Excess mortality associated with the COVID-19 pandemic among Californians 18-65 years of age, by occupational sector and occupation: March through November 2020.
Excess mortality associated with the COVID-19 pandemic among Californians 18-65 years of age, by occupational sector and occupation: March through November 2020.
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DOI：
10.1371/journal.pone.0252454
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Bibbins-Domingo K
中科院分区：
文献类型：
--
作者：
Chen YH;Glymour M;Riley A;Balmes J;Duchowny K;Harrison R;Matthay E;Bibbins-Domingo K
虽然SARS-CoV-2爆发在职业环境中有记录，并且亲自从事必要工作被怀疑是COVID-19的风险因素，但迄今为止，尚未研究过超额死亡率的职业差异。这些信息可以指出干预的机会，例如疫苗的优先顺序或实施更安全工作环境的法规。使用自回归积分移动平均模型和加州公共卫生部的数据，代表2016年1月1日至2020年11月30日期间死亡的356，188名18-65岁死者，我们按职业部门和职业估计了流行病相关的超额死亡率，并按种族/民族对部门分析进行了额外分层。在COVID-19疫情的前9个月，工作年龄成年人的死亡人数比预期多出11，628人，相当于每100，000名活着的人中有22%的相对超额和46人超额死亡。相对和人均超额死亡率最高的部门是食品/农业（相对超额39%;每10万人中有75人超额死亡），运输/物流（31%;每10万人中有91人），制造业（24%;每10万人中有61人）和设施（23%;每10万人中有83人）。在种族和族裔群体中，拉丁裔工作年龄的加州人经历了最高的相对超额死亡率（37%），其中拉丁裔食品和农业工人的超额死亡率最高（59%;每10万人中有97人）。加州工作年龄的黑人人均超额死亡率最高（每10万人中有110人），运输/物流工人的相对超额死亡率最高（36%）。亚裔工作年龄的加州人总体超额死亡率较低，但卫生/紧急工作人员的相对超额死亡率显著（37%），而白色加州人在设施工作人员中的人均超额死亡率较高（每10万人中有70人）。在疫情期间，某些职业部门与高超额死亡率有关，特别是在受COVID-19影响不成比例的种族和族裔群体中。面对面的基本工作是冠状病毒感染的可能传播场所，必须通过接种疫苗和在工作场所严格执行卫生命令来解决。
Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments. Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18–65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000). Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.