RT Journal Article SR Electronic T1 Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants JF Occupational and Environmental Medicine JO Occup Environ Med FD BMJ Publishing Group Ltd SP 307 OP 314 DO 10.1136/oemed-2020-106731 VO 78 IS 5 A1 Mutambudzi, Miriam A1 Niedzwiedz, Claire A1 Macdonald, Ewan Beaton A1 Leyland, Alastair A1 Mair, Frances A1 Anderson, Jana A1 Celis-Morales, Carlos A1 Cleland, John A1 Forbes, John A1 Gill, Jason A1 Hastie, Claire A1 Ho, Frederick A1 Jani, Bhautesh A1 Mackay, Daniel F A1 Nicholl, Barbara A1 O'Donnell, Catherine A1 Sattar, Naveed A1 Welsh, Paul A1 Pell, Jill P A1 Katikireddi, Srinivasa Vittal A1 Demou, Evangelia YR 2021 UL http://oem.bmj.com/content/78/5/307.abstract AB 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.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).