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EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296537


Background: Workplaces are an important potential source of SARS-CoV-2 exposure;however, investigation into workplace contact patterns is lacking. This study aimed to investigate how workplace attendance and features of contact varied between occupations and over time during the COVID-19 pandemic in England. Methods: Data were obtained from electronic contact diaries submitted between November 2020 and November 2021 by employed/self-employed prospective cohort study participants (n=4,616). We used mixed models to investigate the main effects and potential interactions between occupation and time for: workplace attendance, number of people in shared workspace, time spent sharing workspace, number of close contacts, and usage of face coverings. Findings: Workplace attendance and contact patterns varied across occupations and time. The predicted probability of intense space sharing during the day was highest for healthcare (78% [95% CI: 75-81%]) and education workers (64% [59%-69%]), who also had the highest probabilities for larger numbers of close contacts (36% [32%-40%] and 38% [33%-43%] respectively). Education workers also demonstrated relatively low predicted probability (51% [44%-57%]) of wearing a face covering during close contact. Across all occupational groups, levels of workspace sharing and close contact were higher and usage of face coverings at work lower in later phases of the pandemic compared to earlier phases. Interpretation: Major variations in patterns of workplace contact and mask use are likely to contribute to differential COVID-19 risk. Across occupations, increasing workplace contact and reduced usage of face coverings presents an area of concern given ongoing high levels of community transmission and emergence of variants.

EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296536


Background: Workers differ in their risk of SARS-CoV-2 infection according to their occupation, but the direct contribution of occupation to this relationship is unclear. This study aimed to investigate how infection risk differed across occupational groups in England and Wales up to October 2021, after adjustment for potential confounding and stratification by pandemic phase. Methods: Data from 12,182 employed/self-employed participants in the Virus Watch prospective cohort study were used to generate risk ratios for virologically- or serologically-confirmed SARS-CoV-2 infection using robust Poisson regression, adjusting for socio-demographic and health-related factors and non-work public activities. We calculated attributable fractions (AF) amongst the exposed for each occupational group based on adjusted risk ratios (aRR). Findings: Increased risk was seen in nurses (aRR=1.90 [1.40-2.40], AF=47%);doctors (1.74 [1.26-2.40], 42%);carers (2.18 [1.63-2.92], 54%);teachers (primary = 1.94 [1.44- 2.61], 48%;secondary =1.64, [1.23-2.17], 39%), and warehouse and process/plant workers (1.58 [1.20-2.09], 37%) compared to both office-based professional occupations (reported above) and all other occupations. Differential risk was apparent in the earlier phases (Feb 2020 - May 2021) and attenuated later (June - October 2021) for most groups, although teachers demonstrated persistently elevated risk. Interpretation: Occupational differentials in SARS-CoV-2 infection risk are robust to adjustment for socio-demographic, health-related, and activity-related potential confounders. Patterns of differential infection risk varied over time, and ongoing excess risk was observed in education professionals. Direct investigation into workplace factors underlying elevated risk and how these change over time is needed to inform occupational health interventions.

J Epidemiol Community Health ; 76(4): 319-326, 2022 04.
Article in English | MEDLINE | ID: covidwho-1467721


BACKGROUND: Differential exposure to public activities may contribute to stark deprivation-related inequalities in SARS-CoV-2 infection and outcomes but has not been directly investigated. We set out to investigate whether participants in Virus Watch-a large community cohort study based in England and Wales-reported differential exposure to public activities and non-household contacts during the autumn-winter phase of the COVID-19 pandemic according to postcode-level socioeconomic deprivation. METHODS: Participants (n=20 120-25 228 across surveys) reported their daily activities during 3 weekly periods in late November 2020, late December 2020 and mid-February 2021. Deprivation was quantified based on participants' residential postcode using English or Welsh Index of Multiple Deprivation quintiles. We used Poisson mixed-effect models with robust standard errors to estimate the relationship between deprivation and risk of exposure to public activities during each survey period. RESULTS: Relative to participants in the least deprived areas, participants in the most deprived areas exhibited elevated risk of exposure to vehicle sharing (adjusted risk ratio (aRR) range across time points: 1.73-8.52), public transport (aRR: 3.13-5.73), work or education outside of the household (aRR: 1.09-1.21), essential shops (aRR: 1.09-1.13) and non-household contacts (aRR: 1.15-1.19) across multiple survey periods. CONCLUSION: Differential exposure to essential public activities-such as attending workplaces and visiting essential shops-is likely to contribute to inequalities in infection risk and outcomes. Public health interventions to reduce exposure during essential activities and financial and practical support to enable low-paid workers to stay at home during periods of intense transmission may reduce COVID-related inequalities.

COVID-19 , COVID-19/epidemiology , Cohort Studies , England/epidemiology , Health Status Disparities , Humans , Pandemics , SARS-CoV-2 , Wales/epidemiology