Risks of COVID-19 by occupation in NHS workers in England

ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk...

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Veröffentlicht in:Occupational and environmental medicine (London, England) Jg. 79; H. 3; S. 176 - 183
Hauptverfasser: van der Plaat, Diana A, Madan, Ira, Coggon, David, van Tongeren, Martie, Edge, Rhiannon, Muiry, Rupert, Parsons, Vaughan, Cullinan, Paul
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd 01.03.2022
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ISSN:1351-0711, 1470-7926, 1470-7926
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Abstract ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.ResultsWith adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in ‘additional clinical services’ (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.ConclusionsAfter allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.Trial registration number ISRCTN36352994.
AbstractList ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.ResultsWith adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in ‘additional clinical services’ (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.ConclusionsAfter allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.Trial registration number ISRCTN36352994.
To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England.OBJECTIVETo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England.We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.METHODSWe used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in 'additional clinical services' (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.RESULTSWith adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in 'additional clinical services' (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.CONCLUSIONSAfter allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.ISRCTN36352994.TRIAL REGISTRATION NUMBERISRCTN36352994.
ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.ResultsWith adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in ‘additional clinical services’ (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.ConclusionsAfter allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.Trial registration numberISRCTN36352994.
To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England. We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression. With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in 'additional clinical services' (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater. After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations. ISRCTN36352994.
Author Madan, Ira
Muiry, Rupert
Edge, Rhiannon
Parsons, Vaughan
Coggon, David
van der Plaat, Diana A
van Tongeren, Martie
Cullinan, Paul
AuthorAffiliation 4 MRC Lifecourse Epidemiology Centre , University of Southampton , Southampton , UK
6 Lancaster Medical School , Lancaster University , Lancaster , UK
3 School of Population Health and Environmental Sciences , King's College London , London , UK
5 Centre for Occupational and Environmental Health , The University of Manchester , Manchester , UK
1 National Heart and Lung Institute , Imperial College London , London , UK
2 Occupational Health Service , Guy's and St Thomas' NHS Foundation Trust , London , UK
AuthorAffiliation_xml – name: 2 Occupational Health Service , Guy's and St Thomas' NHS Foundation Trust , London , UK
– name: 5 Centre for Occupational and Environmental Health , The University of Manchester , Manchester , UK
– name: 3 School of Population Health and Environmental Sciences , King's College London , London , UK
– name: 1 National Heart and Lung Institute , Imperial College London , London , UK
– name: 4 MRC Lifecourse Epidemiology Centre , University of Southampton , Southampton , UK
– name: 6 Lancaster Medical School , Lancaster University , Lancaster , UK
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  surname: van der Plaat
  fullname: van der Plaat, Diana A
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  surname: Madan
  fullname: Madan, Ira
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  fullname: Muiry, Rupert
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  fullname: Parsons, Vaughan
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  givenname: Paul
  surname: Cullinan
  fullname: Cullinan, Paul
  organization: National Heart and Lung Institute, Imperial College London, London, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34462304$$D View this record in MEDLINE/PubMed
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Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage
Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021
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– notice: This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage
– notice: Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021
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Issue 3
Keywords COVID-19
Language English
License This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
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PublicationTitle Occupational and environmental medicine (London, England)
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Zheng, Hafezi-Bakhtiari, Cooper (R4) 2020; 106
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Kulu, Dorey 2021; 67
Eyre, Lumley, O'Donnell 2020; 9
Jones, Rivett, Sparkes 2020; 9
Beemsterboer, Stewart, Groothoff 2009; 22
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– ident: 2024110805101654000_79.3.176.4
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  doi: 10.1136/bmj.m2375
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Snippet ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in...
To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England. We used...
To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England.OBJECTIVETo...
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StartPage 176
SubjectTerms Adult
Coronaviruses
COVID-19
COVID-19 - epidemiology
Demographics
Dentistry
Disease transmission
England - epidemiology
Exposure
Female
Health care
Health Occupations - statistics & numerical data
Health Personnel
Health services
Humans
Infections
Infectious diseases
Male
Medical personnel
Middle Aged
Mortality
Nurses
Nursing
Occupational diseases
Occupational Exposure - statistics & numerical data
Occupational health
Occupations
Pandemics
Patients
Personal protective equipment
Physicians
Population
Professionals
Risk analysis
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Sick Leave - statistics & numerical data
State Medicine
Variables
Workplace
Title Risks of COVID-19 by occupation in NHS workers in England
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