Rights statement: This article has been accepted for publication in Occupational and Environmental Medicine, 2021 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/oemed-2021-107628 © Authors (or their employer(s)) OR “© BMJ Publishing Group Ltd” ( for assignments of BMJ Case Reports)
Accepted author manuscript, 603 KB, PDF document
Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Risks of COVID-19 by occupation in NHS workers in England
AU - van der Plaat, Diana
AU - Madan, Ira
AU - Coggon, David
AU - van Tongeren, Martie
AU - Edge, Rhiannon
AU - Muiry, Rupert
AU - Parsons, Vaughan
AU - cullinan, Paul
N1 - This article has been accepted for publication in Occupational and Environmental Medicine, 2021 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/oemed-2021-107628 © Authors (or their employer(s)) OR “© BMJ Publishing Group Ltd” ( for assignments of BMJ Case Reports)
PY - 2022/3/31
Y1 - 2022/3/31
N2 - Abstract Objective To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.Methods We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.Results With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in ‘additional clinical services’ (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.Conclusions After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.
AB - Abstract Objective To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.Methods We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression.Results With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in ‘additional clinical services’ (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater.Conclusions After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.
U2 - 10.1136/oemed-2021-107628
DO - 10.1136/oemed-2021-107628
M3 - Journal article
VL - 79
SP - 176
EP - 183
JO - Occupational and Environmental Medicine
JF - Occupational and Environmental Medicine
SN - 1351-0711
IS - 3
ER -