Longitudinal changes in proportionate mortality due to COVID-19 by occupation in England and Wales

Cherrie, Mark; Rhodes, Sarah; Mueller, William A.; Nafilyan, Vahé; Tongeren, Martie van; Pearce, Neil

doi:10.5271/sjweh.4048

Cited by 19 publications

(28 citation statements)

References 32 publications

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“…From studies to date, the main risk factor identified for workplace transmission is contact with patients with Covid‐19, identified in multiple studies, with the use of respiratory protection 11–15 and vaccination 16,17 mitigating that risk 18 . The excess Covid‐19 mortality seen in HCWs in the United Kingdom in the period to September 2020 was no longer evident in later time periods, presumably reflecting rapid access to vaccinations and improved infection controls at the workplace 19 …”

Section: Introductionmentioning

confidence: 99%

“…18 The excess Covid-19 mortality seen in HCWs in the United Kingdom in the period to September 2020 was no longer evident in later time periods, presumably reflecting rapid access to vaccinations and improved infection controls at the workplace. 19 Identification of risk factors other than the place of work or professional role requires contemporary collection of exposure data to reflect events at the time the infection occurred. Ideally, this would be through frequent (daily 7 or weekly 20 ) exposure questionnaires administered repeatedly during a prospective study, but the cost and risk of participant reporting fatigue make this approach difficult.…”

Section: Introductionmentioning

confidence: 99%

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The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

Cherry

Mhonde

Adisesh

et al. 2023

American J Industrial Med

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Background During the early months of the Covid‐19 pandemic, studies demonstrated that healthcare workers (HCWs) were at increased risk of infection. Few modifiable risks were identified. It is largely unknown how these evolved over time. Methods A prospective case‐referent study was established and nested within a cohort study of Canadian HCWs. Cases of Covid‐19, confirmed by polymerase chain reaction, were matched with up to four referents on job, province, gender, and date of first vaccination. Cases and referents completed a questionnaire reporting exposures and experiences in the 21 days before case date. Participants were recruited from October 2020 to March 2022. Workplace factors were examined by mixed‐effects logistic regression allowing for competing exposures. A sensitivity analysis was limited to those for whom family/community transmission seemed unlikely. Results 533 cases were matched with 1697 referents. Among unvaccinated HCWs, the risk of infection was increased if they worked hands‐on with patients with Covid‐19, on a ward designated for care of infected patients, or handled objects used by infected patients. Sensitivity analysis identified work in residential institutions and geriatric wards as high risk for unvaccinated HCWs. Later, with almost universal HCW vaccination, risk from working with infected patients was much reduced but cases were more likely than referents to report being unable to access an N95 mask or that decontaminated N95 masks were reused. Conclusions These results suggest that, after a rocky start, the risks of Covid‐19 infection from work in health care are now largely contained in Canada but with need for continued vigilance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

Cherry

Mhonde

Adisesh

et al. 2023

American J Industrial Med

View full text Add to dashboard Cite

show abstract

“…Healthcare workers (HCWs) were at increased risk of Covid-19 infection early in the Covid-19 pandemic [1] [2], but there is some evidence that this excess risk decreased as the pandemic moved forward [3] [4] [5] [6]. It is unclear whether this reflected improved workplace infection prevention and control practices, vaccination or a combination of these factors.…”

Section: Introductionmentioning

confidence: 99%

Excess risk of Covid-19 infection and mental distress in healthcare workers during successive pandemic waves. Analysis of matched cohorts of healthcare workers and community referents in Alberta, Canada

Galarneau,

Labrèche,

Durand-Moreau

et al. 2023

Preprint

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ObjectivesTo investigate changes in risk of infection and mental distress in healthcare workers (HCWs) relative to the community as the Covid-19 pandemic progressed.MethodsHCWs in Alberta, Canada, recruited to an interprovincial cohort, were asked consent to link to Alberta’s administrative health database (AHDB) and to information on Covid-19 immunization and polymerase chain reaction (PCR) testing. Those consenting were matched to records of up to 5 community referents (CRs). Physician diagnoses of Covid-19 were identified in the AHDB from the start of the pandemic to 31 March 2022. Physician consultations for mental health (MH) conditions (anxiety, stress/adjustment reaction, depressive) were identified from 1 April 2017 to 31 March 2022. Relative risk for HCWs was estimated for each condition, overall and for successive infection waves.Results80% (3050/3812) of HCWs consented to be linked to the AHDB: 97% (2959/3050) were matched to 14546 CRs. HCWs were at greater risk of Covid-19 overall, with first infection defined either from PCR tests or physician records They were also at increased risk for each of the three MH diagnoses. In analyses adjusted for confounding, risk of Covid-19 infection was higher than CRs early in the pandemic and during the fifth (Omicron) wave. The excess risk of stress/adjustment reactions and depressive conditions increased with successive waves during the epidemic, peaking in the 4thwave.ConclusionAdministrative health data, although not a complete reflection of infection or MH, contributed to an understanding of changing risk over time, with excess risk continuing late in the pandemic

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“…1 2 In the UK, rates of SARS-CoV-2 infection and COVID-19related mortality have been shown to vary by occupational group and have also changed over the course of the pandemic. [3][4][5][6][7][8] Such variations could be related to differences in the working environment particularly exposure to other infected people, e.g. the ability to physically distance, indoor versus outdoor working, surface contacts [9][10][11] , differences in vaccination rate within the workforce 12 13 , differences in infection mitigation strategies 14 and the relaxation of these over time.…”

Section: Introductionmentioning

confidence: 99%

Covid-19 Risk by work-related factors: Pooled analysis of individual linked data from 14 cohorts

Gittins,

Wels,

Rhodes

et al. 2023

Preprint

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BackgroundSARS-CoV-2 infection rates vary by occupation, but the association with work-related characteristics (such as home working, key-worker, or furlough) are not fully understood and may depend on ascertainment approach. We assessed infection risks across work-related characteristics and compared findings using different ascertainment approaches.MethodsParticipants of 14 UK-based longitudinal cohort studies completed surveys before and during the COVID-19 pandemic about their health, work, and behaviour. These data were linked to NHS digital health records, including COVID-19 diagnostic testing, within the UK Longitudinal Linkage Collaboration (UK-LLC) research environment. Poisson regression modelled self-reported infection and diagnostic test confirmed infection within each cohort for work-related characteristics. Risk Ratios (RR) were then combined using random effects meta-analysis.ResultsBetween March 2020 and March 2021, 72,290 individuals completed 167,302 surveys. Overall, 11% of 138,924 responses self-reported an infection, whereas 1.9% of 159,820 responses had a linked positive test. Self-reported infection risk was greater in key-workers vs not (RR=1.24(95%C.I.=1.17,1.31), among non-home working (1.08(0.98,1.19)) or some home working (1.08(0.97,1.17)) vs all home working. Part-time workers vs full-time (0.94(0.89,0.99)), and furlough vs not (0.97(0.88,1.01)) had reduced risk. Results for the linked positive test outcome were comparable in direction but greater in magnitude e.g. an 1.85(1.56,2.20) in key-workers.ConclusionThe UK-LLC provides new opportunities for researchers to investigate risk factors, including occupational factors, for ill-health events in multiple largescale UK cohorts. Risk of SARS-CoV-2 infection and COVID-19 illness appeared to be associated with work-related characteristics. Associations using linked diagnostic test data appeared stronger than self-reported infection status.What is already known on this topic-Infection of SARS-CoV2 during the pandemic was shown to vary by occupation, with occupations such as healthcare, and education at higher risk during some or all of the pandemic.-What is not clear, is how are work-related characteristics such employment status, part-time working from home, and schemes such as furlough and key worker status associated with the risk of infection.What this study adds-This is the one of the first studies to examine work-related characteristics including work related government policies, in terms of their infection risk within the working population.-This is also one of the first studies to analyse data from the UK Longitudinal Linkage Collaboration (UK-LLC), in which multiple UK national longitudinal cohorts were linked to national health data including diagnostic testing for SARS-CoV2.-We further compared definitions infection via either a self-reported case of COVID-19 or a linked diagnostic SARS-CoV2 infection.How this study might affect Research Practice or Policy-The findings contribute to our understanding of work-related characteristics and related schemes were associated with infection risk under two definitions. This is pertinent given new and emerging variants are continuing to drive an ever-changing SARS-CoV-2 infection risk within the population, along with the need to adequately prepare for future pandemics that may occur.

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Longitudinal changes in proportionate mortality due to COVID-19 by occupation in England and Wales

Cited by 19 publications

References 32 publications

The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

The evolution of workplace risk for Covid‐19 in Canadian healthcare workers and its relation to vaccination: A nested case‐referent study

Excess risk of Covid-19 infection and mental distress in healthcare workers during successive pandemic waves. Analysis of matched cohorts of healthcare workers and community referents in Alberta, Canada

Covid-19 Risk by work-related factors: Pooled analysis of individual linked data from 14 cohorts

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