Risks of COVID-19 by occupation in NHS workers in England
Risks of COVID-19 by occupation in NHS workers in England
OBJECTIVE: To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England.
METHODS: We 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.
RESULTS: With 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.
CONCLUSIONS: After 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.
176-183.
van der Plaat, Diana A
ae7fbb1a-a36d-4e1f-9072-85950605ec98
Madan, Ira
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Coggon, David
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van Tongeren, Martie
867598b9-e698-490c-8df2-19dd657c1779
Edge, Rhiannon
46b613a8-e035-43c2-8342-70af98701608
Muiry, Rupert
ed06e39c-aca5-47c6-983e-2104c0eafefd
Parsons, Vaughan
5599eaba-c97b-4c50-97b3-d32969d44124
Cullinan, Paul
b5b2eb0a-9fb9-4d4b-af18-5109de92d742
van der Plaat, Diana A
ae7fbb1a-a36d-4e1f-9072-85950605ec98
Madan, Ira
c6fd0de4-6d73-47eb-9e97-79a2941c8767
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
van Tongeren, Martie
867598b9-e698-490c-8df2-19dd657c1779
Edge, Rhiannon
46b613a8-e035-43c2-8342-70af98701608
Muiry, Rupert
ed06e39c-aca5-47c6-983e-2104c0eafefd
Parsons, Vaughan
5599eaba-c97b-4c50-97b3-d32969d44124
Cullinan, Paul
b5b2eb0a-9fb9-4d4b-af18-5109de92d742
van der Plaat, Diana A, Madan, Ira, Coggon, David, van Tongeren, Martie, Edge, Rhiannon, Muiry, Rupert, Parsons, Vaughan and Cullinan, Paul
(2021)
Risks of COVID-19 by occupation in NHS workers in England.
Occupational & Environmental Medicine, 79 (3), .
(doi:10.1136/oemed-2021-107628).
Abstract
OBJECTIVE: To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England.
METHODS: We 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.
RESULTS: With 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.
CONCLUSIONS: After 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.
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Accepted/In Press date: 10 August 2021
e-pub ahead of print date: 30 August 2021
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© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published
by BMJ
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Local EPrints ID: 472706
URI: http://eprints.soton.ac.uk/id/eprint/472706
ISSN: 1351-0711
PURE UUID: 5f742b93-e3a2-4fc0-8311-796000f6bffe
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Date deposited: 15 Dec 2022 17:33
Last modified: 17 Mar 2024 02:43
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Author:
Diana A van der Plaat
Author:
Ira Madan
Author:
David Coggon
Author:
Martie van Tongeren
Author:
Rhiannon Edge
Author:
Rupert Muiry
Author:
Vaughan Parsons
Author:
Paul Cullinan
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