Occupational determinants of Long COVID in the population-based COVICAT cohort, 2025, Matteis et al.

[SNT Gatchaman]

Occupational determinants of Long COVID in the population-based COVICAT cohort

Spoiler: Authors

Sara De Matteis; Dario Consonni; Ana Espinosa; Rafael de Cid; Natalia Blay Magriña; Gemma Castaño-Vinyals; Marianna Karachaliou; Miguel Angel Alba Hidalgo; Kyriaki Papantoniou; Judith Garcia; Manolis Kogevinas; Kurt Straif

OBJECTIVES
Occupational factors affect SARS-CoV-2 infection risk, but the occupational factors associated with Long COVID (LC) are unknown. We aimed to address this issue using individual data in a population-based cohort.

METHODS
In the prospective COVICAT study, 2020–2023, Catalonia, Spain, we examined the association between occupational determinants and LC. Among subjects with previous SARS-CoV-2 infection, those employed in the pandemic and with occupational information were analysed. Different metrics, including four job-exposure matrices, were used to evaluate individual occupational risk factors for LC (postinfection symptoms ≥3 months). Poisson models were used to estimate adjusted risk ratios (RRs) and 95% CIs.

RESULTS
Among 2054 workers (1308 women, 746 men) aged 40–69 years, 486 developed LC (23.7%). Workers in jobs at high COVID-19 risk according to all metrics including health/social care, education, retail, transport and security showed higher LC risk. The main drivers of increased risk were close contact with colleagues and the public (RR up to 1.50; 95% CI 1.18 to 1.91), no social distance at workplace (up to 1.46; 95% CI 1.16 to 1.84), rare or no use of facemask (1.41; 95% CI 1.09 to 1.83) and commute by public transport (1.58; 95% CI 1.20 to 2.08). Working on-site during the pandemic was also associated with a higher LC risk compared with teleworking (1.57; 95% CI 1.19 to 2.09). Individual non-occupational risk factors for LC included female sex, comorbidities, obesity, number and severity of acute infections; vaccination and older age were protective.

CONCLUSIONS
In a population-based cohort, several occupational factors increased LC risk. Focused preventive strategies are warranted to avoid the associated public health burden. LC should be recognised and compensated as an occupational disease.

Web | DOI | PDF | Occupational and Environmental Medicine | Paywall

 

[rvallee]

The main drivers of increased risk were close contact with colleagues and the public (RR up to 1.50; 95% CI 1.18 to 1.91), no social distance at workplace (up to 1.46; 95% CI 1.16 to 1.84), rare or no use of facemask (1.41; 95% CI 1.09 to 1.83) and commute by public transport (1.58; 95% CI 1.20 to 2.08). Working on-site during the pandemic was also associated with a higher LC risk compared with teleworking (1.57; 95% CI 1.19 to 2.09).

All different ways of saying that infections are the only determinant. Can this profession move on from trying to find excuses otherwise? It's endemic, congratulations, you did it! Now what? Now this!

Focused preventive strategies

How Great Barrington Declaration of them. Let's protect, focusely. Or whatever. All protections have been removed because they were such a bummer. So, literally fantasy.

This means the only, and really absolutely the only, solution is to have treatments. No treatments exist. Rehabilitation is useless, even harmful. Prevention is now cringe, even discouraged, to maximize natural infections since the unvoiced strategy is to simply sacrifice the few so that most can just forget that this even happened.

Literally all the research points to infections as the only relevant thing. Even studies showing reduced rates from vaccinations are ultimately about that. But they keep trying to find whether people who get out of bed on their left foot, or maybe people who fancy flowers, or whatever, can be some risk factor.

None of this matters! I've never seen such a lack of coherent focus by any group of professionals, they have stuck themselves in a loop of failure out of multiple terrible decisions and refuse to back out of it.

 

[Utsikt]

All different ways of saying that infections are the only determinant. Can this profession move on from trying to find excuses otherwise? It's endemic, congratulations, you did it! Now what? Now this!

How Great Barrington Declaration of them. Let's protect, focusely. Or whatever. All protections have been removed because they were such a bummer. So, literally fantasy.

This means the only, and really absolutely the only, solution is to have treatments. No treatments exist. Rehabilitation is useless, even harmful. Prevention is now cringe, even discouraged, to maximize natural infections since the unvoiced strategy is to simply sacrifice the few so that most can just forget that this even happened.

Literally all the research points to infections as the only relevant thing. Even studies showing reduced rates from vaccinations are ultimately about that. But they keep trying to find whether people who get out of bed on their left foot, or maybe people who fancy flowers, or whatever, can be some risk factor.

None of this matters! I've never seen such a lack of coherent focus by any group of professionals, they have stuck themselves in a loop of failure out of multiple terrible decisions and refuse to back out of it.

Not to mention that limiting the spread of the infections is the only feasible intervention we have, other than vaccines to limit the impact of the infection.

People will never change anything else to limit the impact of covid, we know that because there are plenty of reasons to make those changes already, so people either don’t want to or are unable to do it - often for reasons outside their control.

 

[Dolphin]

Occupational factors strongly influence long-COVID risk

Work-related factors play a significant and independent role in the risk of developing Long-COVID, shows a new study based on the COVICAT cohort and led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, in collaboration with the University of...

www.eurekalert.org

News Release 16-Dec-2025

Occupational factors strongly influence long-COVID risk​

A large Catalan cohort study shows that healthcare, social care, education, retail, and transport workers are at higher risk for Long-COVID

Peer-Reviewed Publication
Barcelona Institute for Global Health (ISGlobal)


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Work-related factors play a significant and independent role in the risk of developing Long-COVID, shows a new study based on the COVICAT cohort and led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, in collaboration with the University of Turin and the Germans Trias i Pujol Institute (IGTP). The findings, published in BMJ Occupational & Environmental Medicine, highlight that a substantial share of Long-COVID could be prevented through targeted workplace measures and policies.

The public health impact of Long-COVID is far from over. Beyond ongoing infections that continue to cause illness and deaths worldwide, millions of people are living with lasting health consequences. Globally, around 6 in every 100 COVID-19 cases develop Long-COVID, amounting to 400 million affected people and an annual economic impact of roughly 1 trillion dollars, or 1% of the global economy.

“Occupational factors have been associated with incidence and severity of SARS-CoV-2 infection. But the occupational determinants of Long-COVID are largely unknown,” explains Kurt Straif, ISGlobal researcher and study coordinator. This knowledge gap motivated the researchers to explore whether work environments and occupations influence Long-COVID risk based on data from COVICAT, a population cohort established in Catalonia at the beginning of the pandemic.

The analysis included 2,054 employed adults from the COVICAT cohort who had a confirmed SARS-CoV-2 infection, were aged 18–70 years at baseline, answered all three follow-up surveys (2020–2023) and provided complete occupational information. Of these, 486 participants (23.7%) developed Long-COVID. Most presented neurological symptoms (64%), followed by musculoskeletal (38%) and respiratory symptoms (28%).

Key risk factors: who is most vulnerable?​

Individual factors associated with higher Long-COVID risk included being female, having low educational level, obesity, multiple comorbidities, and experiencing more frequent or more severe SARS-CoV-2 infections. In contrast, COVID-19 vaccination prior to the infection, being first infected by Omicron, and older age were protective.

Occupation also emerged as a strong and independent determinant. Workers in high-risk occupations for COVID-19 had a 44% higher likelihood of developing Long-COVID, compared with low-risk jobs. Working onsite rather than teleworking increased risk by 57%; infrequent or inconsistent use of FFP2/FFP3 masks increased it by up to 52%; and commuting regularly by public transport raised it by 58%. The group of occupations with the highest Long-COVID risk scores included healthcare and social care professionals, teachers, retail workers, transport workers, and security staff.

“These results are consistent with emerging international evidence and suggest several mechanisms through which occupational exposures may shape Long-COVID development,” says Sara de Matteis, researcher at the University of Turin and first author of the study. Possible mechanisms include increased viral exposure in jobs with high patient and public contact and weakened immune responses due to high physical demands or work-related stress.

Implications for prevention and policy​

The findings reinforce the need for workplace measures, such as adequate personal protective equipment, mask use, and strategies to reduce close contact, not only for preventing infection, but also for mitigating long-term health consequences.

“Because occupational risk factors are modifiable, our findings mean that much of the associated Long-COVID burden could be avoided with targeted measures,” says Manolis Kogevinas, ISGlobal researcher and study co-author. The authors call for strengthened COVID-19 vaccination campaigns, the provision of FFP2/FFP3 masks, and regular health checks for high-risk occupations. They also urge policymakers to expand recognition and compensation for occupational Long-COVID.

This study is the result of a joint effort by ISGlobal, IGTP, and the University of Turin. It draws on data from the COVICAT cohort, part of the GCAT project—a large Catalan population cohort coordinated by IGTP - which, since 2020 and in coordination with ISGlobal, is leading a dedicated follow-up study to assess the long-term effects of COVID-19.



Reference

De Matteis S, Consonni D, Espinosa A, de Cid R, Blay N, Castaño-Vinyals G, Karachaliou M, Alba Hidalgo MA, Papantoniou K, Garcia J, Kogevinas M, Straif K. Occupational determinants of Long-COVID in the population-based COVICAT cohort. 2025. BMJ OEM. doi:10.1136/oemed-2025-EPICOHabstracts.140

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Journal​

BMJ

DOI​

10.1136/oemed-2025-EPICOHabstracts.140

Method of Research​

Observational study

Subject of Research​

People

Article Title​

Occupational determinants of Long-COVID in the population-based COVICAT cohort.

Article Publication Date​

5-Dec-2025

COI Statement​

The authors declare no conflict of interest

 

[Sean]

Preventative measures are all we have for now. There are certainly no treatments, let alone cures, once you have got it.

So I say crank them up, big time. Encourage masks, air filters and better ventilation in buildings, social distancing (within practical reason), hand hygiene, staying at home when you are sick, etc. Which all has to be paid for, of course. But I think it is pretty clear that the cost of not doing them is far higher, especially in the long term.

Independent of Covid, I think they should become default social behaviour anyway seeing as we are creating a world where infectious diseases are being given every chance to develop, rapidly proliferate, and harm us. The Japanese are right on this one.

 

[rvallee]

Preventative measures are all we have for now. There are certainly no treatments, let alone cures, once you have got it.

So I say crank them up, big time. Encourage masks, air filters and better ventilation in buildings, social distancing (within practical reason), hand hygiene, staying at home when you are sick, etc. Which all has to be paid for, of course. But I think it is pretty clear that the cost of not doing them is far higher, especially in the long term.

Independent of Covid, I think they should become default social behaviour anyway seeing as we are creating a world where infectious diseases are being given every chance to develop, rapidly proliferate, and harm us. The Japanese are right on this one.

This is never happening, and exactly why developing treatments is the only viable solution.

Human nature never changes. The only changes our civilization have seen that have forced social progress have all been technological, by simply working around our nature. This is what makes both psychosomatic/biopsychosocial ideology and the obsessive need to have behavioral solutions to complex problems in general so completely misguided, it literally goes against all of human history and everything we know about human psychology.

It never worked. It will never work. It will be tried again and again regardless, until it's all made irrelevant by technological solutions and everyone forgets all about how it was a massive failure until then because they confuse wanting something to be true with things actually being true. Same as it ever was and forever will be. Humans never change.