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Agius R. COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK. LA MEDICINA DEL LAVORO 2023; 114:e2023055. [PMID: 38060204 PMCID: PMC10731572 DOI: 10.23749/mdl.v114i6.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
This paper addresses lessons learned from the COVID-19 pandemic from a UK Occupational Medicine perspective to permit comparison with other national accounts. In spite of good prior research and statute, the necessary resources to protect workers' health were seriously lacking when the pandemic struck. Weak public health guidance, which did not recognise dominant airborne transmission, was applied to workplaces, leaving workers and others unprotected, especially in respect to Respiratory Protective Equipment (RPE). The Health and Safety Executive (HSE) as regulator was lacking, for example, in not producing guidance to protect HealthCare Workers (HCW) who were amongst the most at risk. The UK COVID-19 Public Inquiry should address shortcomings such as these, but recommendations must be accompanied by robust means to ensure appropriate implementation. These should range from substantial measures to improve indoor air quality, to a permanent pandemic management organization with adequate resources. The enforcing authority has to be obliged to publish more specific workplace guidance than the public health authorities. Occupational medicine as a discipline needs to be better prepared, and hence to assert its responsibility towards high standards of workers' health protection. Future research has to include investigating the best means of mitigation against airborne infection and the management of post-acute covid sequelae.
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Affiliation(s)
- Raymond Agius
- Professor Emeritus of Occupational and Environmental Medicine, The University of Manchester, UK.
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Samant Y, Støver M, Haarberg IS, Lohmann-Lafrenz S, Strømholm T. Underreporting of Work-Related COVID-19 Cases in Norway. New Solut 2023; 33:149-153. [PMID: 37583301 DOI: 10.1177/10482911231191680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Background: This register-based study provides a profile of work-related Covid-19 cases reported by physicians to the Norwegian Labor Inspection Authority (NLIA). Methods: All the reports of work-related Covid-19 cases reported by a physician to the NLIAs Registry for Work-Related Diseases (RAS) between February 2020 and February 2022 were included. Descriptive statistics and the incidence rate of reported cases were computed for age, gender, and occupation. Results: Two hundred and seventeen work-related Covid-19 cases were reported to RAS during the study period. Sixty-five percent of the cases were females (n = 141), and 35 percent (n = 76) were males. Doctors, nurses, and ambulance personnel yielded higher incidence rates than other healthcare and nonhealthcare occupations. Conclusions: This study indicates that women aged 25-39 and employed in the healthcare sector had the highest reported incidence and number of work-related Covid-19 cases. Physician underreporting of work-related Covid-19 cases is an important finding. Plausibly, underreporting is more substantial for at-risk non-healthcare occupations such as waiters, bartenders, food couriers, and taxi drivers than occupations in healthcare.
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Affiliation(s)
- Yogindra Samant
- Department of Working Environment and Regulations, Norwegian Labour Inspection Authority, Trondheim, Norway
- Deputy Chief Medical Officer, Værnesregion Muinicipal Region, Trondheim, Norway
| | - Morten Støver
- Department of Working Environment and Regulations, Norwegian Labour Inspection Authority, Trondheim, Norway
| | - Ingrid Stette Haarberg
- Department of Working Environment and Regulations, Norwegian Labour Inspection Authority, Trondheim, Norway
| | | | - Tonje Strømholm
- Department of Working Environment and Regulations, Norwegian Labour Inspection Authority, Trondheim, Norway
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Cakir MS, Wardman JK, Trautrims A. Ethical leadership supports safety voice by increasing risk perception and reducing ethical ambiguity: Evidence from the COVID-19 pandemic. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:1902-1916. [PMID: 36261397 PMCID: PMC9874882 DOI: 10.1111/risa.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/07/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Misconduct by business and political leaders during the pandemic is feared to have impacted people's adherence to protective measures that would help to safeguard against the spread of COVID-19. Addressing this concern, this article theorizes and tests a model linking ethical leadership with workplace risk communication-a practice referred to as 'safety voice' in the research literature. Our study, conducted with 511 employees from UK companies, revealed that ethical leadership is positively associated with greater intention to engage in safety voice regarding COVID-19. We also find that this association is mediated by relations with the perceived health risk of COVID-19 and ambiguity about ethical decision making in the workplace. These findings therefore underscore the importance of good ethical conduct by leaders for ensuring that health and safety risks are well understood and communicated effectively by organizational members particularly during crises. We discuss the theoretical and practical implications of our study and highlight further opportunities for future research to address the ethical dimensions of leadership, risk management, and organizational risk communication.
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Affiliation(s)
- M. Selim Cakir
- University of Bristol Business SchoolUniversity of BristolBristolUK
| | - Jamie K. Wardman
- Nottingham University Business SchoolUniversity of NottinghamNottinghamUK
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Beale S, Hoskins S, Byrne T, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam AMD, Nguyen V, Patel P, Yavlinsky A, Johnson AM, Van Tongeren M, Aldridge RW, Hayward A. Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales. J Occup Med Toxicol 2023; 18:5. [PMID: 37013634 PMCID: PMC10068189 DOI: 10.1186/s12995-023-00371-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Workers across different occupations vary in their risk of SARS-CoV-2 infection, but the direct contribution of occupation to this relationship is unclear. This study aimed to investigate how infection risk differed across occupational groups in England and Wales up to April 2022, after adjustment for potential confounding and stratification by pandemic phase. METHODS Data from 15,190 employed/self-employed participants in the Virus Watch prospective cohort study were used to generate risk ratios for virologically- or serologically-confirmed SARS-CoV-2 infection using robust Poisson regression, adjusting for socio-demographic and health-related factors and non-work public activities. We calculated attributable fractions (AF) amongst the exposed for belonging to each occupational group based on adjusted risk ratios (aRR). RESULTS Increased risk was seen in nurses (aRR = 1.44, 1.25-1.65; AF = 30%, 20-39%), doctors (aRR = 1.33, 1.08-1.65; AF = 25%, 7-39%), carers (1.45, 1.19-1.76; AF = 31%, 16-43%), primary school teachers (aRR = 1.67, 1.42- 1.96; AF = 40%, 30-49%), secondary school teachers (aRR = 1.48, 1.26-1.72; AF = 32%, 21-42%), and teaching support occupations (aRR = 1.42, 1.23-1.64; AF = 29%, 18-39%) compared to office-based professional occupations. Differential risk was apparent in the earlier phases (Feb 2020-May 2021) and attenuated later (June-October 2021) for most groups, although teachers and teaching support workers demonstrated persistently elevated risk across waves. CONCLUSIONS Occupational differences in SARS-CoV-2 infection risk vary over time and are robust to adjustment for socio-demographic, health-related, and non-workplace activity-related potential confounders. Direct investigation into workplace factors underlying elevated risk and how these change over time is needed to inform occupational health interventions.
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Affiliation(s)
- Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK.
| | - Susan Hoskins
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
- Department of Infectious Disease Epidemiology, London, School of Hygiene and Tropical Medicine , Keppel Street, London, WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Annalan M D Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Alexei Yavlinsky
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Anne M Johnson
- Institute for Global Health, University College London, London, WC1N 1EH, UK
| | - Martie Van Tongeren
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, M13 9NT, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
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Beale S, Burns R, Braithwaite I, Byrne T, Lam Erica Fong W, Fragaszy E, Geismar C, Hoskins S, Kovar J, Navaratnam AMD, Nguyen V, Patel P, Yavlinsky A, Van Tongeren M, Aldridge RW, Hayward A. Occupation, Worker Vulnerability, and COVID-19 Vaccination Uptake: Analysis of the Virus Watch prospective cohort study. Vaccine 2022; 40:7646-7652. [PMID: 36372668 PMCID: PMC9637514 DOI: 10.1016/j.vaccine.2022.10.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Occupational disparities in COVID-19 vaccine uptake can impact the effectiveness of vaccination programmes and introduce particular risk for vulnerable workers and those with high workplace exposure. This study aimed to investigate COVID-19 vaccine uptake by occupation, including for vulnerable groups and by occupational exposure status. METHODS We used data from employed or self-employed adults who provided occupational information as part of the Virus Watch prospective cohort study (n = 19,595) and linked this to study-obtained information about vulnerability-relevant characteristics (age, medical conditions, obesity status) and work-related COVID-19 exposure based on the Job Exposure Matrix. Participant vaccination status for the first, second, and third dose of any COVID-19 vaccine was obtained based on linkage to national records and study records. We calculated proportions and Sison-Glaz multinomial 95% confidence intervals for vaccine uptake by occupation overall, by vulnerability-relevant characteristics, and by job exposure. FINDINGS Vaccination uptake across occupations ranged from 89-96% for the first dose, 87-94% for the second dose, and 75-86% for the third dose, with transport, trade, service and sales workers persistently demonstrating the lowest uptake. Vulnerable workers tended to demonstrate fewer between-occupational differences in uptake than non-vulnerable workers, although clinically vulnerable transport workers (76%-89% across doses) had lower uptake than several other occupational groups (maximum across doses 86%-96%). Workers with low SARS-CoV-2 exposure risk had higher vaccine uptake (86%-96% across doses) than those with elevated or high risk (81-94% across doses). INTERPRETATION Differential vaccination uptake by occupation, particularly amongst vulnerable and highly-exposed workers, is likely to worsen occupational and related socioeconomic inequalities in infection outcomes. Further investigation into occupational and non-occupational factors influencing differential uptake is required to inform relevant interventions for future COVID-19 booster rollouts and similar vaccination programmes.
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Affiliation(s)
- Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK.
| | - Rachel Burns
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Isobel Braithwaite
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Susan Hoskins
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Annalan M D Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Alexei Yavlinsky
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Martie Van Tongeren
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
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Beale S, Hoskins S, Byrne T, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam AM, Nguyen V, Patel P, Yavlinsky A, Johnson AM, Van Tongeren M, Aldridge RW, Hayward A. Workplace contact patterns in England during the COVID-19 pandemic: Analysis of the Virus Watch prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 16:100352. [PMID: 35475035 PMCID: PMC9023315 DOI: 10.1016/j.lanepe.2022.100352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Background Workplaces are an important potential source of SARS-CoV-2 exposure; however, investigation into workplace contact patterns is lacking. This study aimed to investigate how workplace attendance and features of contact varied between occupations across the COVID-19 pandemic in England. Methods Data were obtained from electronic contact diaries (November 2020-November 2021) submitted by employed/self-employed prospective cohort study participants (n=4,616). We used mixed models to investigate the effects of occupation and time for: workplace attendance, number of people sharing workspace, time spent sharing workspace, number of close contacts, and usage of face coverings. Findings Workplace attendance and contact patterns varied across occupations and time. The predicted probability of intense space sharing during the day was highest for healthcare (78% [95% CI: 75-81%]) and education workers (64% [59%-69%]), who also had the highest probabilities for larger numbers of close contacts (36% [32%-40%] and 38% [33%-43%] respectively). Education workers also demonstrated relatively low predicted probability (51% [44%-57%]) of wearing a face covering during close contact. Across all occupational groups, workspace sharing and close contact increased and usage of face coverings decreased during phases of less stringent restrictions. Interpretation Major variations in workplace contact patterns and mask use likely contribute to differential COVID-19 risk. Patterns of variation by occupation and restriction phase may inform interventions for future waves of COVID-19 or other respiratory epidemics. Across occupations, increasing workplace contact and reduced face covering usage is concerning given ongoing high levels of community transmission and emergence of variants. Funding Medical Research Council; HM Government; Wellcome Trust.
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Affiliation(s)
- Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Susan Hoskins
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Annalan M.D. Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Alexei Yavlinsky
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Anne M. Johnson
- Institute for Global Health, University College London, London WC1N 1EH, UK
| | - Martie Van Tongeren
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Robert W. Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Virus Watch Collaborative
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Institute for Global Health, University College London, London WC1N 1EH, UK
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
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Beale S, Patel P, Rodger A, Braithwaite I, Byrne T, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam A, Nguyen V, Shrotri M, Aryee A, Aldridge R, Hayward A. Occupation, work-related contact and SARS-CoV-2 anti-nucleocapsid serological status: findings from the Virus Watch prospective cohort study. Occup Environ Med 2022; 79:oemed-2021-107920. [PMID: 35450951 PMCID: PMC9072780 DOI: 10.1136/oemed-2021-107920] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/28/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Risk of SARS-CoV-2 infection varies across occupations; however, investigation into factors underlying differential risk is limited. We aimed to estimate the total effect of occupation on SARS-CoV-2 serological status, whether this is mediated by workplace close contact, and how exposure to poorly ventilated workplaces varied across occupations. METHODS We used data from a subcohort (n=3775) of adults in the UK-based Virus Watch cohort study who were tested for SARS-CoV-2 anti-nucleocapsid antibodies (indicating natural infection). We used logistic decomposition to investigate the relationship between occupation, contact and seropositivity, and logistic regression to investigate exposure to poorly ventilated workplaces. RESULTS Seropositivity was 17.1% among workers with daily close contact vs 10.0% for those with no work-related close contact. Compared with other professional occupations, healthcare, indoor trade/process/plant, leisure/personal service, and transport/mobile machine workers had elevated adjusted total odds of seropositivity (1.80 (1.03 to 3.14) - 2.46 (1.82 to 3.33)). Work-related contact accounted for a variable part of increased odds across occupations (1.04 (1.01 to 1.08) - 1.23 (1.09 to 1.40)). Occupations with raised odds of infection after accounting for work-related contact also had greater exposure to poorly ventilated workplaces. CONCLUSIONS Work-related close contact appears to contribute to occupational variation in seropositivity. Reducing contact in workplaces is an important COVID-19 control measure.
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Affiliation(s)
- Sarah Beale
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
| | - Parth Patel
- UCL Institute of Health Informatics, University College London, London, UK
| | - Alison Rodger
- UCL Institute of Health Informatics, University College London, London, UK
| | - Isobel Braithwaite
- Extreme Events and Health Protection Team, Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, London, UK
| | - Thomas Byrne
- UCL Institute of Health Informatics, University College London, London, UK
| | | | - Ellen Fragaszy
- UCL Institute of Health Informatics, University College London, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Cyril Geismar
- UCL Institute of Health Informatics, University College London, London, UK
| | - Jana Kovar
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- UCL Institute of Health Informatics, University College London, London, UK
| | - Annalan Navaratnam
- UCL Institute of Health Informatics, University College London, London, UK
| | - Vincent Nguyen
- UCL Institute of Health Informatics, University College London, London, UK
| | - Madhumita Shrotri
- UCL Institute of Health Informatics, University College London, London, UK
| | - Anna Aryee
- UCL Institute of Health Informatics, University College London, London, UK
| | - Robert Aldridge
- UCL Institute of Health Informatics, University College London, London, UK
| | - Andrew Hayward
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
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Abstract
Background By law, covid-19 disease and deaths in workers may lead to coroners’ inquests and/or Health and Safety Executive (HSE) investigations. Aims This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work. Methods Covid-19 guidance from the chief coroner and the HSE was appraised, including using Office for National Statistics (ONS) data. Practitioners were asked to estimate the likelihood that covid-19 disease may have arisen from ‘near-miss’ scenarios. Data from the judiciary and the HSE were analysed. Results The coroners’ guidance allowed a wider range of reports of death than did the HSE and conformed better with ONS data on covid-19 mortality by occupation. In the practitioner survey, 62 respondents considered a higher likelihood that reported covid-19 cases would have arisen from the scenario deemed unreportable as a ‘dangerous occurrence’ by HSE than the reportable scenario (P < 0.001). On average there was only one coroner’s report to prevent future death from occupational disease every year in England and Wales. The HSE dealt with a yearly average of 1611 reports of work-related disease including 104 on biological agents, but has received about 9000 covid-19 reports. Conclusions Current HSE guidance for reporting work-related covid-19 may miss many thousands of cases and needs further iteration. Coroners have very limited experience of inquiry into occupational disease caused by biological agents compared with the HSE. Concerns regarding national policy such as on protective equipment warrant a full public inquiry.
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Affiliation(s)
- R M Agius
- Emeritus Professor of Occupational and Environmental Medicine, The University of Manchester, Manchester, UK
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Ravalier JM. In this issue of Occupational Medicine. Occup Med (Lond) 2020. [DOI: 10.1093/occmed/kqaa172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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