It has been more than a year since the COVID-19 pandemic showed. Community infections have also begun to appear in Taiwan. The emergence of variant viruses has made all countries dare not care. For COVID-19, due to its extremely high infectiousness, plus the severe disease rate and death rate after the infection all higher than the common seasonal viral infections in the past, all countries worried about the paralysis of their medical system by too many emerging patients. This has been a lesson learned in several countries...So finding out the high risk group of severe illness/death after the infection and to provide them appropriate protection will be the first priority (such as: vaccination, improvement of the working environment, complete personal protective equipment, etc.).
At present, during the pandemic, industries that are not necessary for life are usually closed. In this state, everyone knows that "Essential Workers" who maintain the basic operations of society (such as health caregivers, social workers, health workers, transportation workers, etc.) are high risk group of getting COVID-19 infection, because they are more likely to contact the masses compared to other non-basic workers. However, what is the actual relationship between "occupational factors" and "hospitalization/mortality after infection"?
According tothe original paper:《Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants》, Its research team used a large number of health and other basic data collected by the UK Biobank in the past 2006-2010, then collected data on hospitalization or death from the pandemic from 2020/03/16 to 2020/07/26, and used the SOC 2000 occupation classification rules to make all subjects classified into occupations. Finally, of the 502,506 people in the initial UK Biobank database, there are 120,075 peopleaged 49-65 with complete data on all the above items. The research team then included them in the analysis, to understand the relationship between 【showed significantly higher relative risk for 【 Hospitalization/death after infection】and【Occupational factor】,and【Other demographic factors】.
This study mainly wants to discuss the relationship between 【Occupational factor】and【showed significantly higher relative risk for 【 Hospitalization/death after infection】.【Other demographic factors] are covariates (controlling variable that is not the main research variable). Therefore, for occupational factors, the research team made detailed adjustments in order to get closer to the research goals. They re-classified the original 9 occupational categories of SOC 2000 (managers and senior officials, professional occupations, associate professional and technical occupations, administrative and secretarial occupations, skilled trades occupations, personal service occupations, sales and customer service occupations, process, plant and machine operatives, elementary occupations) into two categories, "Essential Workers" and "Non-Essential Workers". And then, they divided "Essential Workers" into 3 sub-categories: "Healthcare workers" (including: health professionals, health associate professionals, and support staff), "Social and education workers", and "Other essential workers" (including: food, transport, police and protective services, etc.). For detailed analysis, the "Essential Workers" category was subdivided into 8 sub-categories: "Healthcare Professionals" (such as physicians, pharmacists), "Health Associate Professionals"(such as nurses, medical assistants), "Medical Support staff" (such as assistants, attendants), "Social Care Workers", "Education Workers", "Food Workers", "Transport Workers", and "Police and Protective Service Workers".
In statistical analysis, the research team included all covariates for correction in models. The control group was "Non-Essential Workers" or "managers and senior officials". We summarized several key points of their conclusions as follows:
1. If "Essential Workers" category was classified into 3 sub-categories: Compared with Non-Essential Workers, Healthcare workers (RR = 7.69), and Social and education workers (RR = 1.88)showed significantly higher relative risk for 【Severe illness/death after infection】, especiallythe relative risk of Healthcare Workers was as high as 7 times! ! ! There was no significant difference in the relative risks between "Other Essential Workers" and "Non-Essential Workers".
2. If "Essential Workers" category was classified into 8 sub-categories: Compared with Non-Essential Workers: Compared with Non-Essential Workers, the relative risks of "Healthcare Professionals" (RR = 8.99),"Health Associate Professionals"(RR = 7.65),"Medical Support staff" (RR = 6.42),"Social Care Workers" (RR = 2.13)showed significantly higher relative risk for 【Severe illness/death after infection】. Among them, the relative risks of "Healthcare Professionals", "Health Associate Professionals", and "Medical Support staff" were all more than 6 times! ! ! Otherwise, there was no significant difference in the relative risks between other sub-categories and "Non-Essential Workers".
Due to the limitations of experimental design, the update of subject data or other factors cannot be perfect. However, considering that the absolute numbers of 【Hospitalization/Mortality after infection】 were relatively small which was hard to be analyzed in a small subject number, this study should be one of the best because of their large subject number and detailed analysis for occupational factors and covariates. In addition, other statistical analysis data showed that junior technical workers are at higher risk of 【Hospitalization/Mortality after infection】, maybe due to the disadvantages of social and economic resources.
We believe that the above information should be carefully referred to and used for future policy adjustments. For individuals, if you are a worker with the above-mentioned high relative risk, it is recommended that you confirm that you have fully used suitable personal protective equipment in your work. Also, Work managers should make improvements to the working environment as soon as possible (such as improving ventilation, adjustment of traffic flow). Furthermore, please have adequate vaccination as soon as possible!