School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Social Medicine, Regionhälsan, Region Västra Götaland, Gothenburg, Sweden.
Eur J Public Health. 2023 Apr 1;33(2):202-208. doi: 10.1093/eurpub/ckad016.
Many studies report that foreign-born healthcare workers (HCWs) in high-income countries have an elevated risk of COVID-19. However, research has not yet specifically evaluated the distribution of COVID-19 among foreign-born workers in different healthcare work groups. We examined the risk of COVID-19 infection and hospitalization among foreign-born HCWs in different occupational roles in Sweden.
We linked occupational data (2019) of 783 950 employed foreign-born workers (20-65 years) to COVID-19 data registered between 1 January 2020 and 30 September 2021. We used Cox proportional hazards regression to estimate the hazard ratio (HR) with 95% confidence intervals (95% CIs) of COVID-19 infection and hospitalization in eight healthcare occupational groups vs. non-HCWs and assessed whether region of birth modified the association between healthcare occupations and COVID-19.
All HCWs had a higher risk of COVID-19 outcomes than non-HCWs, but the risk differed by occupational role. Hospital-based assistant nurses had the highest risk (infection: HR 1.78; 95% CI 1.72-1.85; hospitalization: HR 1.79; 95% CI 1.52-2.11); allied HCWs had the lowest risk (infection: HR 1.22; 95% CI 1.10-1.35; hospitalization: HR 0.98; 95% CI 0.59-1.63). The relative hazard of the outcomes varied across foreign-born workers from different regions. For example, the relative risk of COVID-19 infection associated with being a physician compared to a non-HCW was 31% higher for African-born than European-born workers.
The risk of COVID-19 among foreign-born HCWs differed by occupational role and immigrant background. Public health efforts that target occupational exposures as well as incorporate culturally responsive measures may help reduce COVID-19 risk among foreign-born HCWs.
许多研究报告称，高收入国家的移民医疗工作者（HCWs）感染 COVID-19 的风险较高。然而，研究尚未专门评估不同医疗保健工作群体中移民工人 COVID-19 的分布情况。我们检查了瑞典不同职业角色的移民 HCWs 感染 COVID-19 的风险和住院情况。
我们将 783950 名就业移民工人（20-65 岁）的职业数据（2019 年）与 2020 年 1 月 1 日至 2021 年 9 月 30 日期间登记的 COVID-19 数据进行了关联。我们使用 Cox 比例风险回归来估计八个医疗保健职业群体与非 HCWs 相比 COVID-19 感染和住院的风险比（HR）和 95%置信区间（95%CI），并评估了出生地所在地区是否改变了医疗保健职业与 COVID-19 之间的关联。
所有 HCWs 的 COVID-19 结局风险均高于非 HCWs，但风险因职业角色而异。基于医院的助理护士风险最高（感染：HR 1.78；95%CI 1.72-1.85；住院：HR 1.79；95%CI 1.52-2.11）；联合 HCWs 风险最低（感染：HR 1.22；95%CI 1.10-1.35；住院：HR 0.98；95%CI 0.59-1.63）。不同地区出生的移民工人的结局相对危险度也有所不同。例如，与非 HCWs 相比，非洲出生的医生感染 COVID-19 的风险比欧洲出生的医生高 31%。
移民 HCWs 感染 COVID-19 的风险因职业角色和移民背景而异。针对职业暴露并纳入文化响应措施的公共卫生努力可能有助于降低移民 HCWs 感染 COVID-19 的风险。
