Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank
Objectives To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, working during the COVID-19 pandemic.Design A population-level retrospective study linking occupational registration data to anonymised electronic health records maintained by the Secure Anonymised Infor...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e070637.full |
| _version_ | 1797749094888767488 |
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| author | Ashley Akbari Ann John Fiona V Lugg-Widger Kerenza Hood Hayley Prout Rebecca Cannings-John Hywel Jones Lucy Brookes-Howell Michael Robling Daniel Rh Thomas Simon Schoenbuchner |
| author_facet | Ashley Akbari Ann John Fiona V Lugg-Widger Kerenza Hood Hayley Prout Rebecca Cannings-John Hywel Jones Lucy Brookes-Howell Michael Robling Daniel Rh Thomas Simon Schoenbuchner |
| author_sort | Ashley Akbari |
| collection | DOAJ |
| description | Objectives To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, working during the COVID-19 pandemic.Design A population-level retrospective study linking occupational registration data to anonymised electronic health records maintained by the Secure Anonymised Information Linkage Databank in a privacy-protecting trusted research environment.Setting Registered DCW population in Wales.Participants Records for all linked DCWs from 1 March 2020 to 30 November 2021.Primary and secondary outcome measures Our primary outcome was confirmed COVID-19 infection; secondary outcomes included contacts for suspected COVID-19, mental health including self-harm, fit notes, respiratory infections not necessarily recorded as COVID-19, deaths involving COVID-19 and all-cause mortality.Results Confirmed and suspected COVID-19 infection rates increased over the study period to 24% by 30 November 2021. Confirmed COVID-19 varied by sex (males: 19% vs females: 24%) and age (>55 years: 19% vs <35 years: 26%) and were higher for care workers employed by local authority social services departments compared with the private sector (27% and 23%, respectively). 34% of DCWs required support for a mental health condition, with mental health-related prescribing increasing in frequency when compared with the prepandemic period. Events for self-harm increased from 0.2% to 0.4% over the study period as did the issuing of fit notes. There was no evidence to suggest a miscoding of COVID-19 infection with non-COVID-19 respiratory conditions. COVID-19-related and all-cause mortality were no greater than for the general population aged 15–64 years in Wales (0.1% and 0.034%, respectively). A comparable DCW workforce in Scotland and England would result in a comparable rate of COVID-19 infection, while the younger workforce in Northern Ireland may result in a greater infection rate.Conclusions While initial concerns about excess mortality are alleviated, the substantial pre-existing and increased mental health burden for DCWs will require investment to provide long-term support to the sector’s workforce. |
| first_indexed | 2024-03-12T16:14:15Z |
| format | Article |
| id | doaj.art-37972482fbd94df6a425d04e6679e438 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T16:14:15Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-37972482fbd94df6a425d04e6679e4382023-08-09T05:15:08ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2022-070637Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL DatabankAshley Akbari0Ann John1Fiona V Lugg-Widger2Kerenza Hood3Hayley Prout4Rebecca Cannings-John5Hywel Jones6Lucy Brookes-Howell7Michael Robling8Daniel Rh Thomas9Simon Schoenbuchner10Swansea University Medical School, Swansea University, Swansea, UKSwansea University Medical School, Swansea, UKCentre for Trials Research, Cardiff University, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKDivision of Population Medicine, Cardiff University, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKCommunicable Disease Surveillance Centre, Public Health Wales, Cardiff, UKCentre for Trials Research, Cardiff University, Cardiff, UKObjectives To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, working during the COVID-19 pandemic.Design A population-level retrospective study linking occupational registration data to anonymised electronic health records maintained by the Secure Anonymised Information Linkage Databank in a privacy-protecting trusted research environment.Setting Registered DCW population in Wales.Participants Records for all linked DCWs from 1 March 2020 to 30 November 2021.Primary and secondary outcome measures Our primary outcome was confirmed COVID-19 infection; secondary outcomes included contacts for suspected COVID-19, mental health including self-harm, fit notes, respiratory infections not necessarily recorded as COVID-19, deaths involving COVID-19 and all-cause mortality.Results Confirmed and suspected COVID-19 infection rates increased over the study period to 24% by 30 November 2021. Confirmed COVID-19 varied by sex (males: 19% vs females: 24%) and age (>55 years: 19% vs <35 years: 26%) and were higher for care workers employed by local authority social services departments compared with the private sector (27% and 23%, respectively). 34% of DCWs required support for a mental health condition, with mental health-related prescribing increasing in frequency when compared with the prepandemic period. Events for self-harm increased from 0.2% to 0.4% over the study period as did the issuing of fit notes. There was no evidence to suggest a miscoding of COVID-19 infection with non-COVID-19 respiratory conditions. COVID-19-related and all-cause mortality were no greater than for the general population aged 15–64 years in Wales (0.1% and 0.034%, respectively). A comparable DCW workforce in Scotland and England would result in a comparable rate of COVID-19 infection, while the younger workforce in Northern Ireland may result in a greater infection rate.Conclusions While initial concerns about excess mortality are alleviated, the substantial pre-existing and increased mental health burden for DCWs will require investment to provide long-term support to the sector’s workforce.https://bmjopen.bmj.com/content/13/6/e070637.full |
| spellingShingle | Ashley Akbari Ann John Fiona V Lugg-Widger Kerenza Hood Hayley Prout Rebecca Cannings-John Hywel Jones Lucy Brookes-Howell Michael Robling Daniel Rh Thomas Simon Schoenbuchner Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank BMJ Open |
| title | Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank |
| title_full | Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank |
| title_fullStr | Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank |
| title_full_unstemmed | Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank |
| title_short | Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank |
| title_sort | impact of the covid 19 pandemic on domiciliary care workers in wales uk a data linkage cohort study using the sail databank |
| url | https://bmjopen.bmj.com/content/13/6/e070637.full |
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