Working conditions and outside of the workplace factors influence COVID-19 mortality in England

The COVID-19 pandemic was severe in the UK, where infection and death rates were very high during both waves of the pandemic. While most deaths are among the elderly, many deaths have been reported among the working population, particularly among the essential workers. There have been many reports pointing to important occupational differences in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and risk of death, but there have not been many systematic comparisons of mortality rates across occupations.

SARS-CoV-2 infections in health care workers have received a lot of attention, and there is evidence that intensive care units are at increased risk for COVID-19 patients. In other professions, e.g. However, there may also be an increased risk of infection, for example in the social welfare or public service sectors. Studies show that the age-standardized death rate (ASMR) for COVID-19 is high among bus drivers, taxi drivers, sales and retail assistants, cooks and social workers.

Estimation of occupational differences in COVID-19 mortality in England and Wales

Researchers from England recently estimated the occupational differences in COVID-19 mortality in England and Wales in 2020 and examined how those differences changed after adjusting for factors outside of the workplace. The aim of the study was to identify occupational differences in COVID-19-related mortality and to assess whether these differences are confused by other factors such as ethnicity, regional differences, and educational or non-occupational factors such as pre-pandemic health or disadvantage. This study will be published on the medRxiv * preprint server.

A total of 14,295,900 people living in private households in England in 2019 were part of the retrospective cohort study. The age of the participants ranged from 40 to 64 years with an average age of 52 years. 51% of the study participants were female, and all participants were employed in 2011 and completed the 2011 census.

The primary outcomes were COVID-19-related mortality between January 24, 2020 and December 28, 2020. The researchers estimated the ASMR per 100,000 person-years whose risk is stratified by occupation and gender. To determine the impact of the occupation due to work-related exposures, they used Cox proportional hazard models to account for confounding factors such as ethnicity, region and education, as well as workplace-related factors in the workplace.

At risk rates for COVID-19-related deaths in adults ages 40 to 64 compared to company executives and directors by gender

The results show large differences in COVID-19 mortality between occupations

The results of the study show that there are large differences in COVID-19 mortality between occupations. In many professions, especially those with COVID-19 patients or in public, the risk was three or four times higher than in other professions.

“Our age-standardized mortality rates and age-adjusted risk rates confirm that the risk of COVID-19 mortality varies widely between occupations.”

These increased risks were significantly reduced after adjusting for mediating and confusing factors outside the workplace. For example, the risk quota for male taxi drivers or chauffeurs changed after the adjustment from 4.60 to 1.47. When comparing men in essential and insignificant occupations, the overall risk quota decreased from 1.45 to 1.22 after adjustment. For most occupations, disruptive and placement factors explained almost 70% to 80% of the age-adjusted risk rates.

“Our analysis has confirmed previous findings that many occupations are at increased risk for COVID-19 mortality.”

Non-workplace factors such as sociodemographics, region, and pre-pandemic health also affect COVID-19 mortality

The results of the study show that occupation and working conditions are likely to influence COVID-19 mortality, especially in occupations that involve exposure to the public or COVID-19 patients. However, there is also a significant contribution from factors outside of the workplace such as socio-demographic factors, region, and pre-pandemic health.

“A number of occupations showed increased risks even after major adaptation, and working conditions likely played a role. However, our results also show that factors outside of the workplace also play an important role.”

Therefore, urgent preventive measures are needed to minimize SARS-CoV-2 exposure in the workplace and to reduce exposure to the virus due to other factors such as inadequate housing, overcrowding and deprivation.

* Important NOTE

medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.

Journal reference:

  • Work and COVID-19 Mortality in England: A Nationally Linked Data Study of 14.3 Million Adults, Vahé Nafilyan, Piotr Pawelek, Dan Ayoubkhani, Sarah Rhodes, Lucy Pembrey, Melissa Matz, Michel P. Coleman, Claudia Allemani, Ben Windsor- Shellard and Martie van Tongeren, Neil Pearce medRxiv 05.12.2021.21257123; doi: https://doi.org/10.1101/2021.05.12.21257123, https://www.medrxiv.org/content/10.1101/2021.05.12.21257123v1

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