personal contact with the public, studies in this job category on COVID-19 risk are scarce. Material and Methods We aimed to fill in this knowledge gap by investigating a cohort of over 2,000 employees of the Regional public transport sector in Sardinia, Italy. Incident COVID-19 cases were identified between 1 September 2020 -6 May 2021 by real-time reverse transcription-polymerase chain reaction tests performed on nasopharyngeal swabs during periodic occupational health surveillance. We applied the age-and gender-specific COVID-19 incidence rates in the regional population at the same time frame to the correspondent strata of the study cohort to calculate the expected COVID-19 events. Age-and gender-adjusted relative risks (RRs) of COVID-19 and relative 95% confidence intervals (95% CIs) were estimated as the ratio between the observed and the expected events for the overall cohort and in two sub-cohorts: bus drivers and the rest of the workers (including administrative staff). Results Male bus drivers showed an increased COVID-19 risk (RR = 1.4, 95% C.I. 1.07 -1.79). There was no excess risk among the rest of the personnel. Women were too few to allow reliable risk estimates. Conclusions Our study suggests an excess risk of COVID-19 among bus drivers even in a relatively low incidence area, which could imply inadequacy of occupational preventive measures. Further larger studies, with detailed information on occupational and personal determinants, are warranted to disentangle the underlying causal factors and focus preventive strategies.
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