8271982 Occupational factors of Long-COVID in a population-based cohort in Catalonia: the COVICAT study

<h3>Objective</h3> Occupational factors affect SARS-CoV2 infection risk, but the consequent Long-COVID burden is unknown. We aimed to fill in this research gap by using individual data in a population-based cohort. <h3>Methods</h3> In the large prospective COVICAT study, 2020-2023, Catalonia, Spain, we examined the association between occupational determinants and Long-COVID. Among subjects with previous SARS-CoV2 infection, those employed during the pandemic and with occupational information were analyzed. Different metrics, including 4 job-exposure matrices, were used to evaluate individual occupational risk factors for Long-COVID (post-infection symptoms ≥3months). Poisson models were used to estimate adjusted risk ratios (RRs) and 95% confidence intervals (CIs). <h3>Results</h3> Among 2054 workers (1308 women, 746 men) aged 40-69 years, 486 developed Long-COVID (23.7%). Individual risk factors were female sex (RR:1.45;CIs:1.22-1.73), low education (1.31;0.97-1.76), obesity (1.19;0.97-1.47), co-morbidities (2.32;1.75-3.07 for 3+ diseases), and previous symptomatic vs. asymptomatic SARS-CoV2 infection (3.32;2.19-5.06 for mild/moderate, 9.60;6.10-15.1 for severe/critical). Protective factors were COVID-19 vaccination (0.53;0.43-0.64), and older age (0.90 per 10-year increase). Workers in jobs at high COVID-19 risk according to all metrics (health/social care, education, retail, transport, and security) showed higher Long-COVID risk. The main drivers of increased risk were close contact with colleagues and the public (RR up to 1.50;1.18-1.90), no social distance at workplace (up to 1.47;1.16-1.85), no use of facemask (1.41;1.09-1.83), commute by public transport (1.56;1.18-2.05), and night shift work (1.88;1.38-2.56). <h3>Conclusion</h3> In a population-based cohort, several occupational factors increased Long-COVID risk. Focused preventive strategies are warranted to avoid the associated public health burden. Long-COVID should be recognized/compensated as an occupational disease.