ABSTRACT Background Industrial and coastal regions may experience unique pandemic‐related mortality patterns, yet data from Middle Eastern occupational cohorts are extremely limited. Methods In this retrospective cohort study, we analyzed 58,976 deaths in Bushehr Province, Iran (2014–2023). Autoregressive integrated moving average (ARIMA) models were used to estimate excess mortality, and Poisson regression calculated standardized mortality ratios (SMRs) by occupation and sex. Results During the pandemic period (2020–2022), excess mortality reached 15.1%, peaking at 75% during the Delta wave. Males had 2.2 times higher mortality than females. The highest occupational mortality was among fishermen (SMR = 1.89, 95% CI: 1.75–2.04). Despite 78% vaccination coverage, acute myocardial infarction deaths increased by 27.3% ( p < 0.001), comprising 41% of deaths during the BA.5 wave. Conclusion Significant disparities in COVID‐19 mortality were observed by sex and occupation. Industrial workers, particularly males, require targeted public health strategies, including workplace‐based vaccination and cardiovascular screening.
Soleimaninejad et al. (Sun,) studied this question.