Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
BMC Infect Dis. 2022 Jul 30;22(1):661. doi: 10.1186/s12879-022-07643-5.
Regional labour markets and their properties are named as potential reasons for regional variations in levels of SARS-CoV-2 infections rates, but empirical evidence is missing.
Using nationwide data on notified laboratory-confirmed SARS-CoV-2 infections, we calculated weekly age-standardised incidence rates (ASIRs) for working-age populations at the regional level of Germany's 400 districts. Data covered nearly 2 years (March 2020 till December 2021), including four main waves of the pandemic. For each of the pandemic waves, we investigated regional differences in weekly ASIRs according to three regional labour market indicators: (1) employment rate, (2) employment by sector, and (3) capacity to work from home. We use spatial panel regression analysis, which incorporates geospatial information and accounts for regional clustering of infections.
For all four pandemic waves under study, we found that regions with higher proportions of people in employment had higher ASIRs and a steeper increase of infections during the waves. Further, the composition of the workforce mattered: rates were higher in regions with larger secondary sectors or if opportunities of working from home were comparatively low. Associations remained consistent after adjusting for potential confounders, including a proxy measure of regional vaccination progress.
If further validated by studies using individual-level data, our study calls for increased intervention efforts to improve protective measures at the workplace, particularly among workers of the secondary sector with no opportunities to work from home. It also points to the necessity of strengthening work and employment as essential components of pandemic preparedness plans.
区域劳动力市场及其特征被认为是导致 SARS-CoV-2 感染率区域差异的潜在原因，但缺乏经验证据。
我们使用德国 400 个地区全国范围内报告的实验室确诊 SARS-CoV-2 感染数据，计算了工作年龄人群的每周年龄标准化发病率（ASIR）。数据涵盖了近 2 年（2020 年 3 月至 2021 年 12 月）的时间，包括大流行的四个主要阶段。对于每个大流行阶段，我们根据三个区域劳动力市场指标（1）就业率、（2）部门就业情况和（3）居家办公能力，调查了区域 ASIR 每周差异。我们使用空间面板回归分析，该分析纳入了地理空间信息，并考虑了感染的区域聚类。
在所有四个研究大流行阶段中，我们发现就业人口比例较高的地区具有更高的 ASIR，并且在波期间感染率的上升更陡峭。此外，劳动力构成也很重要：在第二产业比例较大或居家办公机会相对较低的地区，发病率更高。在调整了潜在混杂因素后，包括区域疫苗接种进展的替代指标，关联仍然一致。
如果使用个体数据进行的研究进一步验证了我们的研究结果，那么我们的研究呼吁加强在工作场所采取保护措施的干预措施，特别是针对没有居家办公机会的第二产业工人。它还指出了加强工作和就业作为大流行准备计划的必要组成部分的必要性。
