COVID-19 and healthcare workers: A systematic review and meta-analysis

Gholami, Mandana; Fawad, Iman; Shadan, Sidra; Rowaiee, Rashed; Ghanem, HedaietAllah; Khamis, Amar Hassan; Ho, Samuel B.

doi:10.1016/j.ijid.2021.01.013

Cited by 275 publications

(325 citation statements)

References 37 publications

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“…Our study, however, is unique in examining excess mortality across multiple occupational sectors for all working-age decedents in California for the period of the pandemic, a comprehensive view that highlights the higher mortality risk across essential occupational sector. Though our work is in agreement with prior studies in finding pandemic-related risks among healthcare workers [ 10 ], it suggests that the risks are even higher in other sectors, such as food/agriculture and transportation/logistics.…”

Section: Discussionsupporting

confidence: 92%

“…For example, a study of the UK Biobank cohort found that essential workers, particularly healthcare workers, had high risks for COVID-19 [ 9 ]. Similarly, numerous studies have documented SARS-CoV-2 infection among healthcare workers [ 10 ]. Our study, however, is unique in examining excess mortality across multiple occupational sectors for all working-age decedents in California for the period of the pandemic, a comprehensive view that highlights the higher mortality risk across essential occupational sector.…”

Section: Discussionmentioning

confidence: 99%

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Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through November 2020

et al. 2021

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Background Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments. Methods and findings Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18–65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000). Conclusions Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through November 2020

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Our study, however, is unique in examining excess mortality and multiple occupational sectors. Though our work is in agreement with prior studies in finding pandemic-related risks among healthcare workers [11], it suggests that the risks are even higher in other sectors, such as food/agriculture and transportation/logistics.…”

Section: Discussionsupporting

confidence: 92%

“…For example, a study of the UK Biobank cohort found that essential workers, particularly healthcare workers, had high risks for COVID-19 [10]. Similarly, numerous studies have documented SARS-CoV-2 infection among healthcare workers [11]. Our study, however, is unique in examining excess mortality and multiple occupational sectors.…”

Section: Discussionmentioning

confidence: 94%

Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through October 2020

Chen

Glymour

Riley

et al. 2021

Preprint

101

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BackgroundThough SARS-CoV-2 outbreaks have been documented in occupational settings and though there is speculation that essential workers face heightened risks for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as workplace modifications and prioritization of vaccine distribution.Methods and findingsUsing death records from the California Department of Public Health, we estimated excess mortality among Californians 18–65 years of age by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During the COVID-19 pandemic, working age adults experienced a 22% increase in mortality compared to historical periods. Relative excess mortality was highest in food/agriculture workers (39% increase), transportation/logistics workers (28% increase), facilities (27%) and manufacturing workers (23% increase). Latino Californians experienced a 36% increase in mortality, with a 59% increase among Latino food/agriculture workers. Black Californians experienced a 28% increase in mortality, with a 36% increase for Black retail workers. Asian Californians experienced an 18% increase, with a 40% increase among Asian healthcare workers. Excess mortality among White working-age Californians increased by 6%, with a 16% increase among White food/agriculture workers.ConclusionsCertain occupational sectors have been associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through strict enforcement of health orders in workplace settings and protection of in-person workers. Vaccine distribution prioritizing in-person essential workers will be important for reducing excess COVID mortality.

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“…According to the Centers for Disease Control and Prevention (CDC) during February 12-July 16, 2020, in the USA, 11% of patients had been identified as HCWs [1], while during March 1-May 31, 2020, among hospitalized adults, 5.9% were HCWs [2]. A meta-analysis [3] found that the prevalence of hospitalization among HCWs infected with COVID-19 is 15.1% and the mortality is 1.5%, while another meta-analysis [4] found that the proportion of SARS-CoV-2 positive HCWs among all COVID-19 patients is 10.1% and the mortality is significantly lower in HCWs as compared to that of all patients (0.3% vs. 2.3%). According to an analysis that included studies only in Australia between January 25 th and July 8 th , HCWs were 2.69 times more likely to contract COVID-19 than the general population [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: A systematic review and meta-analysis

Galanis

Vraka

Fragkou

et al. 2021

American Journal of Infection Control

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COVID-19 and healthcare workers: A systematic review and meta-analysis

Cited by 275 publications

References 37 publications

Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through November 2020

Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through November 2020

Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through October 2020

Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: A systematic review and meta-analysis

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