Association of working shifts, inside and outside of healthcare, with severe COVID\u221219: an observational study

A V Rowlands,C Razieh,M J Davies,Y Chudasama,F Zaccardi,N Islam,M Pareek,K Khunti,C Lawson,T Yates,D E Kloecker,C Gillies

doi:10.1186/s12889-021-10839-0

Abstract

BackgroundHealth and key workers have elevated odds of developing severe COVID-19; it is not known, however, if this is exacerbated in those with irregular work patterns. We aimed to investigate the odds of developing severe COVID-19 in health and shift workers.MethodsWe included UK Biobank participants in employment or self-employed at baseline (2006–2010) and with linked COVID-19 data to 31st August 2020. Participants were grouped as neither a health worker nor shift worker (reference category) at baseline, health worker only, shift worker only, or both, and associations with severe COVID-19 investigated in logistic regressions.ResultsOf 235,685 participants (81·5% neither health nor shift worker, 1·4% health worker only, 16·9% shift worker only, and 0·3% both), there were 580 (0·25%) cases of severe COVID-19. The odds of severe COVID-19 was higher in health workers (adjusted odds ratio: 2·32 [95% CI: 1·33, 4·05]; shift workers (2·06 [1·72, 2·47]); and in health workers who worked shifts (7·56 [3·86, 14·79]). Being both a health worker and a shift worker had a possible greater impact on the odds of severe COVID-19 in South Asian and Black and African Caribbean ethnicities compared to White individuals.ConclusionsBoth health and shift work (measured at baseline, 2006–2010) were independently associated with over twice the odds of severe COVID-19 in 2020; the odds were over seven times higher in health workers who work shifts. Vaccinations, therapeutic and preventative options should take into consideration not only health and key worker status but also shift worker status.

Highlights

Health and key workers have elevated odds of developing severe COVID-19; it is not known, if this is exacerbated in those with irregular work patterns
It is not known whether working shifts interacts with health worker status or ethnicity, both of which are independently associated with elevated odds of COVID-19 [6, 19, 20]
After adjustment for potential confounders, a significant association was found between shift worker only (adjusted odds ratios: 2·06 [95% CI: 1·72, 2·47]) or health worker only (2·32 [1·33, 4·05]) status and odds of

Summary

Introduction

Health and key workers have elevated odds of developing severe COVID-19; it is not known, if this is exacerbated in those with irregular work patterns. Shift work is associated with alterations in the immune system and an increased risk for viral infections [16] In this view, it is not surprising that recent evidence suggests that shift work is associated with elevated odds of severe COVID-19 [5, 17], and that health care workers on night shifts have higher odds of in-hospital SARS-CoV2 infection than those on day shifts [18]. It is not surprising that recent evidence suggests that shift work is associated with elevated odds of severe COVID-19 [5, 17], and that health care workers on night shifts have higher odds of in-hospital SARS-CoV2 infection than those on day shifts [18] It is not known whether working shifts interacts with health worker status or ethnicity, both of which are independently associated with elevated odds of COVID-19 [6, 19, 20]

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