Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season

Abstract

Background Health care personnel (HCP) working while experiencing influenza-like illness (ILI) contribute to influenza transmission in health care settings. Studies focused on certain HCP occupations or work settings have demonstrated that some HCP often continue to work while ill. Methods Using a national nonprobability Internet panel survey of 1,914 HCP during the 2014–2015 influenza season, we calculated the frequency of working with self-reported ILI (ie, fever and cough or sore throat) and examined reasons for working with ILI by occupation and work setting. Results Overall, 414 (21.6%) HCP reported ILI, and 183 (41.4%) reported working with ILI (median, 3 days; range, 0–30 days). Pharmacists (67.2%) and physicians (63.2%) had the highest frequency of working with ILI. By work setting, hospital-based HCP had the highest frequency of working with ILI (49.3%). The most common reasons for working while ill included still being able to perform job duties and not feeling bad enough to miss work. Among HCP at long-term care facilities, the most common reason was inability to afford lost pay. Conclusions More than 40% of HCP with ILI work while ill. To reduce HCP-associated influenza transmission, potential interventions could target HCP misconceptions about working while ill and paid sick leave policies.

Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to health care workers presenting to work while ill

“…Presenteeism, defined as the practice of coming to work despite illness, in HCWs with ILI is a known concern. 25, 26 We found that 64% of the HCWs in our outbreak continued to work despite having ILI and based on timing of symptoms, we suspect this outbreak was related to, or at least accelerated by, high rates of presenteeism. The suspected index patient in this outbreak was an HCW.…”

“…This further emphasizes a need for a culture change across the health care industry to limit the risk that ill HCWs pose to inpatients if, and when, they present for duty with an ILI. 26 Banach et al 27 describe the potential for patient visitors to contribute to nosocomial spread of influenza. Although the 2 family members who became infected in this outbreak did not cause the outbreak, this situation demonstrates the challenges in establishing practical visitation policies that limit the potential for visitors to contribute to nosocomial spread of ILI during influenza season.…”

Intensive Care Unit Preparedness During Pandemics and Other Biological Threats

“…Surveys during previous influenza years reported that over 40% of HCWs might come to work while suffering from respiratory infections, increasing the risk of transmission to staff and to patients. 39 Even in settings of potential staff shortages, institutions must maintain policies to prevent HCWs with symptoms of the disease to avoid work and to seek appropriate medical care for themselves.…”

Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice

“…In a study undertaken in a children's hospital in Philadelphia, 299 (55%) of medical staff who were surveyed, reported that they would work with significant respiratory symptoms, despite acknowledging the infection risk to their co-workers and patients [31]. In another study over 40% of US HCWs who were surveyed worked with symptoms of influenza-like illness [32]. Whilst it is important to avoid presenteeism, it may be occasionally unavoidable e.g.…”