Occupational risk of incident COVID-19 related hospital admissions in two Nordic countries with relaxed and rigorous lockdown.

AIMS: To compare COVID-19 related hospital admissions among employees in two Nordic countries that applied a relaxed (Skåne, Sweden) and a rigorous (Denmark) lockdown during the pandemic.

METHODS

We did a register-based follow-up study of the incidence of first-time COVID-19 related hospital admission among all employees aged 20-69 years in Skåne and Denmark. Analyses were performed separately at each site, but according to a uniform study protocol. Adjusted incidence rate ratios (IRRs) during follow-up, 2020 and 2021, for 30 selected occupations were computed by Poisson regression using a reference population of mainly office workers.

RESULTS

The incidence of COVID-19 related hospital admission was 2.02/1000 person-years in Skåne (2443 admissions among 607,179 individuals) and 1.01/1000 person-years in Denmark (4416 admissions among 2,451,542 individuals). The relative risk of COVID-19 related hospital admission was increased among healthcare and transportation workers in both countries (Skåne: IRR 1.38 (95% confidence interval (CI) 1.18-1.60) and 1.33 (95% CI 1.08-1.78), respectively; Denmark: IRR 1.56 (95% CI 1.39-1.75) and 1.48 (95% CI 1.23-1.78), respectively). The relative risk for occupations within education, retail sales, and a broad group of service occupations were, with few exceptions, not increased in either country. There was no indication of higher relative risks in Skåne compared with Denmark-if anything the opposite.

CONCLUSIONS

The relative risk of COVID-19 in at-risk occupations was not higher in a country with relaxed lockdown compared with a country applying rigorous legal lockdown. However, higher absolute risk of infection in Skåne, Sweden might have attenuated occupational differences in hospital admissions.