Researchers: COVID-19 Deaths In Many Industries a ‘Complex Mix’ of Work, Non-work Factors

Nancy Grover

Sarasota, FL ( – “Working conditions play a role in COVID-19 mortality, particularly in occupations involving contact with patients or the public. However, there is also a substantial contribution from non-workplace factors,” says a new study. “While preventive measures are needed to reduce workplace exposures, reducing exposures outside the workplace is also crucial to reduce inequalities in the adverse consequences of COVID-19.”

Researchers came to that conclusion after looking at data for more than 14 million people in England. Writing in the BMJ journal Occupational and Environmental Health, they said differences in the risk of death from COVID-19 among various occupations is the result of a mix of various factors.

The Study

Certain occupations have been associated with the most severe and/or fatal cases of the coronavirus. Essential workers who interact with the public have seen higher hospitalizations and mortality rates. But workers in many sectors may be impacted as much or more so from non-working factors, the researchers said.

To try and distinguish the extent to which occupation vs. non-work issues contribute to the severity of the virus, the researchers conducted a cohort study of 14,295,900 people between the ages of 40 and 64, who were alive n Jan. 24, 2020, living in private households in England in 2019 and were employed and completed the national census in 2011. Between Jan. 24 and Dec. 28, 2020, 4,552 of the study group – .0003 percent – died from COVID-19-related causes.

“There are large age-adjusted differences in COVID-19 mortality across occupations in England,” the authors wrote. “Our results suggest that these differences are unlikely to be solely due to workplace exposures to SARS-CoV-2 but are largely due to confounding factors, such as geography, ethnicity or education, and factors other than workplace exposures, such as living conditions.”

In addition to healthcare workers, age-standardized mortality rates for COVID-19-related deaths have also been high among taxi drivers and chauffeurs, bus drivers, chefs, sales and retail assistants and social care workers.

“Occupational inequality in COVID-19 mortality is a major public health problem, but it is challenging to determine the extent to which working conditions drive these raised risks,” the researchers said. “Occupational differences in COVID-19 mortality could be caused by non-workplace factors such as living conditions at home or poor underlying (prepandemic) health. Deprivation, poor health and occupation are all linked.”

Workers in low-paying, insecure jobs may also be more likely to live in poor and/or overcrowded conditions. The researchers said in addition to workplace issues, those factors could also contribute to COVID-19 mortality. They found that to be the case in a number of occupations.

“Adjusting for confounding factors strongly attenuated the health risks for many occupations, but many remained at elevated risk,” they wrote. “Adjusting for living conditions reduced further the health risks, and many occupations were no longer at excess risk. For most occupations, confounding factors and mediators other than workplace exposure to SARS-CoV-2 explained 70%–80% of the excess age-adjusted occupational differences.”

Where non-work factors made little to no difference in mortality rates due to the coronavirus was in healthcare. The researchers speculated this was due to the fact that most in this profession “tend to be less disadvantaged.”

“Other occupations that do not involve contact with patients or the public may also have increased risks due to specific working conditions (eg, overcrowding in the workplace, lack of ventilation, lack of personal protective equipment, etc),” they wrote, “but our analyses indicate that these relative risks are generally small after adjustment for confounding factors.”

Their findings, the researchers said are “crucial” for public health policy. While employers can reduce risks to their workers to some extent, that may not be enough to stem COVID-19-related mortality rates for workers in many industries.

“Our analyses have confirmed that many occupations have elevated risks of COVID-19 mortality. However, these associations were greatly attenuated, for many occupations, after adjustment for measures of deprivation and geographical factors, suggesting that differences in risk between occupations are a result of a complex mix of different factors,” they concluded. “Preventive measures are needed to reduce workplace exposures, but also to reduce exposures outside the workplace, including overcrowding, inadequate housing and deprivation.”