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

## TL;DR

This study shows that work-related factors explain differences in SARS-CoV-2 infection rates among different job classes in France during the early pandemic.

## Contribution

The study identifies how work-related exposures mediate occupational class disparities in SARS-CoV-2 infection.

## Key findings

- Work-related factors increased symptom risk in middle and lower occupational classes compared to the highest class.
- Middle occupational classes in highly affected regions reported more symptoms than the upper class.
- Workplace exposures played a significant role in shaping infection disparities across regions.

## Abstract

This study examines SARS-CoV-2 infection by occupational class (OC) among working adults during the early pandemic in France and the mediating role of work-related exposures in regions highly and less affected by COVID-19.

We analyzed data from 46,849 workers in the French EpiCoV cohort. SARS-CoV-2 infection was defined by self-reported COVID-19-like symptoms between mid-March and the end of June 2020. We related OC with reporting COVID-19-like symptoms in both regions and assessed the mediating effect of work-related exposures using the Karlson-Holm-Breen method of mediation analysis.

During the study period, 7.1% of workers reported COVID-19-like symptoms. In less-affected regions, the highest OC workers reported symptoms more often than the lowest, while in the highly affected regions, middle OCs reported symptoms more often than those in the upper class. Regardless, work-related factors increased symptom risk in the middle and lower OCs compared to the highest OC.

Distinct transmission dynamics shaped the evolution of occupational class disparities during the early pandemic. Workplace exposures played a significant role in these disparities, even when offset by other exposure-related factors.