A total of 2,494 deaths involving the coronavirus (COVID-19) in the working age population (those aged 20 to 64 years) of England and Wales were registered up to and including 20 April 2020.
Nearly two-thirds of these deaths were among men (1,612 deaths), with the rate of death involving COVID-19 being statistically higher in males, with 9.9 deaths per 100,000 compared with 5.2 deaths per 100,000 females (882 deaths).
Compared with the rate among people of the same sex and age in England and Wales, men working in the lowest skilled occupations had the highest rate of death involving COVID-19, with 21.4 deaths per 100,000 males (225 deaths); men working as security guards had one of the highest rates, with 45.7 deaths per 100,000 (63 deaths).
Men and women working in social care, a group including care workers and home carers, both had significantly raised rates of death involving COVID-19, with rates of 23.4 deaths per 100,000 males (45 deaths) and 9.6 deaths per 100,000 females (86 deaths).
Healthcare workers, including those with jobs such as doctors and nurses, were not found to have higher rates of death involving COVID-19 when compared with the rate among those whose death involved COVID-19 of the same age and sex in the general population.
Among men, a number of other specific occupations were found to have raised rates of death involving COVID-19, including: taxi drivers and chauffeurs (36.4 deaths per 100,000); bus and coach drivers (26.4 deaths per 100,000); chefs (35.9 deaths per 100,000); and sales and retail assistants (19.8 deaths per 100,000).
This analysis does not prove conclusively that the observed rates of death involving COVID-19 are necessarily caused by differences in occupational exposure; we adjusted for age, but not for other factors such as ethnic group and place of residence. We have also published an article that explores possible differences in occupation exposure to COVID-19.
Recent analysis on the occupations with the highest potential exposure to the coronavirus (COVID-19) shows the jobs that are most likely to be exposed are those involving close proximity with others and those where there is regular exposure to disease. Examples include healthcare workers such as nurses and dental practitioners, though during the pandemic some of these are more likely to be using personal protective equipment.
As with our analysis on the occupations with the highest potential exposure to COVID-19, some experts have concluded that COVID-19 exposure will be highest among occupations involving frequent and close interaction with others, either directly, such as healthcare workers attending to sick patients, or indirectly, such as occupations handling goods.
Among initial reported cases in Wuhan, China, a significant proportion of cases have been linked to occupational exposure. The first documented cases were among people working in a sea food and wet animal wholesale market, where the virus is thought to have originated. As cases increased, healthcare workers were seen as another high exposure group; in a series of 138 cases treated in a Wuhan hospital, 29% or 40 of these cases were among healthcare workers. The exposure among healthcare workers has also been identified in other countries, including Italy and the US. Other occupations that have been highlighted as having a possible exposure include protective service occupations, office and administrative support occupations, educational occupations, community and social services occupations, and construction occupations.Back to table of contents
Occupation was defined using the Standard Occupational Classification 2010 (SOC 2010). Full lists of occupations used in the analysis are reported in the accompanying data tables, and descriptions of these can be found in the Office for National Statistics (ONS) SOC Hierarchy. Deaths and the population at risk (see Measuring the data) were both coded using this classification system.Back to table of contents
The figures described in this bulletin include deaths registered in England and Wales between 9 March and 20 April 2020. Deaths were only included in the analyses if the country of usual residence was also England and Wales.
Deaths were defined using the International Classification of Diseases, 10th Revision (ICD-10). Deaths involving the coronavirus (COVID-19) include those with an underlying cause, or any mention, of ICD-10 codes U07.1 (COVID-19, virus identified) or U07.2 (COVID-19, virus not identified). We applied an age restriction, selecting deaths among those aged 20 to 64 years, because of limitations of occupational mortality data for those below the age of 20 years and those above the age of 64 years.
Occupation is reported on the death certificate at the time of death registration by the informant. This information was then coded using the Standard Occupational Classification 2010 (SOC 2010) (see the Glossary).
During the period of analysis, a total of 1,612 deaths and 882 deaths involving COVID-19 were registered among men and women aged 20 to 64 years, respectively. Among men, 81.9% of the deaths (or 1,321 deaths) had information on occupation recorded on the death certificate. For women, this figure was 531 deaths (or 60.2%). For the 291 deaths with no recorded information on occupation among men, the majority of these were because the occupation was not stated on the death certificate (87.3% of these deaths, or 254 deaths). Among women, the majority of the 351 records with no information on occupation were recorded as: full-time carers of the home and/or dependent relatives or that they were working voluntarily (55.8% of these deaths, or 196 deaths) or the occupation was not stated (42.7% of these deaths, or 150 deaths). Of the records included in the analysis of COVID-19 deaths by occupation, the mean age at death for men was 56 years and for women it was 55 years.
Further information on death registrations data can be found in the Mortality statistics in England and Wales QMI.
Population counts for occupations were obtained from the Annual Population Survey (APS), using data collected in 2019. The APS is the largest ongoing household survey in the UK, based on interviews with members of randomly selected households. The survey covers a range of diverse topics, including information on occupation, which is then coded using the SOC 2010. The population counts were also restricted to those aged 20 to 64 years and were weighted to be representative of those living in England and Wales. Further information on the APS can be found in the APS QMI.
Mortality rates for the broader population of all usual residents in England and Wales were based on the mid-year population estimates for 2018.
Figures in the commentary are based on age-standardised mortality rates. These refer to a weighted average of deaths per 100,000 people of a particular age group that is standardised to the 2013 European Standard Population. They allow for differences in age structure of populations and therefore allow valid comparisons to be made between the sexes and different occupations.
The commentary reports findings for occupations with rates that are statistically significantly higher than the rate among those of the same age and sex in England and Wales. Significance has been determined using 95% confidence intervals, which provide the range of values within which we are 95% confident that the true value lies. Instances of non-overlapping confidence intervals between figures indicate the difference is unlikely to have arisen from random fluctuation. The 95% confidence intervals for the estimates are available in the accompanying reference tables.Back to table of contents
In this bulletin, we only refer to occupations that have at least 20 deaths. For these, reliable age-standardised rates can be calculated, reducing the likelihood of the findings being a result of chance. In our accompanying reference tables, rates have been marked as unreliable where there are fewer than 20 deaths, and we have not produced rates for occupations with fewer than 10 deaths. A robust method is used for the analysis: age-standardised rates allow for differences in age structure of populations and therefore allow valid comparisons to be made between the sexes and different occupations.
Quality assurance procedures have been undertaken throughout all stages of the analysis to minimise the risk of error. As an additional step, we have compared some of the data reported here with some of the data being reported in national and local media sources. We found good comparability, with our data appearing to account for most of, if not more than, the numbers of deaths being reported elsewhere (Table 1).
|Web scraped numbers||ONS death registration numbers|
|Occupation||Number aged 20 to 64 years||Number where age was unavailable||Number aged 20 to 64 years|
|Health and social care professions|
|Nurses and midwives||27||9||41|
|Care and support staff||26||13||125|
|Non health and social care professions|
Download this table Table 1: Numbers of deaths involving COVID-19, comparing number of deaths web scraped from national and regional media websites and ONS death registration numbers in this release.xls .csv
Some caution is need in interpreting the findings as this analysis does not prove conclusively that the observed rates of death involving coronavirus (COVID-19) are necessarily caused by differences in occupational exposure. In the analysis we adjusted for age, but not for other factors such as ethnic group, place of residence or deprivation. We have also published an article that explores possible differences in occupation exposure to COVID-19. Additionally, the analysis only considers the occupation of the deceased. We have not taken account of the occupations of others in the household, which could increase exposure to other members of the same household.
The results could change as more deaths are registered over the coming weeks and months. In particular, there may be deaths in some occupations that cannot yet be registered because a coroner’s inquest is required.
The analysis includes all deaths with information on occupation that have been registered pre- and post-lockdown. When more death registrations data are received, future analysis should see how the rate of death involving COVID-19 differs among occupations in the pre- and post-lockdown periods.
The data were taken from two separate sources: death certificates and the Annual Population Survey (APS). The findings could be impacted by a degree of bias because of the misalignment of occupation data between the two sources.
The occupation recorded on the death certificate is reported by the informant and likely reflects the deceased’s main lifetime occupation or the occupation at the time of death. It is also possible that, when they died, the deceased was retired, unemployed or in a different job altogether. Despite this, the occupations found to have higher rates of death involving COVID-19 are generally consistent with recent literature on the occupations that are more likely to be exposed to the virus.
At the time of analysis, we used the most recently available occupation populations, based on data collected in 2019. The analysis may be affected if there has been a rapid increase or decrease in the number of workers in a specific occupation since then.
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