COVID-19 hit public transportation employees disproportionately harder than other workers, according to a new study by California health officials.
The study, led by the California Department of Public Health and released Thursday by the US Centers for Disease Control and Prevention, provides an overview of the toll the pandemic has taken on workers in the transportation, raising new questions about the role of public health interventions, including masks, in these settings.
Employees in the airline and public transportation industries were much more likely to have COVID-19 outbreaks in their workplaces compared to workers in general, the study found.
And compared to employees across all industries, bus and train service workers were twice as likely to die from COVID-19.
“Workers in the public transportation industries are at higher risk of workplace outbreaks and mortality from COVID-19 than the general population of workers in California and should be prioritized for COVID-19 prevention strategies, including vaccination and enhanced protective measures in the workplace,” the report said.
Though she hadn’t read the study herself as of Thursday afternoon, Los Angeles County Public Health Director Barbara Ferrer said there has been “other evidence accumulating over the course of the pandemic indicating that transit workers they were experiencing higher rates of cases and greater severity of illness.” — probably due to unavoidable workplace exposures and less than robust ventilation in some work environments.
The study identified 340 confirmed outbreaks of COVID-19 in California’s public transportation industries over a 29-month period, from the start of the pandemic through May. Scientists identified 5,641 coronavirus cases associated with those outbreaks and 537 deaths from COVID-19.
During that time period, there were 24.7 COVID-19 outbreaks per 1,000 workplaces in all California industries combined, the study found. But the specific rates for public transport sites were much worse.
There were 87.7 outbreaks per 1,000 workplaces in air transport during the same period, and a whopping 129.1 outbreaks per 1,000 workplaces in the bus service and urban transit industry.
In other words, COVID-19 outbreaks were 3½ times more likely in the air transport industry and five times more likely in bus service and urban transit workplaces compared to California industries as a whole, according to the study findings.
Cumulative death rates from COVID-19 were much higher among some public transportation industries. Specifically, rail transport workers; bus service and urban transit; and employees of transportation support services, such as maintenance, airport cargo and airport terminal services, were twice as likely to die during the period examined in the study compared to California industries as a whole.
For all industries in the state, the scientists found 114.4 COVID-19 deaths per 100,000 employees. By comparison, there were 211.5 deaths per 100,000 workers in the bus service and urban transportation industry; 237.4 deaths per 100,000 transportation support service workers; and 241.8 deaths per 100,000 workers in the rail industry.
However, air transport workers were less likely to die from COVID-19 than those in California industries overall. There were 91.3 COVID-19 deaths per 100,000 air transportation employees in the state.
The study used outbreaks reported to local health departments in California and deaths from the state’s COVID-19 case registry that were compared to death certificate data, which includes information about the decedent’s occupation.
Of the 340 COVID-19 outbreaks identified, the vast majority of them, 57%, occurred in bus and urban transport workplaces.
But most of the cases occurred in the airline industry. Of the 5,641 coronavirus cases associated with outbreaks in the transit industry, 43% occurred in air travel.
And the majority of deaths, just over 50%, occurred among workers in the transportation support services sector.
In terms of outbreaks, the highest monthly number was recorded in December, during the first wave of Omicron.
The highest monthly number of deaths in the transportation industry occurred during the initial fall and winter wave of the pandemic, when there were more than 80 per month. The next highest count was during the peak of the Delta Wave last September, when there were nearly 50.
During the height of the first wave of Omicron in January, there were fewer than 30 deaths per month.
By comparison, the number of outbreaks was higher during the first full month of the fall and winter Omicron surge, when there were almost 80. That sum was much higher than the previous monthly peak, when there were more than 40 outbreaks in December 2020.
The authors noted that outbreak data collected in 2021 may be more complete than 2020 figures, in part due to a California public health order that requires employers to report clusters of three or more to local health departments. positive cases of coronavirus in the workplace. In 2020, outbreak notification requirements varied based on local regulations.
“Regardless of whether exposures are from interactions with the public, coworkers, or other sources, these observations indicate that public transportation workers represent a vulnerable group that should be prioritized in COVID-19 prevention strategies. 19,” the authors wrote. “Such strategies may include targeted vaccination efforts, access to antiviral treatments, public health messaging, and enhanced protective measures in the workplace, such as better ventilation and the use of well-fitting masks or respirators (eg, N95s) by part of the workers and members of the public. ”
Most parts of California no longer require masks on public transportation. However, Los Angeles County continues to require face coverings at public transportation and interior transportation hubs, including Los Angeles International Airport and Hollywood Burbank Airport.
The San Francisco Bay Area Rapid Transit system also requires the use of face masks on its 50-station, 131-mile commuter rail network.
Ferrer said Los Angeles County does not plan, at this time, to lift its mask-wearing rules at indoor transit centers or aboard public transportation.
County health officials believe those are higher-risk settings where requiring masks is beneficial. Face coverings also remain mandatory in health care and long-term care facilities, emergency shelters, cooling centers, jails, and prisons.
“We continue to look at transit and transit hubs as places where we really should add an extra layer of protection, particularly when transmission is high,” Ferrer said.