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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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DOI (Published version): 10.1136/bmjopen-2022-070637

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
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>63574</id><entry>2023-06-02</entry><title>Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank</title><swanseaauthors><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-06-02</date><deptcode>HDAT</deptcode><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 (&gt;55 years: 19% vs &lt;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</abstract><type>Journal Article</type><journal>BMJ Open</journal><volume>13</volume><journalNumber>6</journalNumber><paginationStart>e070637</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2044-6055</issnPrint><issnElectronic>2044-6055</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-06-01</publishedDate><doi>10.1136/bmjopen-2022-070637</doi><url>http://dx.doi.org/10.1136/bmjopen-2022-070637</url><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This research was funded by the Economic &amp; Social Research Council (ESRC), as part of UK Research &amp; 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)</funders><projectreference/><lastEdited>2023-11-14T16:53:10.2543323</lastEdited><Created>2023-06-02T14:55:59.2853453</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Rebecca</firstname><surname>Cannings-John</surname><orcid>0000-0001-5235-6517</orcid><order>1</order></author><author><firstname>Simon</firstname><surname>Schoenbuchner</surname><order>2</order></author><author><firstname>Hywel</firstname><surname>Jones</surname><order>3</order></author><author><firstname>Fiona V</firstname><surname>Lugg-Widger</surname><orcid>0000-0003-0029-9703</orcid><order>4</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>5</order></author><author><firstname>Lucy</firstname><surname>Brookes-Howell</surname><order>6</order></author><author><firstname>Kerenza</firstname><surname>Hood</surname><order>7</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>8</order></author><author><firstname>Daniel Rh</firstname><surname>Thomas</surname><orcid>0000-0002-2426-5893</orcid><order>9</order></author><author><firstname>Hayley</firstname><surname>Prout</surname><order>10</order></author><author><firstname>Michael</firstname><surname>Robling</surname><orcid>0000-0002-1004-036x</orcid><order>11</order></author></authors><documents><document><filename>63574__27927__10f2b1be33944f0da3909195c8ecfa2c.pdf</filename><originalFilename>63574.pdf</originalFilename><uploaded>2023-06-21T16:04:32.4264006</uploaded><type>Output</type><contentLength>972937</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. 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spelling v2 63574 2023-06-02 Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2023-06-02 HDAT 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 Journal Article BMJ Open 13 6 e070637 BMJ 2044-6055 2044-6055 1 6 2023 2023-06-01 10.1136/bmjopen-2022-070637 http://dx.doi.org/10.1136/bmjopen-2022-070637 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University Another institution paid the OA fee 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) 2023-11-14T16:53:10.2543323 2023-06-02T14:55:59.2853453 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Rebecca Cannings-John 0000-0001-5235-6517 1 Simon Schoenbuchner 2 Hywel Jones 3 Fiona V Lugg-Widger 0000-0003-0029-9703 4 Ashley Akbari 0000-0003-0814-0801 5 Lucy Brookes-Howell 6 Kerenza Hood 7 Ann John 0000-0002-5657-6995 8 Daniel Rh Thomas 0000-0002-2426-5893 9 Hayley Prout 10 Michael Robling 0000-0002-1004-036x 11 63574__27927__10f2b1be33944f0da3909195c8ecfa2c.pdf 63574.pdf 2023-06-21T16:04:32.4264006 Output 972937 application/pdf Version of Record true This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/ licenses/by/4.0/. true eng https://creativecommons.org/licenses/by/4.0/
title Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank
spellingShingle Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank
Ashley Akbari
Ann John
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_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_sort Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Ashley Akbari
Ann John
author2 Rebecca Cannings-John
Simon Schoenbuchner
Hywel Jones
Fiona V Lugg-Widger
Ashley Akbari
Lucy Brookes-Howell
Kerenza Hood
Ann John
Daniel Rh Thomas
Hayley Prout
Michael Robling
format Journal article
container_title BMJ Open
container_volume 13
container_issue 6
container_start_page e070637
publishDate 2023
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2022-070637
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1136/bmjopen-2022-070637
document_store_str 1
active_str 0
description 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
published_date 2023-06-01T16:53:14Z
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