{
  "abstract": "Background During the COVID-19 pandemic, certain occupational groups faced elevated infection risks. This study investigated changes in occupational risks of COVID-19 hospitalisation between 2020 and 2021.Methods Using a case–cohort design, we analysed data from Germany’s Allgemeine Ortskrankenkasse statutory health insurance, including 28 925 COVID-19 hospitalisation cases and 498 484 non-cases in 2021. HRs with administrative workers as reference were calculated using weighted and stratified Cox regression models, adjusting for age, sex, comorbidities and socioeconomic status. The ratio of relative risk (RRR) assessed the differences between years.Results Healthcare workers showed the greatest reduction in relative risk (HR 2020=2.74, 95% CI 2.46 to 3.05; HR2021=1.58, 95% CI 1.47 to 1.69; RRR=1.73), though remaining elevated compared with administrative workers. Social welfare occupations also experienced a statistically significant risk reduction (HR2020=1.62, 95% CI 1.42 to 1.85; HR2021=1.32, 95% CI 1.21 to 1.44; RRR=1.23). Bank clerks changed from slightly elevated risk to below the reference (HR2020=1.23, 95% CI 0.93 to 1.63; HR2021=0.76, 95% CI 0.62 to 0.94; RRR=0.85). Conversely, HRs for sales occupations increased between 2020 and 2021 (HR2020=1.04, 95% CI 0.92 to 1.18; HR2021=1.23, 95% CI 1.14 to 1.33; RRR=0.85). Several occupations maintained stable elevated risks, including bus drivers, meat processing workers and personal care workers.Conclusions We observed a risk reduction in some sectors, particularly healthcare, likely due to vaccination and protective measures. However, certain occupations maintained elevated risks, perhaps due to unavoidable close physical contact. These findings suggest the need for sector-specific approaches to occupational health protection and permanent structural changes in workplace organisation for future pandemic preparedness.",
  "authors": [
    {
      "affiliations": [
        "Institute and Policlinic of Occupational and Social Medicine (IPAS), Technische Universität Dresden, Dresden, Germany"
      ],
      "name": "Karla Romero Starke"
    },
    {
      "affiliations": [
        "Institute and Policlinic of Occupational and Social Medicine (IPAS), Technische Universität Dresden, Dresden, Germany",
        "Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany"
      ],
      "name": "René Mauer"
    },
    {
      "affiliations": [
        "Institute and Policlinic of Occupational and Social Medicine (IPAS), Technische Universität Dresden, Dresden, Germany"
      ],
      "name": "Ulrich Bolm-Audorff"
    },
    {
      "affiliations": [
        "Institute and Policlinic of Occupational and Social Medicine (IPAS), Technische Universität Dresden, Dresden, Germany",
        "Division Work and Health, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany"
      ],
      "name": "Janice Hegewald"
    },
    {
      "affiliations": [
        "AOK Research Institute (WIdO), Berlin, Germany"
      ],
      "name": "Gabriela Brückner"
    },
    {
      "affiliations": [
        "AOK Research Institute (WIdO), Berlin, Germany"
      ],
      "name": "Katrin Schüssel"
    },
    {
      "affiliations": [
        "AOK Research Institute (WIdO), Berlin, Germany"
      ],
      "name": "Helmut Schröder"
    },
    {
      "affiliations": [
        "University Clinics Hamburg Eppendorf, Institute for Health Service Research in Dermatology and Nursing and German Social Accident Insurance Institution for the Health and Welfare Service, Department of Occupational Health Research, Hamburg, Germany"
      ],
      "name": "Albert Nienhaus"
    },
    {
      "affiliations": [
        "Institute and Policlinic of Occupational and Social Medicine (IPAS), Technische Universität Dresden, Dresden, Germany"
      ],
      "name": "Andreas Seidler"
    }
  ],
  "title": "Temporal changes in occupational risks of COVID-19 hospitalisation in Germany, 2020–2021: a case–cohort study",
  "uid": "b83458a6-3fd2-5fc4-aa54-e62288e347ee"
}