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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Bibliographic Details
Published in:Occupational and environmental medicine (London, England) Vol. 79; no. 3; pp. 176 - 183
Main Authors: van der Plaat, Diana A, Madan, Ira, Coggon, David, van Tongeren, Martie, Edge, Rhiannon, Muiry, Rupert, Parsons, Vaughan, Cullinan, Paul
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 01.03.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Series:Original research
Subjects:
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
England
United Kingdom > UK
COVID-19
ISSN:1351-0711, 1470-7926, 1470-7926
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Summary: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.
Bibliography:Original research
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ISSN:1351-0711
1470-7926
1470-7926
DOI:10.1136/oemed-2021-107628