Occupation and COVID-19 diagnosis, hospitalisation and ICU admission among foreign-born and Swedish-born employees: a register-based study

Abstract

BackgroundResearch on occupation and risk of COVID-19 among foreign-born workers is lacking. We investigated whether working in essential occupations was associated with COVID-19 diagnosis, hospitalisation and intensive care unit (ICU) admission and whether foreign-born workers in similar occupations as Swedish-born individuals had a higher risk of the studied outcomes.MethodsOccupational data (2018–2019) of 326 052 employees (20–65 years) who were resident in Sweden as of 1 January 2020 were linked to COVID-19 data registered from 1 January 2020 to 28 February 2021. We analysed the risk of COVID-19 outcomes in different occupational groups and in four immigrant/occupation intersectional groups using Cox proportional hazards regression with adjustments for sociodemographic and socioeconomic characteristics and pre-existing comorbidities.ResultsWe identified 29797, 1069 and 152 cases of COVID-19 diagnosis, hospitalisations and ICU admissions, respectively, in our cohort. Workers in essential occupations had an elevated risk of COVID-19 diagnosis, hospitalisation, and ICU admissions. Healthcare workers had a higher risk of all the outcomes compared with other essential workers. Relative to Swedish-born workers in non-essential occupations, foreign-born workers in essential occupations had 1.85 (95% CI 1.78 to 1.93), 3.80 (95% CI 3.17 to 4.55) and 3.79 (95% CI 2.33 to 6.14) times higher risk of COVID-19 diagnosis, hospitalisation and ICU admission, respectively. The corresponding risks among Swedish-born workers in essential occupations were 1.44 (95% CI 1.40 to 1.49), 1.30 (95% CI 1.08 to 1.56) and 1.46 (95% CI 0.90 to 2.38).ConclusionOccupation was associated with COVID-19 outcomes and contributed to the burden of COVID-19 among foreign-born individuals in this study.

Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales

“…Elevated infection risk in occupational groups with limited ability to work from home and those involving exposure to patients and/or the public echoes findings from the previous studies with more limited adjustment for potential confounding and from other global regions 1 2 3 4 5 12 13 . Across all analyses in the current study, adjustment for sociodemographic and health-related factors and non-work activities had limited impact on estimates.…”

“…Data from Germany 12 (February – September 2020) and Sweden 13 (January 2020 – February 2021) indicates elevated risk of infection amongst essential workers – including health, care, and service workers – compared to non-essential workers across the respective study periods, after adjustment for a range of socio-demographic factors. However, occupational differences in risk may vary by global region and comparative investigation for the UK is limited.…”

Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants

“…After excluding studies which contained duplicate patient data, 77 studies comprising over 200,000,000 confirmed COVID-19 cases were included. 4 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , ...…”

Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales

“…Data from Germany [ 12 ] (February – September 2020) and Sweden [ 13 ] (January 2020 – February 2021) indicated elevated risk of infection amongst essential workers – including health, care, and service workers – compared to non-essential workers across the respective study periods, after adjustment for a range of socio-demographic factors. However, occupational differences in risk may vary by global region and comparative investigation for the UK is limited.…”