RT Journal Article
SR Electronic
T1 Shift work is associated with positive COVID-19 status in hospitalised patients
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 601
OP 606
DO 10.1136/thoraxjnl-2020-216651
VO 76
IS 6
A1 Robert Maidstone
A1 Simon G Anderson
A1 David W Ray
A1 Martin K Rutter
A1 Hannah J Durrington
A1 John F Blaikley
YR 2021
UL http://thorax.bmj.com/content/76/6/601.abstract
AB Introduction Shift work is associated with lung disease and infections. We therefore investigated the impact of shift work on significant COVID-19 illness.Methods 501 000 UK Biobank participants were linked to secondary care SARS-CoV-2 PCR results from Public Health England. Healthcare worker occupational testing and those without an occupational history were excluded from analysis.Results Multivariate logistic regression (age, sex, ethnicity and deprivation index) revealed that irregular shift work (OR 2.42, 95% CI 1.92 to 3.05), permanent shift work (OR 2.5, 95% CI 1.95 to 3.19), day shift work (OR 2.01, 95% CI 1.55 to 2.6), irregular night shift work (OR 3.04, 95% CI 2.37 to 3.9) and permanent night shift work (OR 2.49, 95% CI 1.67 to 3.7) were all associated with positive COVID-19 tests compared with participants that did not perform shift work. This relationship persisted after adding sleep duration, chronotype, premorbid disease, body mass index, alcohol and smoking to the model. The effects of workplace were controlled for in three ways: (1) by adding in work factors (proximity to a colleague combined with estimated disease exposure) to the multivariate model or (2) comparing participants within each job sector (non-essential, essential and healthcare) and (3) comparing shift work and non-shift working colleagues. In all cases, shift work was significantly associated with COVID-19. In 2017, 120 307 UK Biobank participants had their occupational history reprofiled. Using this updated occupational data shift work remained associated with COVID-19 (OR 4.48 (95% CI 1.8 to 11.18).Conclusions Shift work is associated with a higher likelihood of in-hospital COVID-19 positivity. This risk could potentially be mitigated via additional workplace precautions or vaccination.Data are available on reasonable request.