Occupation and Covid-19 mortality in England

This research used data made available via the Office for National Statistics (ONS) Secure Research Service (SRS), which is being expanded and improved with ADR UK funding.

Author: Professor Neil Pearce (London School of Hygiene and Tropical Medicine), Vahé Nafilyan (King’s College London)

Date: August 2020

Research summary

Research led by the London School of Hygiene and Tropical Medicine in the Office for National Statistics Secure Research Service investigated the variation between occupations in Covid-19 fatalities. The findings, which suggest working conditions are likely to play a role in Covid -19 mortality, have helped develop a wider view of mortality distribution throughout the pandemic. This has supported the Industrial Injuries Advisory Council in deciding issues of compensation for occupational disease in the workplace.

Greater mortality risk was found in roles with contact with the public, such as bus drivers and healthcare workers, particularly those working in intensive care units and those involved in wider social care. These findings have been used by the Industrial and Advisory Council to resolve issues of compensation for occupational disease and as evidence of differences in occupational risk. This research was funded by UK Government Grants, the Colt Foundation and Wellcome Trust.

Data used

Understanding Society, the UK Household Longitudinal Study, is a longitudinal survey of the members of approximately 40,000 households in the United Kingdom. Households are visited each year to collect information on changes to their household and individual circumstances. Interviews are carried out face-to-face in respondents’ homes by trained interviewers or through a self-completion online survey. Young people aged 10-15 complete a youth questionnaire, while respondents aged 16 and over complete the adult survey.

This research also used:

• 2011 Census data
• UK Biobank data
• ONS mortality data

Methods used

Occupations were coded according to Standard Occupation Classification (SOC) unit groups, using four-digit classifiers (e.g., ‘8213’ for bus and coach drivers). Health outcomes, including symptoms, positive tests, hospitalisations, intensive care admissions, and deaths, were compared across occupational groups. Poisson regressions – a method of modelling count data (e.g., deaths due to Covid-19) – were used to identify statistically significant correlations to independent variables. Several models were evaluated for combinations of independent socioeconomic variables, including occupation, age, sex, ethnicity, deprivation and region.

Research findings

The research found health workers were at the greatest risk of exposure to, transmission of, and death due to Covid-19. Intensive care workers and those directly caring for Covid-19 patients were shown to be at particular risk. Other professions in the social care sector also carried a greater risk. Outside of these two groups, those with direct contact with the public were found to have a greater risk of Covid-19 mortality.

 

SOC unit group	Occupation	Mortality rate (per 100,000)
8211	Large goods vehicle drivers	9.8
8212	Van drivers	12.6
8213	Bus and coach drivers	26.4
8214	Taxi and cab drivers and chauffeurs	36.4
n/a	All mean aged 20 to 64 years	9.9

Mortality rate in selected Standard Occupational Classification (SOC) unit groups.

The researchers found several shortcomings of the datasets. For example, Covid-19 test data were found to be heavily biased towards healthcare professionals. The researchers also found that random surveys were affected by non-response and recommended further analysis and triangulation of findings before attributing risk to any given sector. These findings highlighted the importance of strong methodologies when researching Covid-19, in particular the challenges of identifying and resolving bias within the data.

Research impact

The finding that working conditions are likely to play a role in Covid-19 mortality has helped develop a wider view of mortality distribution throughout the pandemic. This has supported the Industrial Injuries Advisory Council in deciding issues of compensation for occupational disease in the workplace as evidence of differences in occupational risk.

Research outputs

Publications and reports

• London School of Hygiene and Tropical Medicine Research Online : Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses.
• Industrial Injuries Advisory Council Position Paper, COVID-19 and occupation: Position Paper 48
• British Medical Journal, Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses: https://pubmed.ncbi.nlm.nih.gov/34141900/

About the ONS Secure Research Service

The ONS Secure Reseach Service (SRS) is an accredited trusted research environment, using the Five Safes Framework to provide secure access to de-identified, unpublished data. If you would like to discuss writing a future case study with us, please get in touch: srs.dev-impact@ons.gov.uk