Occupational differences in SARS-CoV-2 infection: Analysis of the UK ONS Coronavirus (COVID-19) Infection Survey

Abstract

BackgroundConsiderable concern remains about how occupational SARS-CoV-2 risk has evolved during the COVID-19 pandemic. We aimed to ascertain which occupations had 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 Coronavirus (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 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 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 to 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.What is already known on this topicSome occupational groups have observed increased rates of disease and mortality relating to COVID-19.What this study addsRelative differences between occupational groups have varied during different stages of the COVID-19 pandemic with risks for healthcare workers diminishing over time and workers in the education sector seeing persistent elevated risks.How this study might affect research, practice or policyIncreased long term mitigation such as ventilation should be considered in sectors with a persistent elevated risk. It is important for workplace policy to be responsive to evolving pandemic risks.

SARS‐CoV‐2 infection and long COVID among California farmworkers

“…Our prevalence is higher than the 46% noted for farmworkers from Yakima County, Washington, most of whom were male 33 . Our prevalence is also higher than the 10%‐12% noted for workers from public‐facing industries in the UK, such as teaching and education, social care, health care, civil service, retail, and transport 34 . Female farmworkers were over‐represented in our study because they were more willing to participate.…”

“…33 Our prevalence is also higher than the 10%-12% noted for workers from public-facing industries in the UK, such as teaching and education, social care, health care, civil service, retail, and transport. 34 Female farmworkers were over-represented in our study because they were more willing to participate. Additionally, a slightly larger proportion of long COVID was reported by women in our study, as well as in other studies.…”

The association between prolonged SARS-CoV-2 symptoms and work outcomes

“…Extrapolating to 208 million adults working in the U.S., of whom at least 42% are estimated to have been infected with SARS-CoV-2 as of May 2022 [15], our data suggest that symptomatic SARS-CoV-2 infection may have contributed to over 12.9 million individuals not returning to work within three months of infection, of whom 2.4 million may have post-covid conditions. Given the disproportionate burden of SARS-CoV-2 infection observed among workers in public-facing industries, such as education and healthcare, the economic impacts of Long COVID may be disproportionately distributed across the nation [16].…”

Occupation and SARS-CoV-2 infection risk among workers during the first pandemic wave in Germany: potential for bias

“…We read with great interest the paper by Reuter et al ( 1 ) on the differences in risk of SARS-CoV2 infection by occupation during the first pandemic wave in Germany. Occupation has been linked with differential risks of infection ( 2 , 3 ) as well as severe disease and death ( 4 , 5 ). Hence, this is a potentially very important paper, advancing the evidence in relation to occupational risk factors for infection.…”