AUTHOR=Counil Emilie , Ghoroubi Narges , Khlat Myriam 
  
TITLE=Work-Related Exposures Mediate Occupational Class Disparities in SARS-CoV-2 Infection in France
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1608670
  
DOI=10.3389/ijph.2026.1608670
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesThis 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.MethodsWe 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.ResultsDuring 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.ConclusionDistinct 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.