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

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.

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).

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.

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.