Risk for hospitalization due to COVID-19 in relation to occupational exposures as estimated by two different job-exposure matrices

ABSTRACT

IntroductionThe COVID-19 pandemic has profoundly challenged occupational safety and health. We assessed risk for hospitalization for COVID-19 in relation to potential routes and degree of occupational exposure.Material and MethodsThe study includes 1 105 042 subjects in the county of Stockholm of age 18–64 years, with an occupational code, followed regarding hospitalization from 1 March 2020 until 15 September 2022. We used two different job-exposure matrices (JEMs), based on survey data (Office for National Statistics 2020) and expert assessment (Oude Hengel et al 2022, module for Denmark), respectively. Hazard ratios (HRs) and 95% confidence intervals (CI) were obtained with Cox´s proportional hazards models. Fully adjusted models included age, sex, vaccination (time-dependent), household size, living space per person, income quintile, proportion of smokers in the occupation, and country of birth.ResultsWe observed 6523 hospitalizations with COVID-19 as the main diagnosis. HRs increased incrementally with the exposure dimensions in both JEMs and were increased already from the low-exposed categories.The fully adjusted HRs (95% CI) for the highest exposure category were for the survey-based JEM Closeness to other people (very close, almost touching) 1.51 (1.42–1.59);Exposure to other people´s diseases (daily) 1.41 (1.33–1.50). Similarly, we found for the expert-based JEM Number of co-workers in close vicinity (>30/day) 1.47 (1.39–1.57);Nature of contact with other people (regular contact with COVID-19 patients) 1.51 (1.40–1.63);Location of work (>4h/day indoors) 1.25 (1.19–1.31);Inability to keep social distancing (can never maintain >1m) 1.42 (1.33–1.51).ConclusionsDimensions of potential occupational exposure in both the survey- and expert-based JEMs were consistently associated with hospitalization for COVID-19 and may thus guide risk assessment. Increased risks observed already in the lower exposure categories indicate a need for enhanced preventive measures also in those settings.