Not All Essential Workers Faced Increased COVID-19 Risks

Early in the pandemic, many categories of essential workers showed no increase in occupational COVID-19 risks—while some groups of workers categorized as nonessential did have increased risks, reports a study in the October Journal of Occupational and Environmental Medicine.

"The dichotomy of frontline essential and non-essential occupations can bring over- and under-estimation of occupational risk during the COVID-19 pandemic," write Jiannan Li, PhD, and colleagues of Beijing Normal University. Using data from the Chicago Department of Public Health, they analyzed COVID-19 risks for people in different occupational groups.

Overall, those categorized as essential workers had higher rates of COVID-19 incidence, hospitalization, and death. However, the associations varied across occupational groups. All three COVID-19 risks were elevated for essential workers in production and material moving jobs. COVID-19 incidence and mortality (but not hospitalization) were elevated for those in farming, fishing, and forestry occupations.

In contrast, all three COVID-19 outcomes were less frequent for essential workers in education, training, and library occupations. COVID-19 incidence was reduced in personal care and service jobs. COVID-19 risks were unrelated to working in the transportation, protective service, or food preparation and serving occupations.

Most categories of non-essential workers were at lower risk of COVID-19 outcomes. However, some groups had higher risks of all three outcomes, including building and grounds cleaning and construction and extraction occupations. Other groups of non-essential workers with increased risks included installation, maintenance, and repair occupations (incidence and mortality) and community and social service (hospitalization).

The results "show that although essential occupations face higher risk during the pandemic in general, the risks of some occupations are overestimated," Dr. Li and coauthors write. In the education sector, for example, the feasibility of remote learning greatly reduced close contacts and the risks of infection.

In contrast, certain non-essential occupational groups—for example, cleaners and construction workers—were at higher risk. Dr. Li and colleagues conclude, "Policymakers should be aware of misunderstanding of occupational risk brought by simple dichotomy of essential and non-essential occupations."
About the Author
Dr. Li may be contacted for interviews at
ACOEM (, an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Yuan B, Lan J, Li J. Disparity in Occupational Health Risk During the Pandemic: Potential Misestimation and Its Implications for Health Policies. J Occup Environ Med. 2022;64(10):809-814.