Health care workers may be less likely to report for work during influenza pandemic

The rate of health care workers in Montreal who intend to report for work may decrease by more than 30% over a six-week period during the evolution of an influenza pandemic, according to findings presented at the 49th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy.

Data were presented by Andre Dascal, MD, from the division of infectious diseases at McGill University in Montreal. The data was from studies performed in collaboration with Prof. Georges Dionne and his team at Haures Etudes Commerciale and Universite de Montreal.

“We wanted to answer two questions: during an influenza pandemic, how does risk perception for personal and work activities influence whether health care workers report for work?” Dascal said. “And, as the wave occurs, what impact will an increase in determining factors such as affected hospitals and mortality rates have on the number of health care workers who report for work?”

The study was conducted using a 20 to 30-minute web-based survey, carried out from April 2008 to January 2009. There were 3,971 professional health care workers involved in the study. These included professionals as well as support and administrative staff. The researchers used factor analysis to construct scores and determine risk perception factors that applied to various contexts.

“In addition to asking influenza-related questions, we asked about such topics as smoking and lung cancer risk, being stuck with a needle and HIV risk,” Dascal said.

Three hypothetical scenarios of influenza pandemic severity were created and participants were asked whether they would report for work if similar circumstances arose. The hypothetical scenarios were based on an attack rate of 15% and a mortality rate of 0.23%.

“As an influenza pandemic evolves, the likelihood of reporting for work among the study population decreased from 88% in week one to 52% in week six,” Dascal said. “Additionally, the overestimation of risk perception scores varied from -2.4 to +3.8, with an average of zero.”

Risk perception scores impacted the likelihood of reporting for work during a wave of influenza. Health care workers with an overestimate score of 1 were 25% less likely to report to work than those with a score of zero.

The survey also contained questions about reasons for absenteeism. “The main reasons cited for not reporting for work among participants in Montreal included protecting their own health, protecting the health of their family and not trusting safety measures at work,” Dascal said. “The top three reasons to report to work included a moral responsibility, a lack of concern for personal health and trust in the safety of the work environment. Basically, the reasons to work were the mirror opposite of the reasons not to.”

Dascal said risk perception among health care workers plays a major role in their approach toward working during an influenza pandemic. “The main conclusion we can draw from these data is that risk perception was associated less with the risk surrounding pandemic than to the risk surrounding professional and personal lives of the participants,” Dascal said. “They may be non-risk takers or individuals overestimating a number of risks, which leads us to believe that it is not as simple as educating health care workers about pandemic risks or the nature of disease. It is more about the nature of the person involved.”

Dascal A. #K-1918c. Presented at: the 49th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy; San Francisco; Sept. 11-15, 2009.