Occupational differences in COVID-19 hospital admission and mortality risks between women and men in Scotland: a population-based study using linked administrative data

IntroductionOccupations vary with respect to workplace factors that influence exposure to COVID-19, such as ventilation, social contacts and protective equipment. Variations between women and men may arise because they have different occupational roles or behavioural responses. We estimate occupational differences in COVID-19 hospital admission and mortality risks by sex. MethodsWe combined individual-level data from 2011 Census with (i) health records and (ii) household-level information from residential identifiers. We used data for a cohort of 1.7 million Scottish adults aged 40-64 years between 1 March 2020 and 31 January 2021. We estimated age-standardised COVID-19 hospital admission and mortality rates, stratified by sex and occupation. Using Cox proportional hazards models, we estimated COVID-19 hospital admission and death risks, adjusting for relevant factors. ResultsGenerally, women had lower age-standardised COVID-19 hospital admission and mortality rates compared to men. Among women, adjusted death risks were lower for health professionals, and those in associate professional and technical occupations (paramedics and medical technicians). Among men, elevated adjusted admission and death risks were observed for large vehicle and taxi drivers. Additionally, admission risks remained high among men working in caring personal services, including home and care workers, while elevated risks were observed among women working in customer service occupations (call centre operators) and as process, plant and machine operatives (assemblers/sorters). ConclusionOccupational differences in COVID-19 hospital admission and mortality risks between women and men highlight the need to account for sex differences when developing interventions to reduce infections among vulnerable occupational groups.