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Occupational risk of COVID-19 related hospital admission in Skåne, Sweden : A register-based cohort study

Thacher, Jesse D LU orcid ; Vilhelmsson, Andreas LU orcid ; Tøttenborg, Sandra S LU ; Bonde, Jens Peter Ellekilde ; Petersen, Kajsa U ; Flachs, Esben M ; Nielsen, Christel LU orcid ; Jakobsson, Kristina LU ; Nilsson, Kerstin LU orcid and Begtrup, Luise M , et al. (2025) In PLOS ONE 20(11).
Abstract

PURPOSE: Given the paucity of data regarding workplace risk of COVID-19, particularly from countries with limited lockdowns, we aimed to quantify the occupational risks of COVID-19-related hospital admission among workers in Sweden.

METHODS: We identified 607,179 employed individuals, 20-69 years of age, in Skåne, Sweden. From December 31st, 2019-December 31st 2021, 2,633 incident COVID-19-related admissions were identified. Using a job exposure matrix for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting we delineated occupations with low work-related risk. Based on these reference occupations, incidence rate ratios (IRR) and 95% confidence intervals (CI) were computed by Poisson regression for... (More)

PURPOSE: Given the paucity of data regarding workplace risk of COVID-19, particularly from countries with limited lockdowns, we aimed to quantify the occupational risks of COVID-19-related hospital admission among workers in Sweden.

METHODS: We identified 607,179 employed individuals, 20-69 years of age, in Skåne, Sweden. From December 31st, 2019-December 31st 2021, 2,633 incident COVID-19-related admissions were identified. Using a job exposure matrix for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting we delineated occupations with low work-related risk. Based on these reference occupations, incidence rate ratios (IRR) and 95% confidence intervals (CI) were computed by Poisson regression for four-digit occupations defined by the International Standard Classification of Occupations job codes (ISCO-08).

RESULTS: After adjusting for various sociodemographic characteristics, risk compared to reference occupations was elevated among healthcare occupations as a group (IRR 1.31; 95% CI: 1.13-1.51), with nurses, healthcare assistants, and nursing aids having the highest IRRs (ranging from 1.28-1.54). In the educational sector, no apparent elevated overall risk was observed (IRR 1.03; 95% CI: 0.86-1.23). For the transportation sector, an overall excess risk was observed (IRR 1.34; 95% CI: 1.10-1.65), with bus and tram drivers having the highest risks. IRRs < 1 were observed among electricians, some builders, and software developers.

CONCLUSION: Excess risk of COVID-19-related hospital admission was observed in many patient-facing occupations across the healthcare sector and in multiple occupations within the transportation sector. However, despite limited lockdowns and legislation, no apparent increased risks were observed in the educational or retail sales sectors.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Humans, COVID-19/epidemiology, Sweden/epidemiology, Adult, Middle Aged, Male, Female, Aged, Hospitalization/statistics & numerical data, SARS-CoV-2/isolation & purification, Occupational Exposure/adverse effects, Young Adult, Registries, Risk Factors, Occupations/statistics & numerical data, Cohort Studies
in
PLOS ONE
volume
20
issue
11
article number
e0335662
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:105020735427
  • pmid:41187133
  • pmid:41187133
ISSN
1932-6203
DOI
10.1371/journal.pone.0335662
language
English
LU publication?
yes
id
2c434c90-7276-464c-a6c2-4f57e0868d56
date added to LUP
2025-11-05 08:53:17
date last changed
2025-12-15 14:23:56
@article{2c434c90-7276-464c-a6c2-4f57e0868d56,
  abstract     = {{<p>PURPOSE: Given the paucity of data regarding workplace risk of COVID-19, particularly from countries with limited lockdowns, we aimed to quantify the occupational risks of COVID-19-related hospital admission among workers in Sweden.</p><p>METHODS: We identified 607,179 employed individuals, 20-69 years of age, in Skåne, Sweden. From December 31st, 2019-December 31st 2021, 2,633 incident COVID-19-related admissions were identified. Using a job exposure matrix for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting we delineated occupations with low work-related risk. Based on these reference occupations, incidence rate ratios (IRR) and 95% confidence intervals (CI) were computed by Poisson regression for four-digit occupations defined by the International Standard Classification of Occupations job codes (ISCO-08).</p><p>RESULTS: After adjusting for various sociodemographic characteristics, risk compared to reference occupations was elevated among healthcare occupations as a group (IRR 1.31; 95% CI: 1.13-1.51), with nurses, healthcare assistants, and nursing aids having the highest IRRs (ranging from 1.28-1.54). In the educational sector, no apparent elevated overall risk was observed (IRR 1.03; 95% CI: 0.86-1.23). For the transportation sector, an overall excess risk was observed (IRR 1.34; 95% CI: 1.10-1.65), with bus and tram drivers having the highest risks. IRRs &lt; 1 were observed among electricians, some builders, and software developers.</p><p>CONCLUSION: Excess risk of COVID-19-related hospital admission was observed in many patient-facing occupations across the healthcare sector and in multiple occupations within the transportation sector. However, despite limited lockdowns and legislation, no apparent increased risks were observed in the educational or retail sales sectors.</p>}},
  author       = {{Thacher, Jesse D and Vilhelmsson, Andreas and Tøttenborg, Sandra S and Bonde, Jens Peter Ellekilde and Petersen, Kajsa U and Flachs, Esben M and Nielsen, Christel and Jakobsson, Kristina and Nilsson, Kerstin and Begtrup, Luise M and Frankel, Hannah N and Rylander, Lars}},
  issn         = {{1932-6203}},
  keywords     = {{Humans; COVID-19/epidemiology; Sweden/epidemiology; Adult; Middle Aged; Male; Female; Aged; Hospitalization/statistics & numerical data; SARS-CoV-2/isolation & purification; Occupational Exposure/adverse effects; Young Adult; Registries; Risk Factors; Occupations/statistics & numerical data; Cohort Studies}},
  language     = {{eng}},
  number       = {{11}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLOS ONE}},
  title        = {{Occupational risk of COVID-19 related hospital admission in Skåne, Sweden : A register-based cohort study}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0335662}},
  doi          = {{10.1371/journal.pone.0335662}},
  volume       = {{20}},
  year         = {{2025}},
}