Occupation and risk of COVID-19: prospective cohort study of 120,621 UK Biobank participants
Claire L. Niedzwiedz,
Ewan B Macdonald,
Alastair H Leyland,
Frances S Mair,
Jana J. Anderson,
Carlos A Celis-Morales,
Jason MR Gill,
Bhautesh D Jani,
Daniel F. Mackay,
Barbara I Nicholl,
Catherine A O'Donnell,
Naveed I Sattar,
Paul I Welsh,
Srinivasa Vittal Katikireddi,
Posted 23 May 2020
medRxiv DOI: 10.1101/2020.05.22.20109892
Posted 23 May 2020
Objectives: To investigate severe COVID-19 risk by occupational group. Methods: Baseline UK Biobank data (2006-10) for England were linked to SARS-CoV-2 test results from Public Health England (16 March to 26 July 2020). Included participants were employed or self-employed at baseline, alive and aged less than 65 years in 2020. Poisson regression models adjusted sequentially for baseline demographic, socioeconomic, work-related, health, and lifestyle-related risk factors to assess risk ratios (RRs) for testing positive in hospital or death due to COVID-19 by three occupational classification schemes (including Standard Occupation Classification 2000). Results: Of 120,075 participants, 271 had severe COVID-19. Relative to non-essential workers, healthcare workers (RR 7.43, 95% CI:5.52,10.00), social and education workers (RR 1.84, 95% CI:1.21,2.82) and other essential workers (RR=1.60, 95% CI:1.05,2.45) had higher risk of severe COVID-19. Using more detailed groupings, medical support staff (RR 8.70, 95% CI:4.87,15.55), social care (RR 2.46, 95% CI:1.47,4.14) and transport workers (RR= 2.20, 95% CI:1.21,4.00) had highest risk within the broader groups. Compared to white non-essential workers, non-white non-essential workers had a higher risk (RR 3.27, 95% CI: 1.90,5.62) and non-white essential workers had the highest risk (RR 8.34, 95% CI:5.17,13.47). Using SOC2000 major groups, associate professional and technical occupations, personal service occupations and plant and machine operatives had higher risk, compared to managers and senior officials. Conclusions: Essential workers have higher risk of severe COVID-19. These findings underscore the need for national and organizational policies and practices that protect and support workers with elevated risk of severe COVID-19.
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