Objectives 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. Methods 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. Results 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. Conclusion 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.
Counil et al. (Tue,) studied this question.