TY - JOUR
T1 - Occupational risk of COVID-19 related hospital admission in Skåne, Sweden
T2 - A register-based cohort study
AU - Thacher, Jesse D.
AU - Vilhelmsson, Andreas
AU - Tottenborg, Sandra S.
AU - Bonde, Jens Peter Ellekilde
AU - Petersen, Kajsa U.
AU - Flachs, Esben M.
AU - Nielsen, Christel
AU - Jakobsson, Kristina
AU - Nilsson, Kerstin
AU - Begtrup, Luise M.
AU - Frankel, Hannah N.
AU - Rylander, Lars
N1 - Copyright: © 2025 Thacher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/11/4
Y1 - 2025/11/4
N2 - 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.
AB - 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.
KW - Humans
KW - COVID-19/epidemiology
KW - Sweden/epidemiology
KW - Adult
KW - Middle Aged
KW - Male
KW - Female
KW - Aged
KW - Hospitalization/statistics & numerical data
KW - SARS-CoV-2/isolation & purification
KW - Occupational Exposure/adverse effects
KW - Young Adult
KW - Registries
KW - Risk Factors
KW - Occupations/statistics & numerical data
KW - Cohort Studies
U2 - 10.1371/journal.pone.0335662
DO - 10.1371/journal.pone.0335662
M3 - Article
C2 - 41187133
SN - 1932-6203
VL - 20
SP - e0335662
JO - PLoS ONE
JF - PLoS ONE
IS - 11
M1 - e0335662
ER -
