Modeling the impact of respiratory disease outbreaks on the United States agricultural workforce

Background: Emerging respiratory disease outbreaks pose a major threat to food production systems. Agricultural workers face health disparities that amplify their susceptibility to respiratory pathogens, yet the consequences for worker health and food production remain poorly understood. Methods: We developed a household-structured susceptible-infectious-recovered (SIR) transmission model to compare disease dynamics between agricultural workers and the general U.S. population across six regions. We simulated outbreaks across a range of epidemiological scenarios and assessed productivity losses in California for three labor-intensive crops (oranges, iceberg lettuce, strawberries) with different harvest seasonalities. Results: We show that, for a baseline reproduction number of R0 = 2.0, the peak disease prevalence among agricultural workers is 1.41-1.69 times higher than that of the general population across regions, and final outbreak sizes are 1.29-1.42 times higher. Household structure accounts for 54%-68% of the disease disparity. Peak productivity losses range from 0.50%-0.63% across crops, translating to millions in lost potential revenue. At higher transmissibility and severity (R0 = 3 and assuming all infections are symptomatic), losses are 2.4 times higher. Conclusions: Household crowding may lead to disproportionate respiratory disease burden among agricultural workers that is exacerbated by vaccination and obesity disparities, highlighting the need for targeted outbreak preparedness and mitigation strategies in the agricultural sector to maintain food system resilience and support public health in these communities.