Work-Related Exposures Mediate Occupational Class Disparities in SARS-CoV-2 Infection in France

Area of Science:

• Epidemiology
• Occupational Health
• Infectious Disease Dynamics

Background:

• The early COVID-19 pandemic presented unique challenges for working adults.
• Understanding occupational class (OC) disparities in SARS-CoV-2 infection is crucial for public health interventions.
• Regional differences in COVID-19 impact may have influenced occupational risk.

Purpose of the Study:

• To examine SARS-CoV-2 infection rates across different occupational classes in France during the early pandemic.
• To investigate the mediating role of work-related exposures in these occupational disparities.
• To compare findings between regions with high and low COVID-19 prevalence.

Main Methods:

• Analysis of data from 46,849 workers in the French EpiCoV cohort (mid-March to end-June 2020).
• SARS-CoV-2 infection defined by self-reported COVID-19-like symptoms.
• Mediation analysis (Karlson-Holm-Breen method) used to assess work-related exposures' impact on OC disparities.

Main Results:

• 7.1% of workers reported COVID-19-like symptoms.
• In less-affected regions, higher OCs reported more symptoms; in highly affected regions, middle OCs reported more symptoms than upper OCs.
• Work-related factors amplified symptom risk in middle and lower OCs compared to the highest OC.

Conclusions:

• Occupational class disparities in COVID-19 infection evolved differently based on regional transmission dynamics.
• Workplace exposures were a significant factor contributing to these occupational disparities.
• The influence of workplace exposures persisted even when considering other exposure-related factors.