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Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank

Rebecca Cannings-John Orcid Logo, Simon Schoenbuchner, Hywel Jones, Fiona V Lugg-Widger Orcid Logo, Ashley Akbari Orcid Logo, Lucy Brookes-Howell, Kerenza Hood, Ann John Orcid Logo, Daniel Rh Thomas Orcid Logo, Hayley Prout, Michael Robling Orcid Logo

BMJ Open, Volume: 13, Issue: 6, Start page: e070637

Swansea University Authors: Ashley Akbari Orcid Logo, Ann John Orcid Logo

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Abstract

Objectives To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, workingduring 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...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa63574
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Abstract: Objectives To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, workingduring 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 March2020 to 30 November 2021.Primary and secondary outcome measuresOur primary outcome was confirmed COVID-19 infection; secondary outcomes included contacts for suspected COVID-19, mental health including self-harm, fit notes, respiratory infections notnecessarily recorded as COVID-19, deaths involving COVID-19 and all-cause mortality. ResultsConfirmed 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 wasno 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 generalpopulation 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-19infection, 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
College: Faculty of Medicine, Health and Life Sciences
Funders: This research was funded by the Economic & Social Research Council (ESRC), as part of UK Research & Innovation’s rapid response to COVID-19 (ES/ V015206/1). The Centre for Trials Research receives funding from Health and Care Research Wales and Cancer Research UK. The data acquisition and COVID-19 research was supported by Health Data Research UK (HDR-9006), which receives its funding from HDR UK, and the ADR Wales programme of work) funded ADR UK (grant ES/S007393/1)
Issue: 6
Start Page: e070637