Optimizing telework in an epidemic context: contrasting the infectious and non-communicable diseases perspectives

Objectives : In a global context of increasing telework, this study explores its health effects, to determine if there is an optimal teleworking frequency during an epidemic. We aim to quantify the relationship between teleworking frequency and both infectious disease (ID) transmission and non-communicable disease (NCD) risk.  Methods : We developed a mathematical model simulating ID transmission and NCD acquisition in a medium-sized company, analysing how different teleworking levels impact workers health. We conducted a rapid literature review to identify potential exposure-response relationships between teleworking and NCD risk and inform this model. We then simulated infection dynamics over a three-month epidemic wave to contrast ID and NCD risks in relation to the extent of telework engagement.  Results : Evidence from the literature showed varying patterns of NCD risk across different teleworking frequencies. Depending on these relationships, we observed that risk may peak at low, intermediate, or high teleworking levels. We demonstrated the existence of a benefit-risk balance between reducing ID transmission and potentially increasing NCD burden.  Conclusions :. Based on current scientific knowledge, no single optimal teleworking frequency can be identified, as the optimum varies depending on the NCD outcome considered. Our study highlights the need for stronger evidence to estimate robust exposure-response functions linking teleworking frequency and NCDs, and ultimately to inform prevention strategies for both infectious and NCD risks in an epidemic context.