Beale, Sarah Frances;
(2023)
Occupation, Work-Related Exposure, and SARS-CoV-2 Transmission.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Early evidence from the Coronavirus Disease 2019 (COVID-19) pandemic suggests that workers differ in their risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and adverse outcomes according to their occupation. The direct contribution of occupation to these inequalities in unclear, given a lack of comprehensively-adjusted estimates. Potential work-related mechanisms underlying differential risk are also poorly understood. / Objectives: This thesis aimed to investigate (1) how SARS-CoV-2 infection risk and (2) features of work-related contact varied between occupations and over time, (3) whether work-related contact mediated the relationship between occupation and infection risk, (4) how vaccination uptake varied across occupations overall and according to vulnerability status and work-related exposure, and (5) how implementation and perception of pandemic mitigation methods varied between occupations and over time. / Methods: All analyses were conducted using data from Virus Watch, a community prospective cohort study in England and Wales. Infection outcomes and vaccination status were ascertained based on linkage, weekly participant self-report, and – for infection outcomes – virological and serological testing within the study. Measures were developed to investigate workplace contact patterns and mitigations. / Results: Frontline workers from several sectors had elevated infection risk compared to office-based professional occupations. Differential risk was most marked in early waves, and only teaching, education, and childcare workers demonstrated elevated risk across all waves. Groups with elevated infection risk also tended to demonstrate greater workplace contact and exposure and, often, lower reporting of mitigations. Work-related close contact was a mediator of infection risk. Occupational differences in vaccination uptake emerged primarily amongst non-vulnerable workers. Workers had a high level of agreement with most mitigations. / Conclusions: Occupation is an important factor influencing SARS-CoV-2 infection risk. Workers differed substantially in workplace exposure, vaccination uptake, and work-related mitigations. Evidence-based suggestions for research and practice are made regarding pandemic preparation and endemic SARS-CoV-2 transmission.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Occupation, Work-Related Exposure, and SARS-CoV-2 Transmission |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10173530 |
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