Background

Ticks are responsible for more than a dozen known tickborne diseases, including Lyme disease, Rocky Mountain Spotted Fever (RMSF), and Anaplasmosis. Transmission varies geographically based on where the ticks and reservoirs (e.g., deer, mice, etc.) live. Although Lyme disease is the most reported tickborne illness, other illnesses are increasingly being identified. Co-infection, or experiencing different tickborne illnesses at the same time, is also possible. The frequency of co-infection differs depending on the pathogen and geographic region. For example, a review of published studies found co-infection with Lyme disease and Anaplasmosis to be relatively common with rates ranging from 1% to 28% across several northeastern states, and another study among Lyme disease patients in New York found coinfection with Babesiosis of roughly 10%.

Some common symptoms that may occur with tickborne illnesses include fever/chills, aches, joint stiffness, and rashes. Symptoms may present within a few days or up to several weeks following the bite, depending on the illness and geographic region where the tick bite occurred. There is also considerable variability in the severity of tickborne illnesses. For example, RMSF can become fatal if not treated within 5 days of symptom onset, whereas untreated Lyme disease is rarely fatal, but can progress to a diverse range of disorders affecting the heart, nervous system, bones, joints, and organs.

Workers who spend time outdoors in wooded, grassy areas throughout certain geographic regions of the U.S. are at higher risk of exposure to disease-carrying ticks and should take appropriate precautions to avoid tick bites throughout the year, regardless of weather conditions. Understanding what ticks are present in your area, which diseases they may carry, the symptoms of these diseases, and effective protective measures can help prevent tickborne illnesses.

Occupations and worker populations with documented tick exposures

Occupations with increased tick exposure include those involving outdoor work (e.g., agriculture, landscaping, forestry, construction, utilities, and park/wildlife management). Between 2011 and 2020, an average of 969 workers each year reported tick and other mite bites that involved days away from work, according to the Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses data. However, these occurrences are likely underreported given the difficulties associated with recognizing tick bites and diagnosing tickborne diseases.

Outdoor workers

• A review of global studies evaluating occupational Lyme disease among exposed workers between 2002 and 2021 found that about 20% of outdoor workers tested positive for Borrelia burgdorferi, the bacteria found in certain ticks that causes Lyme disease. Forestry and agricultural workers were over two times more likely to test positive for Lyme disease compared to other workers who may be exposed to the disease-carrying tick, such as veterinarians, animal breeders, and soldiers.
• In a study among U.S. Forest Service workers in the upper Midwest, 97% of respondents reported recent tick exposure, and 70% reported they found ticks on themselves "always" or "most of the time" while working outdoors. Additionally, 26% of respondents had a history of a tickborne disease, with 88% of respondents reporting that their diagnosis occurred while working at their current job.

Increased potential risk in Hispanic workers

• According to a study assessing Lyme Disease among Hispanics in the U.S., approximately 43.5% of outdoor workers are Hispanic, increasing their risk of occupational exposure to ticks. The study found that Hispanics were more likely than non-Hispanics to have signs of disseminated infection and symptom onset during the fall months.
• A study on knowledge and prevention of tickborne diseases found that Hispanics were less likely to conduct daily tick checks and to report familiarity with Lyme disease symptoms. Having a non-English primary language was a significant predictor of whether an individual had knowledge to recognize Lyme disease symptoms, identify ticks as vectors for Lyme Disease, and perform daily tick checks.
• Training workers about ticks in their primary language is critical to preventing work-related tickborne diseases. Workers have the right to receive information and training in a language and vocabulary the worker understands about workplace hazards, methods to prevent them, and the OSHA standards that apply to their workplace.