key: cord-0888675-uf90vgg2
authors: Welsh, Claire E.
title: Workplace contact patterns across occupational groups
date: 2022-03-24
journal: Lancet Reg Health Eur
DOI: 10.1016/j.lanepe.2022.100356
sha: 2ed11d469b0f05522c05f4f36b64b32eb199ffa0
doc_id: 888675
cord_uid: uf90vgg2

nan

Occupational risks to personal health persist in all sectors. Few occupations present as broad a range of potential challenges to employee health as healthcare itself. Over these recent pandemic-afflicted years, interacting with others in the workplace has become inherently dangerous: not only for employees but for their families and wider society. Much work both in the UK and internationally showed that frontline occupations were linked with greater risk of exposure to COVID-19, especially those with public-facing roles. 1 Working from home remained a privilege of a small proportion of workers, who consequently suffered fewer infections. Government-mandated lockdowns imposed the most stringent restrictions on interactions at work and home, but 'softer' guidelines (masking mandates, social distancing, the 'rule of six' 2 etc.) were also differentially imposed. How changing rules affected the behaviour of employees in different sectors is the focus of this study.

The study by Beale et al. 3 describes the contact patterns of nearly 5000 employees in a wide range of roles in England at various time points across one year (November 2020 to November 2021, nominally waves 2 and 3), gathered from the Virus Watch prospective cohort study. Analyses explored the likelihood of various 'risky' behaviours (e.g. sharing space with others, having close contacts at work) using a mixed models approach. How these behaviours changed over time with alterations in restrictions, was assessed by occupational group. The predicted probability of intense space sharing 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). Their findings showed that, as expected, people in public-facing and frontline roles (such as teachers, healthcare workers, transport workers), were more likely to attend work at all time points than other occupations (once sectoral and seasonal closures were taken into account). Professional occupations were more likely to work from home.

Interestingly, the authors note that the likelihood of participants recording 'risky' workplace behaviours reduced when restrictions were in place. When restrictions eased, the likelihood of sharing space with others increased across occupations, despite the co-occurrence of high case rates nationally. This might suggest that government or employer mandated restrictions (or the lack thereof) are a stronger driver of workplace behaviour than epidemiology.

Within term time, teachers were among those most likely to attend the workplace on the index date, and to share space and to have close contacts. Teachers were also one of the least likely occupations to report having worn a facemask. This may partly explain why there was a greater risk of infection for teachers compared to other occupations, but high rates of infection in their pupils and colleagues would also pose a significant risk 4 . The study may have suffered from some recall bias in respondents, and was unable to link behaviours directly to likelihood of infection in individuals, but did compare behaviours with overall occupational mortality rates.

Of course, attempts to mitigate transmission benefit all of society, not just those adhering to them. This work reminds us that risk is not shared equally across occupations. The success of future pandemic restrictions will likely vary depending on the nature of the work. Public-facing occupations, where the risk of transmission to large numbers of other people, should be supported to adopt any possible mitigations to prevent onward viral spread. This is particularly important if those employees are at greater risk of poor outcomes themselves.

This study adds to the growing literature on interpersonal contact patterns, augmenting the literature with deeper understanding of occupational differences in transmission-related behaviours in a UK context. Intelligent pandemic responses should aim to apply fair, proportionate restrictions on risky interactions in an evidence-based way to minimise the impact on individuals, while maximising their effect on viral transmission. This work adds to the body of knowledge that could be used for such a task in future.

frontline workers and COVID-19 inequities

Coronavirus: how to stay safe and help prevent the spread. Guidance

Workplace contact patterns in England during the COVID-19 pandemic: analysis of the virus watch prospective cohort study. Lancet Reg Health Eur

Risk of hospital admission with COVID-19 among teachers compared with healthcare workers and other adults of working age in Scotland