COVID-19 cleaning protocol changes, experiences, and respiratory symptom prevalence among cleaning services personnel

A risk-risk tradeoff approach for incorporating the public's risk perceptions into quantitative microbial risk assessment

In public health, risk experts often define acceptable risk targets without community input. We developed a novel method for applying behavioral microeconomics to integrate individuals' risk preferences into risk assessment. To demonstrate this methodology, we explored a risk-risk tradeoff case scenario: increased asthma risk from increased cleaning and disinfection (C&D) and increased infection risk from decreased C&D for healthcare staff. Utilizing a risk-risk tradeoff (RRTO) framework, two datasets were informed with RRTO survey data describing the risks individuals would accept for one outcome to offset risk in another (i.e., "risk target"). A quantitative microbial risk assessment (QMRA) was deployed to output "critical concentrations," viral concentrations on surfaces that yield risk targets for a single contaminated surface touch and a work shift. Critical concentrations were over four orders of magnitude larger for single-touch scenarios. Critical concentrations across risk target datasets were similar. Using the RRTO framework to inform QMRA advances the incorporation of individuals' risk preferences in risk analyses outside economics.

Recruitment strategies in marginalized industries for occupational health research: an example in a pilot study of cleaning staff during COVID-19

This commentary describes challenges in recruiting workers from marginalized industries with examples from a pilot study of janitors, custodians, and maids and their experiences of cleaning and disinfection protocols during COVID-19 and potentially associated respiratory symptoms. Recruitment strategies included contacting a local hospital, national workers' unions, and a large Arizona employer; using online Facebook groups; and contacting Arizona maid service companies and a school district. English and Spanish online and hard copy surveys about cleaning protocols and respiratory symptoms were used. Participants could also participate in online/phone interviews. Worker's compensation, liability, and confidentiality were concerns across organizations. Online surveys yielded unreliable data. Hard copy surveys were used due to workers' limited technology access. We reflect upon these challenges and discuss other strategies for recruiting from marginalized populations for occupational health research. Building trust with organizations and workers and considering technology access may ultimately increase recruitment feasibility.