An innovative index for assessing vulnerability of employees of different occupations from the COVID-19 pandemic in Iran

Abstract

The vulnerability of employees of different occupations from the Coronavirus disease 2019 (COVID-19) pandemic in Iran was assessed using an innovative index. The vulnerability index was developed in five steps as follows: (1) determining the principles and components of employees' susceptibility and resilience, (2) weighting the principles and components, (3) converting the levels of components to the sub-index values, (4) introducing the aggregation functions, and (5) characterizing the vulnerability index values in five categories as very high (80-100), high (65-79), medium (50-64), low (30-49), and very low (0-29). The average values of susceptibility, resilience, and vulnerability index of the employees were determined to be 35.2 ± 15.0, 73.9 ± 17.0, and 32.9 ± 12.7, respectively. The average resilience of the employees was more desirable than their average susceptibility. The distribution of the employees into the vulnerability index categories was 46.3% for very low, 41.9% for low, 3.6% for medium, and 8.2% for high. The worst cases of susceptibility and resilience principles were exposure to contaminated surfaces (59.1 ± 22.8) and top management commitment (66.6 ± 23.1). The elderly staff (especially over 50 years old), employees with low education levels, and employees in private and self-employment sectors were significantly more vulnerable (p value < 0.01) from the COVID-19 pandemic. The principles with significant incremental effects on the vulnerability index (p value < 0.05) were respectively top management commitment (+1.78), exposure to COVID-19 patients at work (+1.36), exposure to contaminated surfaces (+0.82), installing clear shields and wearing PPE (+0.59), observance of social distancing (+0.48), and just culture (+0.22). An especial plan to support the more vulnerable employees with an emphasis on the principles with the most incremental effects on the vulnerability index can efficiently control the inequality between the employees as well as occupational transmission of the COVID-19 in Iran.

Keywords: COVID-19; Hand hygiene; Healthcare worker; Occupational health; Personal protective equipment; Respiratory hygiene; Social distancing.

Fig. 1

The employees' perception about an increase in the risk of catching COVID-19 at work (A) and disruption of work procedures during the COVID-19 pandemic (B).

Fig. 2

Frequency distribution of vulnerability components of employees of different occupations from the COVID-19 pandemic in Iran: (A) susceptibility components and (B) resilience components (green: The best condition, red: The worst case, gray: Do not know, full description of the choices is presented in Table 1). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 3

Box plot diagrams of the vulnerability principles of employees of different occupations from the COVID-19 pandemic in Iran: (A) susceptibility principles and (B) resilience principles.

Fig. 4

Distribution of employees of different occupations in Iran into the categories of susceptibility (A), resilience (B), and vulnerability indices (C) (from August 16, 2020 to September 16, 2020).

Fig. 5

Effect of removing each input principle on the average value of the vulnerability index of employees of different occupations from the COVID-19 pandemic in Iran (* shows significant effect with a p value < 0.05 and ** indicates significant effect with a p value < 0.01).