95% healthcare workers 'soldier on' when sick

Ninety-five per cent of people working in health care do so while sick, according to a new study. As a result, large numbers of healthcare workers risk transmitting respiratory viruses to patients and co-workers.

The Canadian study, published in Infection Control & Hospital Epidemiology, found that healthcare workers who work while sick generally do so because their symptoms are mild or started during their workday.

“We found that physicians and people working in areas that required the most intensive contact with patients were less likely than other workers to stay at home or to leave work if symptoms progressed after the start of the day,” said Brenda Coleman, PhD, study lead author and clinical scientist in the Infectious Disease Epidemiology Research Unit at Mount Sinai Hospital, Toronto. “Managers and senior staff need to both model and insist on workers staying home when symptomatic as it protects both patients and co-workers from infection.”

Hospital-acquired respiratory viral infections are recognised as causing significant illness and even death, as well as increasing healthcare costs. It is recommended that healthcare workers with fever and respiratory symptoms ask for temporary reassignment or remain at home. However, working with symptoms of an acute respiratory viral illness is common, with as many as 92% of healthcare workers reporting to work while symptomatic.

Researchers conducted a four-season prospective cohort study of influenza and other respiratory illnesses in nine Canadian hospitals in Toronto, Hamilton and Halifax. Healthcare workers in acute-care hospitals who worked more than 20 hours a week were asked to complete daily online illness diaries whenever they developed symptoms. Illness diaries collected information about symptoms, possible exposure, attendance at work, reason for work or absence, and medical consultations.

A total of 10,156 illness diaries were completed by 2728 participants. Diaries of participants not scheduled to work were excluded, leaving 5281 remaining diaries for analysis. Analysis of the diaries found that 69% of participants said they worked during an illness because they had mild symptoms and felt well enough to work; 11% said they had things to do at work; 8% felt obligated to work; and 3% stated that they could not afford to stay at home. Half of the participants reported episodes of acute respiratory viral illness during each influenza season, with 95% of those who reported an acute respiratory viral illness working one or more days of their illness. Seventy-nine per cent said they were entitled to paid sick leave.

Coleman said the findings suggest the need to educate healthcare workers, managers, workplace health and safety and infection-control staff, and administrators about the risk of transmission associated with respiratory viral infection, to clarify what symptoms require exclusion from work, and to develop and implement policies for working while symptomatic.

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