Objectives To investigate severe COVID-19 risk by occupational group.
Methods Baseline UK Biobank data (2006–10) for England were linked to SARS-CoV-2 test results from Public Health England (16 March to 26 July 2020). Included participants were employed or self-employed at baseline, alive and aged <65 years in 2020. Poisson regression models were adjusted sequentially for baseline demographic, socioeconomic, work-related, health, and lifestyle-related risk factors to assess risk ratios (RRs) for testing positive in hospital or death due to COVID-19 by three occupational classification schemes (including Standard Occupation Classification (SOC) 2000).
Results Of 120 075 participants, 271 had severe COVID-19. Relative to non-essential workers, healthcare workers (RR 7.43, 95% CI 5.52 to 10.00), social and education workers (RR 1.84, 95% CI 1.21 to 2.82) and other essential workers (RR 1.60, 95% CI 1.05 to 2.45) had a higher risk of severe COVID-19. Using more detailed groupings, medical support staff (RR 8.70, 95% CI 4.87 to 15.55), social care (RR 2.46, 95% CI 1.47 to 4.14) and transport workers (RR 2.20, 95% CI 1.21 to 4.00) had the highest risk within the broader groups. Compared with white non-essential workers, non-white non-essential workers had a higher risk (RR 3.27, 95% CI 1.90 to 5.62) and non-white essential workers had the highest risk (RR 8.34, 95% CI 5.17 to 13.47). Using SOC 2000 major groups, associate professional and technical occupations, personal service occupations and plant and machine operatives had a higher risk, compared with managers and senior officials.
Conclusions Essential workers have a higher risk of severe COVID-19. These findings underscore the need for national and organisational policies and practices that protect and support workers with an elevated risk of severe COVID-19.
- health care workers
- exposure assessment
- public health
- investigation of outbreaks of illness
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MM and CN contributed equally.
SVK and ED contributed equally.
Contributors SVK and ED conceived the idea for the study. ED, SVK, CLN, JPP and MM designed the study. CLN led and conducted the statistical analysis and was supported by MM. MM, CLN and ED drafted the manuscript. All authors contributed to the interpretation of the results, critically revised the paper and agreed on the final version for submission.
Funding We also acknowledge financial support from the Medical Research Council and Chief Scientist Office (MC_UU_12017/13; SPHSU13). CLN is supported by a Medical Research Council Fellowship (MR/R024774/1) and SVK by a NRS Senior Clinical Fellowship (SCAF/15).
Disclaimer The views and opinions expressed are those of the authors and do not necessarily reflect those of the above funding bodies.
Competing interests JPP is a member of the UK Biobank Scientific Steering Committee.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available. This research has been conducted using the UK Biobank Resource (https://www.ukbiobank.ac.uk/; application No 41686 & 17333).
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