Occupation and SARS-CoV-2 infection risk among 108 960 workers during the first pandemic wave in Germany

Reuter, Marvin; Rigó, Mariann; Formazin, Maren; Liebers, Falk; Latza, Ute; Castell, Stefanie; Jöckel, Karl‐Heinz; Greiser, Karin Halina; Michels, Karin B.; Krause, Gérard; Albrecht, Stefan; Öztürk, Ilter; Kuß, Oliver; Berger, Klaus; Lampl, Benedikt; Leitzmann, Michael F.; Zeeb, Hajo; Starke, Karla Romero; Schipf, Sabine; Meinke-Franze, Claudia; Ahrens, Wolfgang; Seidler, Andreas; Klee, Bianca; Pischon, Tobias; Deckert, Andreas; Schmidt, Börge; Mikolajczyk, Rafael; Karch, André; Bohn, Barbara; Brenner, Hermann; Holleczek, Bernd; Dragano, Nico

doi:10.5271/sjweh.4037

Cited by 39 publications

(38 citation statements)

References 27 publications

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“…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.…”

Section: Discussionsupporting

confidence: 59%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Beale

Hoskins

Byrne

et al. 2021

Preprint

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BackgroundWorkers differ in their risk of SARS-CoV-2 infection according to their occupation, but the direct contribution of occupation to this relationship is unclear. This study aimed to investigate how infection risk differed across occupational groups in England and Wales up to October 2021, after adjustment for potential confounding and stratification by pandemic phase.MethodsData from 12,182 employed/self-employed participants in the Virus Watch prospective cohort study were used to generate risk ratios for virologically- or serologically-confirmed SARS-CoV-2 infection using robust Poisson regression, adjusting for socio-demographic and health-related factors and non-work public activities. We calculated attributable fractions (AF) amongst the exposed for each occupational group based on adjusted risk ratios (aRR).FindingsIncreased risk was seen in nurses (aRR=1.90 [1.40-2.40], AF=47%); doctors (1.74 [1.26-2.40], 42%); carers (2.18 [1.63-2.92], 54%); teachers (primary = 1.94 [1.44-2.61], 48%; secondary =1.64, [1.23-2.17], 39%), and warehouse and process/plant workers (1.58 [1.20-2.09], 37%) compared to both office-based professional occupations (reported above) and all other occupations. Differential risk was apparent in the earlier phases (Feb 2020 - May 2021) and attenuated later (June - October 2021) for most groups, although teachers demonstrated persistently elevated risk.InterpretationOccupational differentials in SARS-CoV-2 infection risk are robust to adjustment for socio-demographic, health-related, and activity-related potential confounders. Patterns of differential infection risk varied over time, and ongoing excess risk was observed in education professionals. Direct investigation into workplace factors underlying elevated risk and how these change over time is needed to inform occupational health interventions.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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

Beale

Hoskins

Byrne

et al. 2021

Preprint

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“…COVID-19 disease in the workplace will be a consequence of exposure to SARS-CoV-2 virus; workplace factors known to be related to exposure include ventilation, ability to social distance and number of daily contacts. 3 4 Several studies have found increased risks of infection and mortality from COVID-19 among healthcare workers [5][6][7][8] when compared with other workers. Other studies have not found an increased risk 9 or suggest it varies by type of worker and/or stage of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

“… 17 The evidence for whether this perceived exposure translates to increased infection and/or mortality is varied. 8 10 15 16 18–21 This can be partially explained by different approaches to ascertaining outcome, often using testing regimens linked to self-referral or occupation. In addition, different time periods had different mitigation strategies in place.…”

Section: Introductionmentioning

confidence: 99%

Occupational differences in SARS-CoV-2 infection: analysis of the UK ONS COVID-19 infection survey

Rhodes

Pearce

Mueller

et al. 2022

J Epidemiol Community Health

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BackgroundConcern remains about how occupational SARS-CoV-2 risk has evolved during the COVID-19 pandemic. We aimed to ascertain occupations with the greatest risk of SARS-CoV-2 infection and explore how relative differences varied over the pandemic.MethodsAnalysis of cohort data from the UK Office of National Statistics COVID-19 Infection Survey from April 2020 to November 2021. This survey is designed to be representative of the UK population and uses regular PCR testing. Cox and multilevel logistic regression were used to compare SARS-CoV-2 infection between occupational/sector groups, overall and by four time periods with interactions, adjusted for age, sex, ethnicity, deprivation, region, household size, urban/rural neighbourhood and current health conditions.ResultsBased on 3 910 311 observations (visits) from 312 304 working age adults, elevated risks of infection can be seen overall for social care (HR 1.14; 95% CI 1.04 to 1.24), education (HR 1.31; 95% CI 1.23 to 1.39), bus and coach drivers (1.43; 95% CI 1.03 to 1.97) and police and protective services (HR 1.45; 95% CI 1.29 to 1.62) when compared with non-essential workers. By time period, relative differences were more pronounced early in the pandemic. For healthcare elevated odds in the early waves switched to a reduction in the later stages. Education saw raises after the initial lockdown and this has persisted. Adjustment for covariates made very little difference to effect estimates.ConclusionsElevated risks among healthcare workers have diminished over time but education workers have had persistently higher risks. Long-term mitigation measures in certain workplaces may be warranted.

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“…Ideally, research into risks of COVID-19 by occupation would be based on cases ascertained through systematic prospective follow-up of large cohorts of workers, with regular ascertainment of symptoms, clinical signs, and polymerase chain reaction (PCR) testing. As that has not been feasible, researchers have been forced to use proxy measures of incidence based on: PCR testing (4)(5)(6)(7)(8)(9)(10)(11), measurements of specific immunoglobulins against SARS-CoV-2 (12)(13)(14), symptoms and sickness absence (6), COVID-19 related hospital admission (7,15,16), or mortality from the disease (7,15,(17)(18)(19)(20)(21)(22). In most studies to date, with broad coverage of occupations, mortality from COVID-19 has been the outcome measure (7,15,(17)(18)(19)(20)(21)(22).…”

mentioning

confidence: 99%

Occupational risk of COVID-19 related hospital admission in Denmark 2020–2021: a follow-up study

Bonde¹,

Sell²,

Flachs³

et al. 2022

Scand J Work Environ Health

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Occupation and SARS-CoV-2 infection risk among 108 960 workers during the first pandemic wave in Germany

Cited by 39 publications

References 27 publications

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

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

Occupational differences in SARS-CoV-2 infection: analysis of the UK ONS COVID-19 infection survey

Occupational risk of COVID-19 related hospital admission in Denmark 2020–2021: a follow-up study

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