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Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during 4 influenza seasons: 2010–2011 to 2013–2014

  • Lili Jiang (a1), Allison McGeer (a1) (a2), Shelly McNeil (a3) (a4), Kevin Katz (a2) (a5), Mark Loeb (a6) (a7), Matthew P. Muller (a2) (a8), Andrew Simor (a2) (a9), Jeff Powis (a10), Philipp Kohler (a1), Julia M. Di Bella (a2), Brenda L. Coleman (a1) (a2) and for the Canadian Healthcare Worker Study Group (a1) (a2) (a3) (a4) (a5) (a6) (a7) (a8) (a9) (a10)...

Abstract

Background:

Healthcare workers (HCWs) are at risk of acquiring and transmitting respiratory viruses while working in healthcare settings.

Objectives:

To investigate the incidence of and factors associated with HCWs working during an acute respiratory illness (ARI).

Methods:

HCWs from 9 Canadian hospitals were prospectively enrolled in active surveillance for ARI during the 2010–2011 to 2013–2014 influenza seasons. Daily illness diaries during ARI episodes collected information on symptoms and work attendance.

Results:

At least 1 ARI episode was reported by 50.4% of participants each study season. Overall, 94.6% of ill individuals reported working at least 1 day while symptomatic, resulting in an estimated 1.9 days of working while symptomatic and 0.5 days of absence during an ARI per participant season. In multivariable analysis, the adjusted relative risk of working while symptomatic was higher for physicians and lower for nurses relative to other HCWs. Participants were more likely to work if symptoms were less severe and on the illness onset date compared to subsequent days. The most cited reason for working while symptomatic was that symptoms were mild and the HCW felt well enough to work (67%). Participants were more likely to state that they could not afford to stay home if they did not have paid sick leave and were younger.

Conclusions:

HCWs worked during most episodes of ARI, most often because their symptoms were mild. Further data are needed to understand how best to balance the costs and risks of absenteeism versus those associated with working while ill.

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Copyright

Corresponding author

Author for correspondence: Brenda L. Coleman, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5. Email: Brenda.Coleman@sinaihealthsystem.ca

Footnotes

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a

Nonauthor members of the Canadian Healthcare Worker Study Group: Todd Hatchette, Dalhousie University, Halifax, Nova Scotia, Canada; Steven Drews, University of Alberta, Edmonton, Alberta, Canada; Linn Holness, University of Toronto, Toronto, Ontario, Canada; Janet Raboud, University of Toronto, Toronto, Ontario, Canada; Joanne Langley, Dalhousie University, Halifax, Nova Scotia, Canada; Tony Mazzulli, University of Toronto, Toronto, Ontario, Canada; Kathryn Nichol, University of Toronto, Toronto, Ontario, Canada; Leon Genesove, University of Toronto, Toronto, Ontario, Canada; John Oudyk, McMaster University, Hamilton, Ontario, Canada; Lisa McCaskell, Ontario Public Service Employees Union, Toronto, Ontario, Canada; and Nancy Johnson, Ontario Nurses Association, Toronto, Ontario, Canada.

PREVIOUS PRESENTATION: An abstract of this analysis has been presented as poster in the 2018 Canadian Immunization Conference on December 5, 2018, in Ottawa, Ontario.

Footnotes

References

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1.Aitken, C, Jeffries, DJ. Nosocomial spread of viral disease. Clin Microbiol Rev 2001;14:528546.
2.Hong, H-L, Hong, S-B, Ko, G-B, et al. Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. PLoS One 2014;9(4):e95865.
3.Horcajada, JP, Pumarola, T, Martínez, JA, et al. A nosocomial outbreak of influenza during a period without influenza epidemic activity. Eur Respir J 2003;21:303307.
4.Pollara, CP, Piccinelli, G, Rossi, G, et al. Nosocomial outbreak of the pandemic Influenza A (H1N1) 2009 in critical hematologic patients during seasonal influenza 2010–2011: detection of oseltamivir resistant variant viruses. BMC Infect Dis 2013;13:127133.
5.Thorburn, K, Kerr, S, Taylor, N, van Saene, HKF. RSV outbreak in a paediatric intensive care unit. J Hosp Infect 2004;57:194201.
6.Langley, JM, LeBlanc, JC, Wang, EE, et al. Nosocomial respiratory syncytial virus infection in Canadian pediatric hospitals: a Pediatric Investigators Collaborative Network on Infections in Canada Study. Pediatrics 1997;100:943946.
7.Reese, SM, Thompson, M, Price, CS, Young, HL. Evidence of nosocomial transmission of human rhinovirus in a neonatal intensive care unit. Am J Infect Control 2016;44:355357.
8.James, L, Vernon, MO, Jones, RC, et al. Outbreak of human adenovirus type 3 infection in a pediatric long-term care facility—Illinois, 2005. Clin Infect Dis 2007;45:416420.
9.Hall, CB. Nosocomial viral respiratory infections: perennial weeds on pediatric wards. Am J Med 1981;70:670676.
10.Rao, S, Nyquist, A-C. Respiratory viruses and their impact in healthcare. Curr Opin Infect Dis 2014;27:342347.
11.Eibach, D, Casalegno, J-S, Bouscambert, M, et al. Routes of transmission during a nosocomial influenza A(H3N2) outbreak among geriatric patients and healthcare workers. J Hosp Infect 2014;86:188193.
12.Kelly, SG, Metzger, K, Bolon, MK, et al. Respiratory syncytial virus outbreak on an adult stem cell transplant unit. Am J Infect Control 2016;44:10221026.
13.Kolmos, HJ. Health care associated infections: sources and routes of transmission. Infection Control – Updates. https://cdn.intechopen.com/pdfs/28876.pdf. Published 2012. Accessed May 17, 2019.
14.Huttunen, R, Syrjänen, J. Healthcare workers as vectors of infectious diseases. Eur J Clin Microbiol Infect Dis 2014;33:14771488.
15.Prevention strategies for seasonal influenza in healthcare settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Accessed May 17, 2019.
16.Esbenshade, JC, Edwards, KM, Esbenshade, AJ, et al. Respiratory virus shedding in a cohort of on-duty healthcare workers undergoing prospective surveillance. Infect Control Hosp Epidemiol 2013;34:373378.
17.LaVela, S, Goldstein, B, Smith, B, Weaver, FM. Working with symptoms of a respiratory infection: staff who care for high-risk individuals. Am J Infect Control 2007;35:448454.
18.Mossad, SB, Deshpande, A, Schramm, S, Liu, X, Rothberg, MB. Working despite having influenza-like illness: results of an anonymous survey of healthcare providers who care for transplant recipients. Infect Control Hosp Epidemiol 2017;38:966969.
19.RSV surveillance case definitions. World Health Organization website. https://www.who.int/influenza/rsv/rsv_case_definition/en/.
20.Whitley, RJ, Boucher, CA, Lina, B, et al. Global assessment of resistance to neuraminidase inhibitors, 2008-2011: the Influenza Resistance Information Study (IRIS). Clin Infect Dis 2013;56:11971205.
21.Midi, H, Sarkar, SK, Rana, S. Collinearity diagnostics of binary logistic regression model. J Interdiscip Math 2010;13:253267.
22.Pan, W. Akaike’s information criterion in generalized estimating equations. Biometrics 2001;57:120125.
23.Ranganathan, P, Pramesh, CS, Aggarwal, R. Common pitfalls in statistical analysis: logistic regression. Perspect Clin Res 2017;8:148151.
24.Chiu, S, Black, CL, Yue, X, et al. Working with influenza-like illness: presenteeism among US healthcare personnel during the 2014–2015 influenza season. Am J Infect Control 2017;45:12541258.
25.Lau, LLH, Cowling, BJ, Fang, VJ, et al. Viral shedding and clinical illness in naturally acquired influenza virus infections. J Infect Dis 2010;201:15091516.
26.Walsh, EE, Peterson, DR, Kalkanoglu, AE, Lee, FE-H, Falsey, AR. Viral shedding and immune responses to respiratory syncytial virus infection in older adults. J Infect Dis 2013;207:14241432.
27.Tanksley, AL, Wolfson, RK, Arora, VM. Changing the “working while sick” culture: promoting fitness for duty in health care. JAMA 2016;315:603604.
28.Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control. Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings. Ottawa: Public Health Agency of Canada; 2013.
29.Bockerman, P, Laukkanen, E. What makes you work while you are sick? Evidence from a survey of workers. Eur J Public Health 2010;20:4346.
30.Gimeno, D. Distribution of sickness absence in the European Union countries. Occup Environ Med 2004;61:867869.
31.Collins, A, Cartwright, S. Why come into work ill? Individual and organizational factors underlying presenteeism. Empl Relat 2012;34:429442.
32.Bierla, I, Huver, B, Richard, S. Presenteeism at work: the influence of manager. Int J Bus Manag Stud 2011;3:97107.
33.Szymczak, JE, Smathers, S, Hoegg, C, Klieger, S, Coffin, SE, Sammons, JS. Reasons why physicians and advanced practice clinicians work while sick: a mixed-methods analysis. JAMA Pediatr 2015;169:815821.
34.Mitchell, R, Ogunremi, T, Astrakianakis, G, et al. Impact of the 2009 influenza A (H1N1) pandemic on Canadian health care workers: a survey on vaccination, illness, absenteeism, and personal protective equipment. Am J Infect Control 2012;40:611616.
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