Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses

There are important differences in the risk of SARS-CoV-2 infection and death depending on occupation. Infections in healthcare workers have received the most attention, and there are clearly increased risks for intensive care unit workers who are caring for COVID-19 patients. However, a number of other occupations may also be at an increased risk, particularly those which involve social care or contact with the public. A large number of data sets are available with the potential to assess occupational risks of COVID-19 incidence, severity, or mortality. We are reviewing these data sets as part of the Partnership for Research in Occupational, Transport, Environmental COVID Transmission (PROTECT) initiative, which is part of the National COVID-19 Core Studies. In this report, we review the data sets available (including the key variables on occupation and potential confounders) for examining occupational differences in SARS-CoV-2 infection and COVID-19 incidence, severity and mortality. We also discuss the possible types of analyses of these data sets and the definitions of (occupational) exposure and outcomes. We conclude that none of these data sets are ideal, and all have various strengths and weaknesses. For example, mortality data suffer from problems of coding of COVID-19 deaths, and the deaths (in England and Wales) that have been referred to the coroner are unavailable. On the other hand, testing data is heavily biased in some periods (particularly the first wave) because some occupations (e.g. healthcare workers) were tested more often than the general population. Random population surveys are, in principle, ideal for estimating population prevalence and incidence, but are also affected by non-response. Thus, any analysis of the risks in a particular occupation or sector (e.g. transport), will require a careful analysis and triangulation of findings across the various available data sets. Copyright: .. 2023 Pearce N et al.

Differences in COVID-19 vaccination coverage by occupation in England: a national linked data study

Background: Monitoring differences in COVID-19 vaccination uptake in different groups is crucial to help inform the policy response to the pandemic. A key data gap is the absence of data on uptake by occupation. This study investigates differences in vaccination rates by occupation in England, using nationwide population-level data. Methods: We calculated the proportion of people who had received three COVID-19 vaccinations (assessed on 28 February 2022) by detailed occupational categories in adults aged 18-64 and estimated adjusted ORs to examine whether these differences were driven by occupation or other factors, such as education. We also examined whether vaccination rates differed by ability to work from home. Results: Our study population included 15 456 651 adults aged 18-64 years. Vaccination rates differed markedly by occupation, being higher in health professionals (84.7%) and teaching and other educational professionals (83.6%) and lowest in people working in elementary trades and related occupations (57.6%). We found substantial differences in vaccination rates looking at finer occupational groups. Adjusting for other factors likely to be linked to occupation and vaccination, such as education, did not substantially alter the results. Vaccination rates were associated with ability to work from home, the rate being higher in occupations which can be done from home. Many occupations with low vaccination rates also involved contact with the public or with vulnerable people Conclusions: Increasing vaccination coverage in occupations with low vaccination rates is crucial to help protecting the public and control infection. Efforts should be made to increase vaccination rates in occupations that cannot be done from home and involve contact with the public.

Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET): Achievements after 4 years of networking, collaboration and training

Introduction OMEGA-NET (2017-2022) is a COST Action network, funded by EU, involving about 200 occupational health researchers in 40 countries, including non-European partners. The goal is to create a network to optimize the coordination and use of occupational, industrial, and population cohorts in Europe and beyond, to inform evidence-based interventions and policy. Material and Methods A range of networking tools are available for COST Actions, such as meetings, workshops, conferences, training schools, short-term scientific missions (STSMs) and dissemination activities. Results Despite COVID-19 restrictions, the network has made great achievements, including two online searchable inventories: the Inventory of Occupational Cohorts, with more than 140 cohorts registered, and the Inventory of Occupational Exposure Tools, with about 75 tools, of which half are Job-Exposure Matrices. Working groups have discussed and written papers on harmonisation and standardisation of occupational exposure and health outcome information. So far, 15 papers are published, some as editorials or position papers, others are accepted or in progress. A webinar series, available on YouTube, present work of OMEGA-NET. The Action also includes opportunities for networking, leadership and training for early career researchers in occupational epidemiology and exposure assessment, and visits to other research institutions (STSMs), as well as stakeholder engagement. Conclusions OMEGA-NET is the largest coordination activity on occupational health globally and will substantially enhance future European and international research.

Comparison of reported relative risks for health care, transport, and food processing workers

BackgroundRisk of SARS-CV-2 infection has been strongly linked to occupation, with specific occupational sectors such as health care, food production, and transport, particularly affected. To better understand the potential risks by occupational sector we investigated the reported risks of COVID-19 infection and mortality for employees in the three sectors.MethodsWe performed a rapid review of observational studies reporting COVID-19 risk for employees in health care, food manufacturing, and transport sectors. All studies published in the peer-review and pre-print literature between March 2020 and June 2021 were considered. The primary outcome measure was COVID-19 infection, with COVID-19 related mortality and hospitalisation considered as secondary measures. We extracted odds ratios/relative risks (and standard errors) comparing workers in each sector to within study reference category. To avoid complications due to study heterogeneity, we simply produced descriptive forest plots where possible utilising the odds ratios that have been adjusted for demographics.ResultsEight studies were identified from Norway (one), and California (one), and the UK (five). Three studies at time of writing were peer reviewed, and five of the eight were cohort studies. Food production was the least well investigated with limited evidence of increased infection, severe infection or mortality compared to the ‘other’ groups. Healthcare and transport show wide variation in the odds ratios reported. Public facing roles did indicate greater infection risk, specifically in the first wave. ConclusionsConsiderable study heterogeneity is present, particularly with respect to the chosen reference groups, meaning objective comparisons are limited here. However, as would be expected public facing roles, especially in the first wave, did appear to experience increased infection. Further prospective work with subject level data is needed to better understand the occupational risks.