Feasibility of molecular-based testing strategies for SARS-CoV-2-screening in workplaces: a systematic review and reporting checklist.

BACKGROUND

The COVID-19 pandemic underscored the need for effective workplace screening methods, particularly where remote work is not feasible. While lateral flow tests were common, molecular-based testing methods like PCR offer higher sensitivity and specificity. This review examines the feasibility, methods, barriers and facilitators of implementing molecular testing strategies in workplace settings.

METHODS

We conducted a systematic search in the databases PubMed, Cochrane, Web of Science and medRxiv for publications from 1 January 2020 onwards. The search was conducted twice (last in January 2025) to update results. Studies focused on non-healthcare workplaces, excluding schools, universities and care settings. Quality was assessed using standard reporting guidelines, and data were synthesised narratively due to heterogeneous study designs.

RESULTS

From 1777 records, 51 studies met inclusion criteria, primarily from industrial, laboratory and office settings across 21 countries, mostly in the Global North. Implementation of molecular-based testing was effective in reducing COVID-19 incidence in workplace settings when combined with quick turnaround times and frequent testing. Many employees felt it was the employer's responsibility to provide safety measures like testing. Challenges for implementation included logistical issues (sample collection, turnaround and ensuring employee participation). Some studies reported higher participation with saliva-based testing compared with nasopharyngeal swabs. While voluntary PCR testing does not increase on-site work when working from home is possible, regular PCR testing decreases durations of absence due to quarantine or isolation. Although higher sensitivity of tests can improve risk reduction in various scenarios, quick turnaround times of test results appear to be at least as or more important than test sensitivity.

CONCLUSIONS

Molecular-based testing strategies in workplaces are feasible and can contribute to pandemic disease control. However, success depends on consideration of ethical, logistical and financial factors. Core parameters are testing frequency, test sensitivity and turnaround. This review suggests a checklist for reporting on workplace testing strategies in future epidemic or pandemic situations.

PROSPERO REGISTRATION NUMBER: CRD42023391600.