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Antigen Testing for Screening in Non-Healthcare Workplaces
A tool to prevent the spread of COVID-19
The Occupational Safety and Health Administration (OSHA) provides resources to assist employers and workers identify COVID-19 exposure risks and help them take appropriate steps to prevent exposure and infection. See the OSHA Coronavirus Disease (COVID-19) topic pageexternal icon for the most current requirements, guidance, and tools.
Antigen tests are an effective tool to help employers prevent the spread COVID-19 in the workplace. Antigen tests, when used for screening employees in non-healthcare workplaces, can detect current infection before an employee enters the workplace or returns to work. Antigen tests are
- Easy to give
- Quick to return results
- Low in cost
Antigen tests are especially useful for screening because they can identify staff
- With COVID-19 who do not have signs or symptoms and no known exposure to COVID-19
- Who are at increased risk of exposure to COVID-19, such as business travelers and those who work in crowded indoor spaces
Other rapid point-of-care screening testsexternal icon are available, such as nucleic acid amplification tests (NAATs). However, this fact sheet only provides information about antigen testing in non-healthcare settings to help employers in those settings make informed choices about this type of screening testing option.
Developing a plan for employee testing
Testing for the virus that causes COVID-19 should be offered as part of a comprehensive COVID-19 prevention and control program. When developing a plan for employee testing, an employer must consider several factors including
- Availability of tests. Several antigen tests have received Emergency Use Authorization (EUA)external icon from the U.S. Food and Drug Administration (FDA) to detect SARS-CoV-2, the virus that causes COVID-19.
- Cost of tests. Antigen tests typically cost $5-$50. Employers who require antigen screening tests should not make employees pay for the tests.
- Vaccination status. If feasible, fully vaccinated employees with no symptoms and no known exposure should be exempt from routine screening testing programs.
Employers that require screening
- Must make sure the testing is job-related and consistent with a business need
- Must get employee consent before giving a test
- If employees do not consent, employers should consider providing other options that are appropriate, such as reassignment to tasks that can be performed via telework or working in a way that maintains physical distance from other workers or customers.
How to provide antigen tests
There are two main ways employers can provide antigen tests to screen employees for the virus that causes COVID-19.
- Testing personnel. An employer can directly run a testing program or hire testing personnel to test employees at the workplace or at a clinic location. Employers should ensure that they, or that the laboratories or testing sites they hire or contract, obtain a Clinical Laboratory Improvement Amendments (CLIA) certificate and meet CLIA regulations.
- Test kit. A kit that employers provide or employees can purchase, and can be used anywhere — at home, in a car, or any other private and convenient location.
If providing test kits for screening your employees, you as the employer will want to
- Use a test that received EUA by the FDA.
- Develop policies that encourage employees to participate in a testing program without fear of reprisals for having a positive test, and ensure employees are aware of these policies.
- Encourage the use of mobile apps that record, store, and display the date and time of a test result.
Swabbing for antigen testing
Most antigen testing is done by inserting a swab into a person’s nostril to collect nasal discharge. There are different locations in the nostril for collecting specimens. Always refer to test kit instructions to determine the proper swab location.
Understanding the results of screening antigen tests
If an employee with no symptoms and no known exposure to COVID-19 receives a positive screening antigen test result, they should stay at home and quarantine while waiting for that result to confirmed with a laboratory-based NAAT pdf icon[457KB, 1 page]. Laboratory-based NAATs detect the virus’s genetic material and are commonly used in laboratories. These tests are typically more accurate but take longer to process results than other types of tests.
If the laboratory-based NAAT is positive, the employee has been infected with the virus that causes COVID-19. The employee should
- Remain at home
- Keep away from others who are not infected
- Stay in touch with their doctor
- Work with public health authorities to support contact tracing efforts
If an employee receives a negative screening antigen test result, that means the employee
- Was not infected with the virus that causes COVID-19 at the time the specimen was collected
- Did not have enough virus in the specimen to be detected by the test at the time the test was performed.
Employees who test negative can work. A negative test result does not mean the employee is not infected or will not get sick. The employee could become sick after the test, or they could be exposed to the virus that causes COVID-19 after the test. They should continue to take steps to protect themselves and others.
Reporting antigen test results from employees
All employee antigen test results collected as part of a workplace testing program should be reported to the employer to determine who is permitted to enter the workplace. Employers must keep employee test results confidential.
The Coronavirus Aid, Relief, Economic Security (CARES) Act requires laboratories to report test results to state or local health departments. Sharing results with local public health authorities supports contact tracing efforts to slow the spread of COVID-19.
Contact tracing helps identify cases quickly to protect employees, their families, and their community. Everyone can support contact tracing efforts — even those who are fully vaccinated. Contact tracing efforts help by
- Letting people know they may have been exposed to COVID-19 and should monitor their health for signs and symptoms of COVID-19
- Helping people who may have been exposed to COVID-19 get tested
- Asking all people, including those who are fully vaccinated, to self-isolate if they have COVID-19
- Asking unvaccinated people to self-quarantine if they are a close contact
Deciding how often to test employees
Repeatedly testing employees can help detect infections and prevent COVID-19 from spreading to other workers. CDC recommends using two community indicators over the past 7 days to decide how often to test employees
- Total number of new cases of COVID-19 per 100,000 people
- Percent positive NAAT COVID-19 tests
These two community indicators should be considered at the county level in communities where employees live as well as the location of the workplace. This information is typically available on state and local health department websites.
Depending on the level (high, substantial, moderate, or low) of new cases and positive NAAT tests, screening testing may be recommended at least weekly. If testing regularly, it is important to inform your public health authorities of your testing program since it may produce many test results.
Antigen testing by itself cannot prevent the spread of COVID-19. Taking everyday preventive actions to slow the spread of COVID-19 is critical.
You can help protect your employees by
- Encouraging employees to get vaccinated, when available to them, and supporting efforts to vaccinate employees.
- Encouraging sick employees to stay home.
- Screening employees for COVID-19 symptoms and potential exposure to COVID-19.
- Collecting employee test results before they enter the workplace.
- Consulting with a building ventilation professional to improve ventilation in the workplace.
- Installing physical barriers, such as plexiglass or similar materials, to separate workers from each other or from customers.
- Limiting the number of employees or customers in a facility.
- Encouraging people to stay at least 6 feet apart and using visual cues to support physical distance.
- Providing handwashing stations or hand sanitizer with at least 60% alcohol.
- Suppling materials and training for cleaning of frequently touched surfaces.
- Providing masks and personal protective equipment (PPE) required for the job, and requiring consistent, proper wearing of masks and PPE while in the workplace other than when eating or drinking.