Ethnic background and risk of SARS-CoV-2 infection among the healthcare workforces: Results of a large occupational cohort study in rural United Kingdom.
Abstract Black and South Asian healthcare workers have been found at higher risk of SARS-CoV-2 infection in the United Kingdom. However, many studies do not consider all potential confounders (e.g., professional exposure, living environment) and those conducted during the second wave of the COVID-19 outbreak remain scarce. Using 1-year-folow-up data from a cohort of 13,366 healthcare workers employed in 119 facilities in Lincolnshire, we aimed to quantify the risk of SARS-CoV-2 infection among ethnic minority healthcare staff and to elucidate pathways of infection. Overall, 1258 individuals (9.4%) recorded a positive SARS-CoV-2 test during the observation period, incidence per person-year was 5.2% [Cluster adjusted 95% CI: 3.6–7.6%] during the first COVID-19 wave (Jan-Aug 2020) and 17.2% [13.5–22.0%] during the second wave (Sep 2020-Feb 2021). Compared to Whites, Black and South Asian employees were at higher risk of SARS-CoV-2 infection during both the first wave (Clustered adjusted Hazard Ratio, 1.58 [0.91-2.75] and 1.69 [1.07-2.66] respectively) and the second wave (HR 2.09 [1.57-2.76] and 1.46 [1.24-1.71]). Higher risk of SARS-CoV-2 infection significantly persisted even after controlling on age, gender, pay grade, residence environment, type of work and time exposure at work. Higher adjusted risk of SARS-CoV-2 infection were also found among lower-paid health professionals. Black and South Asian health workers continue to be more exposed to SARS-CoV-2 infection compared to their white counterparts. Urgent interventions are required to reduce SARS-CoV-2 exposure with these ethnic groups.
