportionately Black and Hispanic
Author(s) -
House Hans R.,
Vakkalanka J. Priyanka,
Behrens Nathan G.,
De Haan Jessica,
Halbur Christopher R.,
Harrington Elaine M.,
Patel Pooja H.,
Rawwas Lulua,
Camargo Carlos A.,
Kline Jeffrey A.
Publication year - 2021
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.14314
Subject(s) - medicine , confidence interval , emergency department , retrospective cohort study , intensive care unit , covid-19 , relative risk , outbreak , cohort study , emergency medicine , disease , infectious disease (medical specialty) , virology , psychiatry
Objective Facilities that process and package meat for consumer sale and consumption (meatpacking plants) were early sites of coronavirus disease 2019 (COVID‐19) outbreaks. The aim of this study was to characterize the association between meatpacking plant exposure and clinical outcomes among emergency department (ED) patients with COVID‐19 symptoms. Methods This was a retrospective cohort study of patients presenting to a single ED, from March 1 to May 31, 2020, who had: 1) symptoms consistent with COVID‐19 and 2) a COVID‐19 test performed. The primary outcome was COVID‐19 positivity, and secondary outcomes included hospital admission from the ED, ventilator use, intensive care unit (ICU) admission, hospital length of stay (LOS; <48 or ≥48 h), and mortality. Results Patients from meatpacking plants were more likely to be Black or Hispanic than the ED patients without this occupational exposure. Patients with a meatpacking plant exposure were more likely to test positive for COVID‐19 (adjusted relative risk [aRR] = 2.37, 95% confidence interval [CI] = 1.59 to 3.53) but had similar rates of hospital admission (aRR = 0.94, 95% CI = 0.82 to 1.07) and hospital LOS (aRR = 0.76, 95% CI = 0.45 to 1.23). There was no significant difference in ventilator use among patients with meatpacking and nonmeatpacking plant exposure (8.2% vs. 11.1%, p = 0.531), ICU admissions (4.1% vs. 12.0%, p = 0.094), and mortality (2.0% vs. 4.1%, p = 0.473). Conclusions Workers in meatpacking plants in Iowa had a higher rate of testing positive for COVID‐19 but were not more likely to be hospitalized for their illness. These patients were disproportionately Black and Hispanic.