Covid-19 Risk by work-related factors: Pooled analysis of individual linked data from 14 cohorts

Abstract

ABSTRACT Background SARS-CoV-2 infection rates vary by occupation, but the association with work-related characteristics (such as home working, key-worker, or furlough) are not fully understood and may depend on ascertainment approach. We assessed infection risks across work-related characteristics and compared findings using different ascertainment approaches. Methods Participants of 14 UK-based longitudinal cohort studies completed surveys before and during the COVID-19 pandemic about their health, work, and behaviour. These data were linked to NHS digital health records, including COVID-19 diagnostic testing, within the UK Longitudinal Linkage Collaboration (UK-LLC) research environment. Poisson regression modelled self-reported infection and diagnostic test confirmed infection within each cohort for work-related characteristics. Risk Ratios (RR) were then combined using random effects meta-analysis. Results Between March 2020 and March 2021, 72,290 individuals completed 167,302 surveys. Overall, 11% of 138,924 responses self-reported an infection, whereas 1.9% of 159,820 responses had a linked positive test. Self-reported infection risk was greater in key-workers vs not (RR=1.24(95%C.I.=1.17,1.31), among non-home working (1.08(0.98,1.19)) or some home working (1.08(0.97,1.17)) vs all home working. Part-time workers vs full-time (0.94(0.89,0.99)), and furlough vs not (0.97(0.88,1.01)) had reduced risk. Results for the linked positive test outcome were comparable in direction but greater in magnitude e.g. an 1.85(1.56,2.20) in key-workers. Conclusion The UK-LLC provides new opportunities for researchers to investigate risk factors, including occupational factors, for ill-health events in multiple largescale UK cohorts. Risk of SARS-CoV-2 infection and COVID-19 illness appeared to be associated with work-related characteristics. Associations using linked diagnostic test data appeared stronger than self-reported infection status.