Occupational Therapy Exposure Risk to Diseases such as COVID-19

Background

Are you are considering a career in healthcare with occupational therapy? You may be wondering about the exposure risks and hazards to diseases with the recent pandemic of COVID-19. This post will outline the exposure risk in comparison with some other professions to help you gain insight and make an informed decision about occupational therapy school.

The Public Risk

In general, being in public exposes you to COVID-19 compared to working at home. You may have heard in the news of factories, companies, or small businesses closing down – not as a prevention technique but because workers have actually been infected and many have died. In recent news, Foster Farms was forced to shut down one of its factories due to an outbreak.

At least 358 employees have tested positive, and eight employees have died due to the coronavirus, according to a letter obtained from the Merced County Health Department.

Workplace Shift

With the COVID-19 pandemic, society has gone from a shift from working outside to working from home. Whether this trend will continue after the pandemic depends on the risks vs. benefits of the two. This may be the case for the tech industry where employees can work remotely compared to other essential jobs such as factories or cashiers that require employees be out in public. The same goes for occupational therapists who work in hospitals, nursing homes, clinics, schools, people’s homes, and other public places.

Worker risk of occupational exposure to SARS-CoV-2, the virus that causes COVID-19, during an outbreak may depend in part on the industry type and need for contact within 6 feet of people known to have, or suspected of having, COVID-19.

The Scales

Before you can compare different jobs including occupational therapy to each other, you need to learn about the scales that OSHA and O*NET use. For COVID-19 specifically, OSHA has a risk exposure scale. O*NET compares jobs based on how often per day a worker is exposed to diseases and infections in general.

The Exposure Risk Scale

OSHA classifies COVID-19 on an exposure risk scale containing four levels:

  • Lower Exposure Risk (Caution)
  • Medium Exposure Risk
  • High Exposure Risk
  • Very High Exposure Risk

Lower Exposure Risk

Jobs that do not require contact with people known to be, or suspected of being, infected.  Workers in this category have minimal occupational contact with the public and other coworkers.

Medium Exposure Risk

Jobs that require frequent/close contact with people who may be infected, but who are not known or suspected patients. Workers in this category include: Those who may have contact with the general public (e.g., schools, high-population-density work environments, some high-volume retail settings), including individuals returning from locations with widespread COVID-19 transmission.

High Exposure Risk

Jobs with a high potential for exposure to known or suspected sources of COVID-19. Workers in this category include: Healthcare delivery, healthcare support, medical transport, and mortuary workers exposed to known or suspected COVID-19 patients or bodies of people known to have, or suspected of having, COVID-19 at the time of death.

Very High Exposure Risk

Jobs with a high potential for exposure to known or suspected sources of COVID-19 during specific medical, postmortem, or laboratory procedures. Workers include: Healthcare and morgue workers performing aerosol-generating procedures on or collecting/handling specimens from potentially infectious patients or bodies of people known to have, or suspected of having, COVID-19 at the time of death.

occupational therapists’ COVID-19 risk is likely medium to high.

O*NET Scale

O*NET classifies exposure risk to diseases and infections on a scale based on how often per day.

  • 0 – Never
  • 25 – Once a year or more but not every month
  • 50 – Once a month or more but not every week
  • 75 – Once a week or more but not every day
  • 100 – Every day

Job Disease Exposure Frequency

100   29-1141.01Acute Care Nurses
100   29-2021.00Dental Hygienists
100   29-1063.00Internists, General
100   29-1065.00Pediatricians, General
99   29-1141.03Critical Care Nurses
99   29-1069.03Hospitalists
99   29-1022.00Oral and Maxillofacial Surgeons
98   29-1126.00Respiratory Therapists
98   29-2054.00Respiratory Therapy Technicians
97   29-1071.01Anesthesiologist Assistants
97   31-1015.00Orderlies
96   31-9091.00Dental Assistants
96   29-2011.00Medical and Clinical Laboratory Technologists
96   29-1151.00Nurse Anesthetists
96   29-1069.12Urologists
95   29-1069.01Allergists and Immunologists
95   29-1021.00Dentists, General
95   29-1062.00Family and General Practitioners
95   29-1124.00Radiation Therapists
95   29-1141.00Registered Nurses
94   29-1141.04Clinical Nurse Specialists
94   29-2061.00Licensed Practical and Licensed Vocational Nurses
94   29-1064.00Obstetricians and Gynecologists
94   29-1069.11Sports Medicine Physicians
93   29-1069.02Dermatologists
93   29-2033.00Nuclear Medicine Technologists
93   29-1071.00Physician Assistants
93   29-2053.00Psychiatric Technicians
92   31-9093.00Medical Equipment Preparers
92   29-1122.00Occupational Therapists 

 

Interpretation

As you can see, occupational therapy is quite high on the lost of more than once a week and almost daily exposure to diseases and infection. This should be no surprise as occupational therapists work with patients who themselves are infected. However, this broad generalization cannot be made because occupational therapists work in many different settings. The 92 rating may be more applicable to occupational therapists who work in the hospital, in nursing homes, or in people’s homes. Occupational therapists that work in mental health, outpatient clinics, and school classrooms/gyms likely have lower exposure risk – likely the same that a teacher would.

Okay, so what about COVID-19? The NY Times posted an article titled, “The Workers Who Face the Greatest Coronavirus Risk“. They source the same O*NET data for various job categories that are at higher risk for diseases. Nurses on the top along with dentists, paramedics/EMS, flight attendants, and couriers.

Healthcare workers are exposed to higher risks of disease. Credit: New York Times

The risk isn’t limited to those on the front lines. Many people who do service jobs like cashiers and fast-food workers face elevated risks. Walmart, Starbucks and Uber are among the many companies that have had workers fall sick.

Some Thoughts

So who is safer? The healthcare worker or the cashier or the courier? While I am not an epidemiologist by any means, I have been in healthcare since day 1 of the first case of US COVID-19 confirmed case. Here are my thoughts.

Some arguments I’ve heard my colleagues make include:

  • Some healthcare facilities, e.g. acute rehab unit is actually safer than some public places. Why?
    • Each patient that comes in gets tested for COVID-19.
    • No visitors are allowed.
    • Every employee is screened daily and has their temperature taken.
    • Employees wear PPE and follow strict infection prevention practices including masks, N95, face shields, and gowns.
    • High-touch surfaces, rooms, and equipment are constantly cleaned and scrubbed down – even with UV-C Light.
  • In public, you may be at high risk for exposure. Why?
    • Some people do not wear masks.
    • Some people do not obey social distancing.
    • You do not know if a stranger is COVID-19 positive and highly contagious.
    • Indoor air quality may be poor compared to that of the hospital.

As mentioned before and shown in the Foster Farms outbreak, some public-facing jobs have lead to larger upticks in COVID-19 cases than hospital workers. One could argue that non-healthcare jobs are just as risky.

Diseases and infections are not new to the healthcare world. Doctors and healthcare providers work very hard to prevent and cure infections, pretty much all the time and follow “standard precautions” for this reason. Patients may be on contact, droplet, or airborne precautions for a variety of reasons: urinary tract infections (UTI), MRSA, C-dif, you name it. Although a pandemic may make disease risk higher across the world, in general, hospitals and similar settings carry a higher risk for all workers – doctors, nurses, janitorial/EVS, technicians, social workers, and so on. As an example, social workers before COIVD-19 frequently visited patients in their room and can come into close contact with them. It’s not so much as looking at occupational therapy vs. other jobs, but more at looking at healthcare professionals as a whole.

Still, even if you consider the COVID-19 exposure risk from a healthcare worker standpoint, occupational therapists are not part of the high-risk group that comes into contact with aerosolize generating procedure that dentists, doctors, and respiratory therapists do.

Do occupational therapists work directly with COVID-19 patients? Populations may include acute care in the hospital and skilled nursing facilities. Even among the same profession, school-based occupational therapists have largely been laid off due to school closures and moving to online learning.

All jobs have their own risks and benefits. The nature of jobs including responsibilities also changes with time and society’s exposure to public health issues. Don’t let the fear of COVID-19 and disease keep you from pursuing a rewarding and fulfilling career in occupational therapy.

Closing Thoughts

One appeal of occupational therapy as a profession is its career versatility. An occupational therapist graduates as a generalist and can practice in many different settings. Occupational therapists can also specialize in specific settings, even driver rehab. When the COVID-19 pandemic ends, a lot will still be unknown. However, if the following benefits of occupational therapy appeal to you:

  • Helping people regain their independence
  • Working with people directly on a 1:1 or small group setting
  • Working with infants
  • Working with children
  • Working with adults
  • Working with older adults
  • Using the latest technology and tools
  • Using your creativity
  • Not working a desk-job
  • Working in a rewarding team
  • Seeing direct results and feeling a sense of accomplishment
  • All while earning a competitive salary

Then Occupational Therapy is the career for you.

Next Steps

Still unsure? Deciding between occupational therapy and nursing? I also created an online course for people who are interested in becoming an occupational therapist. Check it out to learn more. Good luck!

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