key: cord-1047737-55a9dr1i
authors: Descatha, Alexis; Fadel, Marc; Pitet, Sabrina; Verdun-Esquer, Catherine; Esquirol, Yolande; Legeay, Clément; Dinh, Aurelien; Clodore, Brigitte; Duprat, Pascal; Cartégnie, Sandrine; Dagrenat, Céline; Andujar, Pascal; Leclerc, Jean-Pierre; Letheux, Corinne
title: Matrice emplois-exposition pour le SARS-CoV-2 (COVID-19) :Création de « Mat-O-Covid », validité et perspectives
date: 2021-07-30
journal: Archives des Maladies Professionnelles et de l'Environnement
DOI: 10.1016/j.admp.2021.07.008
sha: 833d015468fa99cb917b8ae7044367ab5ac0b7fb
doc_id: 1047737
cord_uid: 55a9dr1i

L’évaluation de l’exposition est difficile pour le chercheur du domaine des risques professionnels. L’objectif du travail est de développer et de valider une matrice emplois-exposition (MEE) pour l'exposition professionnelle au SARS-CoV-2 appelée " Mat-O-Covid ". Grâce à un groupe d’expert français, la matrice a été développée pour tous les travailleurs sur la profession et les catégories socioprofessionnelles de 2003 (avec une passerelle de transcodage vers la Classification internationale type des professions de 2008) et un focus sur le secteur de soin et médicosocial. La moyenne des codages des experts a été utilisée comme estimation pour l’exposition « sujets » (collègues et/ou public) et « patients » pour le focus secteurs sanitaires, ainsi que la probabilité de prévention pour chaque. Les corrélations intraclasses ont été considérés comme bonnes à excellentes, sauf pour la prévention en santé. Comparées à la matrice américaine O*Net, l’évaluation a été considérée comme satisfaisante. En conclusion, une MEE "Mat-O-Covid" fournissant une probabilité d'exposition professionnelle au SARS-CoV-2 aura des implications pour la recherche et en santé publique, sous réserve de connaître ses limites et de poursuivre sa validation. While exposure assessment is complex for the occupational risk researcher, the objective of our work is to develop and validate a job-exposure matrix (JEM) for SARS-CoV-2 exposure called “Mat-O-Covid” project (“COVID-Mate” in French). A group of French experts, the JEM was developed for all workers using the 2003 Occupation and Socioprofessional Categories (with a transcoding gateway to the 2008 International Standard Classification of Occupations) and a focus on the health and care sector. The average of the experts' coding was used as estimates for both estimates, exposure "subjects" (colleagues and/or public) and "patients" for the focus on the health and care sector, as well as the probability of prevention for each. Intraclass correlations were considered good to excellent except for health prevention. Compared to the United States O*Net JEM, the evaluation was considered as fair. In conclusion, a "Mat-O-Covid" JEM providing a probability of occupational exposure to SARS-CoV-2 will have implications for research and public health, taking into account that its limitations are known, and its validation is still in progress.

While exposure assessment is complex for the occupational risk researcher, the objective of our work is to develop and validate a job-exposure matrix (JEM) for SARS-CoV-2 exposure called "Mat-O-Covid" project ("COVID-Mate" in French).

A group of French experts, the JEM was developed for all workers using the 2003 Occupation and Socioprofessional Categories (with a transcoding gateway to the 2008 International Standard Classification of Occupations) and a focus on the health and care sector. The average of the experts' coding was used as estimates for both estimates, exposure "subjects" Page 3 of 13 J o u r n a l P r e -p r o o f (colleagues and/or public) and "patients" for the focus on the health and care sector, as well as the probability of prevention for each. Intraclass correlations were considered good to excellent except for health prevention. Compared to the United States O*Net JEM, the evaluation was considered as fair.

In conclusion, a "Mat-O-Covid" JEM providing a probability of occupational exposure to SARS-CoV-2 will have implications for research and public health, taking into account that its limitations are known, and its validation is still in progress.

J o u r n a l P r e -p r o o f De nombreux défis de santé publique autour de la pandémie de COVID-19 demeurent non résolus, notamment dans le domaine de la prévention en milieu professionnel. Même si l'exposition professionnelle n'est pas la principale source de contamination, de nombreuses études en cours et futures devront prendre en compte ce facteur, pour mieux caractériser la prévention en milieu de travail [1] [2] [3] [4] . L'évaluation de l'exposition en milieu professionnel est difficile, mais une première étape possible est de l'évaluer grâce à une matrice emploisexposition (MEE) pour l'exposition au SARS-CoV-2 [5] . En effet, les MEE sont couramment utilisées dans la recherche en l'absence de données sur l'exposition individuelle ou de données anciennes [6, 7] . Les MEE permettent d'estimer l'exposition d'un individu à l'aide de codes Many public health challenges stemming from the COVID-19 pandemic remain unresolved, particularly in the field of workplace prevention. Even though occupational exposure is not the main source of contamination, many ongoing and future studies will need to consider this factor to better characterise prevention in occupational settings. [1] [2] [3] [4] Assessing transmission in an occupational setting is difficult, but a possible first step is to compute a job-exposure matrix (JEM) for SARS-CoV-2 exposure. [5] Indeed, JEMs are commonly used in occupational research in the absence of individual exposure data or historical data. [6, 7] JEMs enable an individual's exposure to be estimated using coded job titles which are converted into mean exposure estimates for epidemiological studies, as well as for prevention. Since no relevant data considering exposure to SARS-CoV-2 were yet available in our country, a JEM for SARS-CoV-2 exposure was built using expertise relating to the "Mat-O-Covid" project ("COVID-Mate" in French). [ 

Following the construction of other JEMs, [9, 10] For exposure to patients ("patients"), the care and health activities sector was also considered in detail, and for hospital cases, the level of patient density was taken into account, as J o u r n a l P r e -p r o o f recommended in our country. [13] Similar methods were used by three experts, including two occupational practitioners and one infection control specialist, from different regions.

A group of prevention experts improved a list of SARS-CoV-2 prevention measures for professionals both in contact with the public/colleagues and, when relevant, in contact with patients; it agreed on a list of prevention methods and on their general impact on exposure (Table 1 ). Based on this list, the same two groups ("subjects" and "patients") blindly contributed to evaluating the SARS-CoV-2 prevention probability from 0 to 1. Since there is no gold standard, it was not possible to assess validity at this stage. However, O*Net JEM provided one estimation of contact for the exposure assessment of contact with J o u r n a l P r e -p r o o f "subjects" ("To what extent does this job require the worker to perform job tasks in close physical proximity to other people?") with a fair correlation to P1 (Spearman Rho 0.40, p<0.0001), as well as one estimation for the exposure assessment of contact with patients ("How often does this job require exposure to disease/infections?") with a good correlation (Spearman Rho 0.63, p<0.0001). [14] Limitations and perspectives This first COVID JEM, which is available, might help researchers take occupational exposure into account. Additional steps are needed, including merging four proportions into one that would include the level of circulation of the virus, correlations and discrepancies with results of large datasets and possible other COVID JEMs, and a re-evaluation after time.

In addition to the usual limitations of all JEMs (difficulties in coding jobs, only an overall evaluation, differences within job groups, differences between countries), the degree of nonoccupational exposure to SARS-CoV-2, the difficulty of assessing prevention methods found in the care and health sector, and fluctuations over time in viral circulation, prevention, and work exposure, are major limitations that should be known.

A "Mat-O-Covid" JEM with a probability of occupational exposure to SARS-CoV-2 will have implications for public health research. It might also help companies improve their prevention, health insurance evaluate work compensation, and occupational practitioners in their negotiations with stakeholders for decreasing SARS-CoV-2 exposure. 

Irset (Institut de recherche en santé, environnement et travail) -UMR_S 1085

Unité de prévention et de lutte des infections nosocomiales

Unité des maladies infectieuses

Service de Pathologies Professionnelles et de l'Environnement, Centre Hospitalier Intercommunal Créteil

Ingénierie des procédés, Nancy Vandoeuvre, France 15

« Is It Safe for Me to Go to Work? » Risk Stratification for Workers during the Covid-19 Pandemic

Occupational risks for COVID-19 infection

COVID-19: Tribute to Health Care Warriors, to their occupational health units, and to their strategists

Coronavirus outbreak: the role of companies in preparedness and responses

Not just a research method: If used with caution, can job-exposure matrices be a useful tool in the practice of occupational medicine and public health? Scand

Use of job-exposure matrix in an occupational analysis of lung and bladder cancers on the basis of death certificates

COVID-19 Job Exposure Matrix: From the Mat-O-Covid Design to Its Execution

The recognition of health consequences of difficult working conditions in France and its evaluation with the use of a job-exposure matrix

Sante Publique Vandoeuvre--Nancy Fr

Cross-national comparison of two general population job exposure matrices for physical work exposures

Unique tool for the approach of risks by business line

Guidelines for occupational health professionals managing health care institution where Covid-19 patients are hospitalized

Comparison Between a Self

J o u r n a l P r e -p r o o f Availability of products, type of surface, simple washing/disinfection/surgical procedure

None Very regular and with every potential contact Availability of products, type of surface, maintenance procedure

No protection Regular adapted wear Type (surgical mask/FFP2/KN95/consumer mask), change, fit, fitting and change procedure, activity type (heat and stress tolerance)

No protection Regular adapted wear Glove/apron and gown, change/proper wear/procedure.

No protection Regular suitable wear Goggles, face protection, change/correct wearing/procedure.

None All personnel with an effective vaccine Incomplete vaccination