Occupational risks of Cv-19 infection in NHS staff. [COVID-19]
Research type
Research Study
Full title
Occupational risks of Covid-19 in NHS staff; an analysis of sickness absence by ethnicity, professional role, age, sex and antigen/antibody test results.
IRAS ID
284146
Contact name
Paul Cullinan
Contact email
Sponsor organisation
Imperial College London
ISRCTN Number
ISRCTN36352994
Duration of Study in the UK
0 years, 5 months, 28 days
Research summary
Summary of Research
We propose a study using anonymised national data from NHSs electronic staff records (ESR) to explore the risk of sickness absence due to suspected Covid-19 according to ethnicity, professional role, sex and age and in relation to available antigen/antibody test results. This will help us understand not only the differential risks of Covid-19 infection in health care workers but also the possible modifying roles of ethnicity, age and sex. We will also examine sickness absence for mental illness. In addition, in a limited number of NHS Trusts we will collect group information on hospital admissions, staff redeployment and the availability of PPE.\n\nAccordingly the study will answer the following three questions:\nAmong staff employed by NHS acute medical Trusts:\n1) how have rates of sickness absence ascribed to suspected Covid-19 infection varied according to ethnicity, age, sex, and potential for occupational contact with Covid-19 as indicated by occupation and department? How are these related to available data on antigen/antibody test results?\n2) how have rates of prolonged sickness absence ascribed to suspected Covid-19 infection varied according to ethnicity, age, sex, and potential for occupational contact with Covid-19 as indicated by occupation and department?\n3) how have rates of sickness absence ascribed to mental illness and other causes unrelated to Covid-19, varied over the course of the epidemic as compared with 12 months earlier, and have changes differed by ethnicity, occupation and department?\n\nThe study duration will be six months.[Study relying on COPI notice]Summary of Results
This project was successfully completed on time and its findings have been submitted for publication in four separate manuscripts. These are listed below with summaries of their main findings:1. van der Plaat DA, Madan I, Coggon D, van Tongeren M, Edge R, Muiry R, Parsons V, Culli-nan P. Occupational risks of COVID-19 in NHS workers in England. OEM 2021; in press
Between March and July 2000, the overall risk of COVID-19 sickness absence in National Health Service staff in England was lower at older ages, higher in non-white staff, and (in comparison with administrative and clerical staff) more than doubled in registered nurses and among workers such as healthcare assistants providing support to health professionals. Risk in health care scientists was little different from that in administrative and clerical occupations These observations suggest that the risk reduction strategies that were in place for healthcare scientists were effective. However, the protection for nursing and supporting health professionals was insufficient. In the event of a further ‘wave’ of infections resulting in high hospital admissions, attention should be paid to ensuring that risk reduction strategies for nurses and supporting health professionals are improved.
2. Edge R, van der Plaat D, Parsons V, Coggon D, van Tongeren M, Muiry R, Cullinan P, Madan I. Ethnic differences in risk of severe COVID-19: to what extent are they driven by exposure? Public Health 2021; in press
Among staff employed by NHS trusts in England, during the first wave of COVID-19, once staff group, age, sex, prior sickness absence, trust and occupational exposure category were accounted for, the risk of short duration COVID-19 (a marker of mild illness) was similar for Black people compared with White, and only marginally elevated for people of South Asian origin. In contrast those from Black and other ethnic minority groups were at a higher risk of prolonged COVID-19 sickness absence (a marker for more severe infection) compared to White NHS employees, suggesting important ethnic differences in vulnerability, whether because of comorbidities or for other reasons.
Understanding ethnic differences in the vulnerability of healthcare workers to COVID-19 should inform future occupational health interventions, such as provision of personal protective equipment and COVID-19 vaccination strategies3. Edge R, van der Plaat D, Parsons V, Coggon D, van Tongeren M, Muiry R, Madan I, Cullinan P. Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic. Public Health 2021; in press
During the first wave of COVID-19, incidence of sickness absence changed markedly when compared to the previous year, with major increases for some categories of illness, and large declines for many others, including cancer.
The findings support a need to plan for effects from delayed diagnosis and treatment of cancer, and to manage a large backlog of treatment for many other diseases.4. van der Plaat DA, Edge R, Coggon D, van Tongeren M, Muiry R, Parsons V, Cullinan P, Madan I. Impact of COVID-19 pandemic on sickness absence for mental ill health in na-tional health service staff. BMJ Open.2021; under review
Over the study period, 164,202 new sickness absence episodes for mental ill health were recorded in 12.5% (119,525) of the study sample. There was a spike of sickness absence for mental ill health in March-April 2020 (899,730 days lost) compared with 519,807 days in March-April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May/June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%-136%). Among doctors and dentists the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of Covid-19 sickness absence during the same period.
Although the Covid-19 epidemic led to an increase in sickness absence attributed to mental ill health in NHS staff, this had substantially declined by May/June 2020, corresponding with the decrease in pressures at work as the first wave of the epidemic subsided.REC name
South Central - Hampshire A Research Ethics Committee
REC reference
20/SC/0282
Date of REC Opinion
3 Aug 2020
REC opinion
Further Information Favourable Opinion