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

Abstract

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.

Predictors of SARS-CoV-2 Infection in University Students: A Case-Control Study

“…These results contrast to some extent with the findings that healthcare students seem to have a high prevalence of previous SARS-CoV-2 contacts [ 14 ]. Indeed, while healthcare workers have a high prevalence of previous infections with SARS-CoV-2 [ 38 ] and a high risk of infection [ 39 , 40 ], undergraduate students probably have reduced contact with patients and access to hospital wards because of the general restrictions in access to healthcare services, thus reducing their risk of infection.…”

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

“…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).…”

Exploring the relationship between job characteristics and infection: Application of a COVID-19 Job Exposure Matrix to SARS-CoV-2 infection data in the United Kingdom

“…Previous surveys on the UK health sector suggested logistical issues with PPE in the UK health sector including a lack of means, inadequate training and inconsistent guidance during the first period of the pandemic (22). In addition, analysis amongst these occupational groups have shown lower risks in later stages of the pandemic, possibly related to better access to PPE, being a priority group for vaccination, or previous infection (23). Another exception is the domain relating to use of face coverings, where the low risk group appears to have a reduced risk of infection in time periods 2 and 3 when compared to the ‘no risk/work from home’ group; perhaps due to an increased risk in the homeworker group as restrictions changed.…”