Education and pandemic SARS-CoV-2 infections in the German working population - the mediating role of working from home.

Benjamin Wachtler, Florian Beese, Ibrahim Demirer, Sebastian Haller, Timo-Kolja Pförtner, Morten Wahrendorf, Markus M Grabka, Jens Hoebel
Author Information
  1. Benjamin Wachtler: ORCID ID 0000-0002-3959-5676, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany. wachtlerb@rki.de.

Abstract

OBJECTIVES: SARS-CoV-2 infections were unequally distributed during the pandemic, with those in disadvantaged socioeconomic positions being at higher risk. Little is known about the underlying mechanism of this association. This study assessed to what extent educational differences in SARS-CoV-2 infections were mediated by working from home.
METHODS: We used data of the German working population derived from the seroepidemiological study "Corona Monitoring Nationwide - Wave 2 (RKI-SOEP-2)" (N=6826). Infections were assessed by seropositivity against SARS-CoV-2 antigens and self-reports of previous PCR-confirmed infections from the beginning of the pandemic until study participation (November 2021 - February 2022). The frequency of working from home was assessed between May 2021 and January 2022.We used the Karlson-Holm-Breen (KHB) method to decompose the effect of education on SARS-CoV-2 infections.
RESULTS: Individuals with lower educational attainment had a higher risk for SARS-CoV-2 infection (adjusted prevalence ratio of low versus very high = 1.76, 95% confidence interval 1.08-2.88; P=0.023). Depending on the level of education, between 27% (high education) and 58% (low education) of the differences in infection were mediated by the frequency of working from home.
CONCLUSIONS: Working from home could prevent SARS-CoV-2 infections and contribute to the explanation of socioeconomic inequalities in infection risks. Wherever possible, additional capacities to work remotely, particularly for occupations that require lower educational attainment, should be considered as an important measure of pandemic preparedness. Limitations of this study are the observational cross-sectional design and that the temporal order between infection and working from home remained unclear.

References

  1. Scand J Work Environ Health. 2023 May 1;49(4):259-270 [PMID: 36913703]
  2. Addict Behav Rep. 2021 Dec;14:100377 [PMID: 34549078]
  3. Glob Epidemiol. 2022 Dec;4:100095 [PMID: 36447481]
  4. Dtsch Arztebl Int. 2021 Dec 10;118(49):842-843 [PMID: 35264284]
  5. Epidemiology. 1999 Jan;10(1):37-48 [PMID: 9888278]
  6. Front Psychol. 2023 Feb 22;14:1065593 [PMID: 36910835]
  7. Front Public Health. 2022 Sep 16;10:980482 [PMID: 36187688]
  8. J Pers Soc Psychol. 1986 Dec;51(6):1173-82 [PMID: 3806354]
  9. Int J Equity Health. 2022 Jan 14;21(1):6 [PMID: 35031078]
  10. Scand J Work Environ Health. 2022 Jan 1;48(1):52-60 [PMID: 34665872]
  11. Front Public Health. 2022 Oct 31;10:981270 [PMID: 36388332]
  12. Clin Infect Dis. 2023 Apr 3;76(7):1285-1294 [PMID: 36373203]
  13. Scand J Work Environ Health. 2022 Sep 1;48(7):530-539 [PMID: 35780381]
  14. J Epidemiol Community Health. 2020 Nov;74(11):964-968 [PMID: 32535550]
  15. MMWR Morb Mortal Wkly Rep. 2020 Nov 06;69(44):1648-1653 [PMID: 33151918]
  16. BMJ Open. 2023 Feb 28;13(2):e063771 [PMID: 36854599]
  17. Nucleic Acids Res. 2023 Jan 6;51(D1):D1512-D1518 [PMID: 36350613]
  18. BMC Public Health. 2023 Feb 6;23(1):260 [PMID: 36747171]
  19. J Health Monit. 2020 Oct 09;5(Suppl 7):3-17 [PMID: 35146298]
  20. Cureus. 2021 Feb 1;13(2):e13064 [PMID: 33680606]
  21. Ethn Dis. 2022 Apr 21;32(2):123-130 [PMID: 35497392]
  22. BMJ Open. 2021 Jan 4;11(1):e043577 [PMID: 33397669]
  23. Health Aff (Millwood). 2021 Aug;40(8):1252-1260 [PMID: 34288698]
  24. BMC Public Health. 2022 Jan 7;22(1):47 [PMID: 34996400]
  25. Int J Public Health. 2022 Aug 29;67:1605128 [PMID: 36105178]
  26. Int J Environ Res Public Health. 2022 Apr 13;19(8): [PMID: 35457547]
  27. BMC Infect Dis. 2022 Jul 30;22(1):661 [PMID: 35907791]
  28. Scand J Work Environ Health. 2023 Sep 1;49(6):386-394 [PMID: 37417898]
  29. BMC Psychol. 2023 Jun 27;11(1):188 [PMID: 37370153]
  30. Vaccines (Basel). 2020 Dec 19;8(4): [PMID: 33352743]
  31. Int J Epidemiol. 2016 Dec 1;45(6):1887-1894 [PMID: 28089956]
  32. Addict Behav. 2022 Dec;135:107439 [PMID: 35914417]
  33. Cities. 2022 Dec;131:103892 [PMID: 35942406]
  34. Scand J Work Environ Health. 2022 Jul 1;48(5):380-390 [PMID: 35470862]
  35. Sustain Cities Soc. 2022 Nov;86:104158 [PMID: 36060423]
  36. BMJ Open. 2022 Apr 4;12(4):e052733 [PMID: 35379616]
  37. Lancet Reg Health Eur. 2021 Aug;7:100148 [PMID: 34124709]
  38. BMJ. 2023 May 9;381:1041 [PMID: 37160309]
  39. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 Aug;66(8):857-868 [PMID: 37466654]
  40. Infect Drug Resist. 2022 Jul 21;15:3871-3879 [PMID: 35903580]
  41. Occup Environ Med. 2022 Apr 21;: [PMID: 35450951]
  42. Scand J Work Environ Health. 2022 Sep 1;48(6):446-456 [PMID: 35670286]
  43. Int J Equity Health. 2021 Nov 24;20(1):248 [PMID: 34819081]
  44. Public Health Res (Southampt). 2023 May;11(4):1-100 [PMID: 37452651]
  45. PLoS Med. 2007 Oct 16;4(10):e297 [PMID: 17941715]
  46. JAMA Netw Open. 2022 Apr 1;5(4):e228406 [PMID: 35452107]

MeSH Term

Humans
COVID-19
Cross-Sectional Studies
Educational Status
Pandemics
SARS-CoV-2

Word Cloud

Created with Highcharts 10.0.0SARS-CoV-2workinginfectionshomepandemicstudyeducationinfectionassessededucational-socioeconomichigherriskdifferencesmediatedusedGermanpopulation20212022frequencylowerattainmentlowhigh1OBJECTIVES:unequallydistributeddisadvantagedpositionsLittleknownunderlyingmechanismassociationextentMETHODS:dataderivedseroepidemiological"CoronaMonitoringNationwideWave2RKI-SOEP-2"N=6826Infectionsseropositivityantigensself-reportspreviousPCR-confirmedbeginningparticipationNovemberFebruaryMayJanuaryWeKarlson-Holm-BreenKHBmethoddecomposeeffectRESULTS:Individualsadjustedprevalenceratioversus=7695%confidenceinterval08-288P=0023Dependinglevel27%58%CONCLUSIONS:WorkingpreventcontributeexplanationinequalitiesrisksWhereverpossibleadditionalcapacitiesworkremotelyparticularlyoccupationsrequireconsideredimportantmeasurepreparednessLimitationsobservationalcross-sectionaldesigntemporalorderremainedunclearEducationmediatingrole

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