Occupational role and COVID-19 among foreign-born healthcare workers in Sweden: a registry-based study. (10th February 2023)

• Record Type: Journal Article
• Authors: Nwaru, Chioma; Li, Huiqi; Bonander, Carl; Santosa, Ailiana; Franzén, Stefan; Rosvall, Maria; Nyberg, Fredrik
• Is Part Of: European journal of public health. Volume 33:Number 2(2023)
• Page Start: 202
• Page End: 208
• Publication Date: 2023-02-10
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckad016
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: Many studies report that foreign-born healthcare workers (HCWs) in high-income countries have an elevated risk of COVID-19. However, research has not yet specifically evaluated the distribution of COVID-19 among foreign-born workers in different healthcare work groups. We examined the risk of COVID-19 infection and hospitalization among foreign-born HCWs in different occupational roles in Sweden. Methods: We linked occupational data (2019) of 783 950 employed foreign-born workers (20–65 years) to COVID-19 data registered between 1 January 2020 and 30 September 2021. We used Cox proportional hazards regression to estimate the hazard ratio (HR) with 95% confidence intervals (95% CIs) of COVID-19 infection and hospitalization in eight healthcare occupational groups vs. non-HCWs and assessed whether region of birth modified the association between healthcare occupations and COVID-19. Results: All HCWs had a higher risk of COVID-19 outcomes than non-HCWs, but the risk differed by occupational role. Hospital-based assistant nurses had the highest risk (infection: HR 1.78; 95% CI 1.72–1.85; hospitalization: HR 1.79; 95% CI 1.52–2.11); allied HCWs had the lowest risk (infection: HR 1.22; 95% CI 1.10–1.35; hospitalization: HR 0.98; 95% CI 0.59–1.63). The relative hazard of the outcomes varied across foreign-born workers from different regions. For example, the relative risk of COVID-19 infection associated with being a physician compared to a non-HCW was 31% higher for African-born than European-born workers. Conclusions: The risk of COVID-19 among foreign-born HCWs differed by occupational role and immigrant background. Public health efforts that target occupational exposures as well as incorporate culturally responsive measures may help reduce COVID-19 risk among foreign-born HCWs.