Multiple outbreaks of COVID-19 have been observed in several workplace settings within and beyond Ireland, including slaughterhouses, meat processing plants, nursing homes, mines and building sites [1,2,3]. We’re exploring the reasons why workplace clusters and outbreaks spread in particular occupational settings as outlined below:

Working in confined indoor spaces

Studies have shown that in Europe >80% of working time is spent indoors, and variations in the socioeconomic and demographic status lead to different work-day patterns indoors [4]. Participating in meetings and sharing the same office space has been reported in the literature as a risk factor for contracting COVID-19 [5,6]. 

Lack of social distancing

Outbreaks in different workplaces have been described when there were difficulties maintaining the recommended distance of at least two metres [6,7]. Sharing facilities (e.g. canteen and dressing rooms), transport and accommodation may also contribute to transmission [8].

Close or direct contact with a COVID-19 cases

Healthcare workers are known to be at greater risk of occupational exposure to biological agents, particularly infectious pathogens such as TB, influenza, SARS, measles etc. [9,10]. 

In a UK study of more than 120,000 employed persons, the risk of healthcare workers testing positive for COVID-19 was over seven times higher than for non-essential workers, and those in social care had a risk that was three times higher [11]. Further specific occupations which are probably at risk of exposure to COVID-19 include:

  • Transport workers (taxi and bus drivers)
  • Salespeople
  • Postal/package delivery workers  
  • Domestic cleaners (as they are exposed to multiple clients)

A study from Sweden that looked at cases of COVID-19 diagnosed in different occupations found the highest risk among taxi drivers, with a relative risk of being diagnosed with COVID-19 that was 4.8 times higher than in all other professions (95% confidence interval 3.9-6) followed by bus and tram drivers (RR 4.3, 95% CI 3.6–5.1) [12]. 

Insufficient or incorrect use of protective personal equipment (PPE)

Some work sites where outbreaks have occurred have been slow to implement appropriate infection control and hygiene standards or have done so inadequately [13]. Insufficient access to PPE has been identified as an additional risk factor. A systematic review and meta-analysis of 172 observational studies both in healthcare settings and the community that looked into the effect of distance from the source patient and the use of respiratory and eye protection in the risk of transmission of SARS-CoV, MERS-CoV and SARS-CoV-2, concluded that physical distancing of at least one metre, use of face masks and eye protection were associated with a much lower risk of transmission. 

‘Presenteeism’ (i.e. reporting to work despite being symptomatic)

Fear of losing a job or inability to reduce working hours in order to stay home, may lead to continued commuting and working, even when the employee or a family member are exhibiting symptoms compatible with COVID-19 [13].

Adhering to all the public health guidelines we are used to hearing on the television and radio is still the most powerful way to protect one another against COVID-19. The virus jumps from person to person suspended in respiratory droplets. Keeping apart by two metres at the workplace is important. If you work in an environment where close contact is difficult to avoid, keeping the indoors ventilated and wearing personal protective equipment is key. It goes without saying that you should stay at home if you don’t feel well or have a cough. 


1. Leclerc QJ, Fuller NM, Knight LE, Funk S, Knight GM. What settings have been linked to SARS-CoV-2 transmission clusters? [version 2; peer review: 2 approved]. Wellcome Open Research. 2020;5(83):83.

2. Waltenburg MA, Victoroff T, Rose CE, Butterfield M, Jervis RH, Fedak KM, et al. Update: COVID-19 Among Workers in Meat and Poultry Processing Facilities – United States, April-May 2020. MMWR Morb Mortal Wkly Rep. 2020 Jul 10;69(27):887-92.

3. Earthworks (USA), Institute for Policy Studies – Global Economy Program (USA), London Mining Network (UK), MiningWatch Canada, Terra Justa, (UK) WoW, et al. Voices from the ground – How the Global Mining Industry is Profiting from the COVID-19 Pandemic. [Internet]2020. Available from: https://miningwatch.ca/sites/default/files/covid-19_and_mining_-_snapshot_report.pdf.

4. Schweizer C, Edwards RD, Bayer-Oglesby L, Gauderman WJ, Ilacqua V, Jantunen MJ, et al. Indoor time–microenvironment–activity patterns in seven regions of Europe. Journal of exposure science & environmental epidemiology. 2007;17(2):170-81.

5. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al.Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. The New England journal of medicine. 2020;382(10):970-1.

6. Park SY, Kim YM, Yi S, Lee S, Na BJ, Kim CB, et al. Coronavirus Disease Outbreak in Call Center, South Korea. Emerging infectious diseases. 2020 Aug;26(8):1666-70.

7. Dyal JW. COVID-19 Among Workers in Meat and Poultry Processing Facilities―19 States, April 2020. MMWR Morbidity and mortality weekly report. 2020;69.

8. Centers for Disease Control and Prevention (CDC), Occupational Safety and Health Administration (OSHA). Meat and Poultry Processing Workers and Employers [Internet]. Atlanta: CDC; 2020 [cited 17 July 2020]. Available from: https://www.cdc.gov coronavirus/2019-ncov/community/organizations/meat-poultry-processing-workers-employers.html.

9. European Commission. Directorate-General for Employment, Social Affairs and Inclusion. Occupational health and safety risks in the healthcare sector [Internet]. Luxembourg: Publications Office of the European Union; 2020. Available from: https://op.europa.eu/en/publication-detail/-/publication/b29abb0a-f41e-4cb4-b787-4538ac5f0238.

10. Koh D, Goh HP. Occupational health responses to COVID-19: What lessons can we learn from SARS? Journal of occupational health. 2020 Jan;62(1):e12128.

11. Mutambudzi M, Niedźwiedź CL, Macdonald EB, Leyland AH, Mair FS,Anderson JJ, et al. Occupation and risk of COVID-19: prospective cohort study of 120,621 UK Biobank participants. medRxiv. 2020.

12. Folkhälsomyndigheten. Förekomst av covid-19 i olika yrkesgrupper [Internet]. Stockholm: Folkhälsomyndigheten; 2020. Available from: https://www.folkhalsomyndigheten.se/contentassets/5e248b82cc284971a1c5fd922e7770f8/forekomst-covid-19-olika-yrkesgrupper.pdfhttps://www.folkhalsomyndigheten.se/contentassets/5e248b82cc284971a1c5fd922e7770f8/forekomst-covid-19-olika-yrkesgrupper.pdf.

13. Baker MG. Non Relocatable Occupations at Increased Risk During Pandemics: United States, 2018. American journal of public health. 2020 (0):e1-e7.79. Zhang Z, Liu S, Xiang M, Li S, Zhao D, Huang C, et al. Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions. Frontiers of medicine. 2020;14(2):229-31.