Beale Sarah, Hoskins Susan, Byrne Thomas, Fong Wing Lam Erica, Fragaszy Ellen, Geismar Cyril, Kovar Jana, Navaratnam Annalan M D, Nguyen Vincent, Patel Parth, Yavlinsky Alexei, Johnson Anne M, Van Tongeren Martie, Aldridge Robert W, Hayward Andrew
Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK.
J Occup Med Toxicol. 2023 Apr 3;18(1):5. doi: 10.1186/s12995-023-00371-9.
Workers across different occupations vary in their risk of SARS-CoV-2 infection, but the direct contribution of occupation to this relationship is unclear. This study aimed to investigate how infection risk differed across occupational groups in England and Wales up to April 2022, after adjustment for potential confounding and stratification by pandemic phase.
Data from 15,190 employed/self-employed participants in the Virus Watch prospective cohort study were used to generate risk ratios for virologically- or serologically-confirmed SARS-CoV-2 infection using robust Poisson regression, adjusting for socio-demographic and health-related factors and non-work public activities. We calculated attributable fractions (AF) amongst the exposed for belonging to each occupational group based on adjusted risk ratios (aRR).
Increased risk was seen in nurses (aRR = 1.44, 1.25-1.65; AF = 30%, 20-39%), doctors (aRR = 1.33, 1.08-1.65; AF = 25%, 7-39%), carers (1.45, 1.19-1.76; AF = 31%, 16-43%), primary school teachers (aRR = 1.67, 1.42- 1.96; AF = 40%, 30-49%), secondary school teachers (aRR = 1.48, 1.26-1.72; AF = 32%, 21-42%), and teaching support occupations (aRR = 1.42, 1.23-1.64; AF = 29%, 18-39%) compared to office-based professional occupations. Differential risk was apparent in the earlier phases (Feb 2020-May 2021) and attenuated later (June-October 2021) for most groups, although teachers and teaching support workers demonstrated persistently elevated risk across waves.
Occupational differences in SARS-CoV-2 infection risk vary over time and are robust to adjustment for socio-demographic, health-related, and non-workplace activity-related potential confounders. Direct investigation into workplace factors underlying elevated risk and how these change over time is needed to inform occupational health interventions.
不同职业的工作者感染新冠病毒的风险各异，但职业对这种关系的直接影响尚不清楚。本研究旨在调查截至2022年4月，在对潜在混杂因素进行调整并按疫情阶段分层后，英格兰和威尔士不同职业群体的感染风险有何差异。
利用病毒监测前瞻性队列研究中15190名受雇/自营职业参与者的数据，通过稳健泊松回归生成病毒学或血清学确诊的新冠病毒感染风险比，并对社会人口统计学、健康相关因素及非工作公共活动进行调整。我们根据调整后的风险比（aRR）计算了各职业群体中暴露者的归因分数（AF）。
与办公室职业相比，护士（aRR = 1.44，1.25 - 1.65；AF = 30%，20 - 39%）、医生（aRR = 1.33，1.08 - 1.65；AF = 25%，7 - 39%）、护理人员（1.45，1.19 - 1.76；AF = 31%，16 - 43%）、小学教师（aRR = 1.67，1.42 - 1.96；AF = 40%，30 - 49%）、中学教师（aRR = 1.48，1.26 - 1.72；AF = 32%，21 - 42%）和教学辅助职业（aRR = 1.42，1.23 - 1.64；AF = 29%，18 - 39%）的感染风险增加。在早期阶段（2020年2月至2021年5月），大多数群体的风险差异明显，后期（2021年6月至10月）有所减弱，不过教师和教学辅助人员在各波疫情中风险持续升高。
新冠病毒感染风险的职业差异随时间变化，在对社会人口统计学、健康相关及非工作场所活动相关的潜在混杂因素进行调整后依然显著。需要直接调查风险升高背后的工作场所因素以及这些因素如何随时间变化，以便为职业健康干预提供依据。
