Articlehybrid2021

Shift work is associated with positive COVID-19 status in hospitalised patients

Robert J. Maidstone · Simon George Anderson · David William Ray · Martin K. Rutter · Hannah Jane Durrington · John Blaikley

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Sleep and Work-Related Fatigue Circadian rhythm and melatonin COVID-19 epidemiological studies

Abstract

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.

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2016Health consequences of shift work and insufficient sleep 2017Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being 2013Chronotype Modulates Sleep Duration, Sleep Quality, and Social Jet Lag in Shift-Workers 2018Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank 2019Working conditions in a global perspective 2002Prevalence of Common Infections Among Employees in Different Work Schedules 2020Night shift work is associated with an increased risk of asthma

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