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Health care personnel frequently work with influenza-like symptoms
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A recent national survey found that more than 40% of health care professionals with an influenza-like illness went to work while they were sick.
“The statistics are alarming. At least one earlier study has shown that patients who are exposed to a health care worker who is sick are five times more likely to get a health-care associated infection,” Sophia Chiu, MD, MPH, of the National Institute of Occupational Safety and Health, said in a press release. “We recommend all health care facilities take steps to support and encourage their staff to not work while they are sick.”
Chiu and colleagues conducted an online survey of 1,914 health care personnel (HCP) across the U.S. during the 2014-2015 influenza season. The researchers calculated the self-reported frequency of HCPs working with symptoms such as fever and cough or sore throat, and they assessed their reasons for going to work while ill.
A total of 414 (21.6%) professionals reported experiencing influenza-like illnesses, Chiu and colleagues wrote. Of these, 41.4% reported that they had worked while ill (median, 3 days).Of those who went to work while they were sick, pharmacists (67.2%) had the highest frequency, followed by physicians (63.2%). HCPs who worked in hospitals had the highest incidence of working while ill (49.3%).
The most commonly cited reasons for coming into work sick were that HCPs could still carry out their duties and did not feel “bad enough to miss work,” the researchers wrote. However, roughly half of respondents who worked at long-term care facilities said they reported to work while sick because they could not afford to lose pay (49.8%).
“Understanding the reasons for presenteeism can help inform interventions to reduce health care-associated influenza transmission,” Chiu told Infectious Disease News.
“To reduce HCP-associated influenza transmission, interventions should target HCP misconceptions about working while ill and consider the influence of paid sick leave policies,” the researchers wrote. – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Health care settings are known sites for influenza transmission. Compliance with vaccination among HCPs is poor, and — as this study found — some HCPs often continue to work while ill. The study was conducted to understand the magnitude of and reasons why HCPs with influenza-like illness (ILI) still report to work, known as presenteeism.
The researchers used a national nonprobability internet panel survey of HCPs during the 2014-2015 influenza season, calculated the frequency of HCPs who worked with self-reported ILI (eg, fever and cough or sore throat) and examined their reasons for working with ILI. The study pulled data from HCPs across occupations and work settings.
In total, 12 probable reasons were offered for HCPs to select why they still came to work despite having ILI. Of these, the survey identified the most common reasons for HCP presenteeism, namely “I could still perform my job duties,” “I wasn’t feeling bad enough to miss work,” “I did not think I was contagious or could make other people sick,” “I have a professional obligation to my co-workers,” and “It is difficult for me to find someone to cover for me.”
Researchers also found that 44.6% of HCPs who reported working with ILI received an influenza vaccination, compared with 29.2% who were not vaccinated. HCPs’ perceptions about their ability to perform duties and professional obligations reflected a misconception about the risks of ILI to patients and colleagues.
The study’s limitations included that the data from the opt-in internet panel did not stem from a random sample and, thus, the results might not be generalizable to all HCPs. In addition, the sample size was small, and the timing of symptoms was unknown. Moreover, the severity and duration of the symptoms — factors that might influence the decision to work with ILI — were not directly assessed.
The study suggests that presenteeism with ILI is common among HCPs across occupations and work settings. Clinical encounters are opportunities for medical providers to reinforce recommendations to HCPs to refrain from working with ILI. Also, misconceptions about ILI among HCPs must be addressed, including ensuring HCPs are aware of sick leave policies.
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