Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults

Nafilyan, Vahe ¹Pawelek, Piotr ²Ayoubkhani, Daniel ²Rhodes, Sarah ³Pembrey, Lucy ⁴Matz, Melissa ⁵Coleman, Michel ⁶Allemani, Claudia ⁶Windsor-Shellard, Ben ¹van Tongeren, Martie ³Pearce, Neil⁷

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作者信息

1. Hlth Anal Div,Off Natl Stat
2. Methodol Div,Off Natl Stat
3. Fac Biol Med & Hlth,Univ Manchester
4. Fac Epidemiol & Populat Hlth,London Sch Hyg & Trop Med
5. Fac Publ Hlth & Policy,London Sch Hyg & Trop Med
6. Dept Noncommunicable Dis Epidemiol,London Sch Hyg & Trop Med
7. Epidemiol & Populat Hlth,London Sch Hyg
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Abstract

Objectives To estimate occupational differences in COVID-19 mortality and test whether these are confounded by factors such as regional differences, ethnicity and education or due to non-workplace factors, such as deprivation or prepandemic health. Methods Using a cohort study of over 14 million people aged 40-64 years living in England, we analysed occupational differences in death involving COVID-19, assessed between 24 January 2020 and 28 December 2020. We estimated age-standardised mortality rates (ASMRs) per 100 000 person-years at risk stratified by sex and occupation. We estimated the effect of occupation on COVID-19 mortality using Cox proportional hazard models adjusted for confounding factors. We further adjusted for non-workplace factors and interpreted the residual effects of occupation as being due to workplace exposures to SARS-CoV-2. Results In men, the ASMRs were highest among those working as taxi and cab drivers or chauffeurs at 119.7 deaths per 100 000 (95% CI 98.0 to 141.4), followed by other elementary occupations at 106.5 (84.5 to 132.4) and care workers and home carers at 99.2 (74.5 to 129.4). Adjusting for confounding factors strongly attenuated the HRs for many occupations, but many remained at elevated risk. Adjusting for living conditions reduced further the HRs, and many occupations were no longer at excess risk. For most occupations, confounding factors and mediators other than workplace exposure to SARS-CoV-2 explained 70%-80% of the excess age-adjusted occupational differences. Conclusions Working conditions play a role in COVID-19 mortality, particularly in occupations involving contact with patients or the public. However, there is also a substantial contribution from non-workplace factors.

Key words

COVID-19/occupational health/RISK-FACTORS/WORKERS/UK

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出版年

2022

Occupational and environmental medicine

SCI

ISSN：1351-0711

被引量28

参考文献量29

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