Lack of access to personal protective equipment is associated with severe COVID-19 symptoms among in-person workers.

The use of personal protective equipment (PPE) at work can greatly reduce risk of SARS-CoV-2 transmission. However, it is unclear whether adequate PPE reduces disease severity if transmission occurs. This study investigated associations between workplace access to adequate PPE and self-reported COVID-19 symptom severity among in-person workers. We used data from the Michigan COVID-19 Recovery Surveillance Study (MI CReSS), a population-based survey of Michigan adults with a PCR-confirmed positive SARS-CoV-2 test. The sample was restricted to employed, in-person respondents with COVID-19 onset on or before November 15, 2020 (n = 893). Access to adequate PPE at work was categorized as often/always, sometimes, or rarely/never. Self-reported symptom severity was dichotomized as severe (severe or very severe) or not severe (mild, moderate, or asymptomatic). We used modified Poisson regression to estimate prevalence ratios for the relationship between adequate PPE at work and severe COVID-19 symptoms. We examined effect modification of the relationship by occupation by including a multiplicative interaction term for healthcare worker versus other occupations. After adjusting for sociodemographic and clinical covariates, respondents who rarely/never had access to PPE at work had a 24.7 % higher prevalence of self-reported severe COVID-19 symptoms (PR: 1.25, 95 % CI 1.03-1.51, p-value = 0.024) compared to respondents who often/always had access to PPE at work. Healthcare worker status did not modify the association between access to PPE and symptom severity. The findings from this study suggest an added benefit of PPE in reducing prevalence of severe COVID-19 among all in-person workers.