40% of healthcare employees work while ill

Doctors may not be sticking to their own guidelines—four in 10 healthcare workers who come down with the flu continue to work in spite of their symptoms, a new study published in the American Journal of Infection Control reports.

Lead author Sophia Chiu, MD, MPH, and colleagues used a national non-probability Internet panel survey of 1,914 healthcare personnel (HCP) to map the patterns of ill employees and the impact their bout of influenza-like illness (ILI) had on their professional lives. The results of the survey, released this week, were based on the 2014-2015 influenza season.

More than 77 percent of all HCP surveyed during the season said they received a flu vaccination that year, according to the study, but that number still doesn’t live up to the Healthy People 2020 standard of a 90 percent vaccination rate among healthcare workers. While continuing to work while ill can be dangerous in any environment, the risk is especially high in healthcare settings, with denser concentrations of elderly people and patients with immunosuppression or severe chronic disease.

“The statistics are alarming,” Chiu said in a release from Elsevier. “At least one earlier study has shown that patients who are exposed to a healthcare worker who is sick are five times more likely to get a healthcare-associated infection.” Chiu, who works with the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health, said the organization recommends all healthcare institutions take precautions against such possibilities.

Of the original surveyed group, 414 respondents—21.6 percent of the cohort—reported they’d come down with an ILI during the 2014-2015 flu season. Though these individuals missed, on average, two days of work, 41.4 percent of them said they had worked during their illness for a median of three days.

Pharmacists and physicians had the highest frequency of working with an ILI, Chiu and co-authors wrote, at 67.2 percent and 63.2 percent of the ill group, respectively. Compared to physicians, fewer assistants and aides, nonclinical HCP, nurse practitioners, physician assistants and other clinical HCP reported being sick on the job.

HCP who said they worked while sick didn’t differ by baseline characteristics like age group or job type, according to the data. Those who worked at long-term care facilities were, however, less likely to work while sick than clinicians at hospitals.

Employees who worked with an ILI said they did so because they could either still perform their job duties, weren’t feeling bad enough to miss work, didn’t think they were contagious, couldn’t find someone to cover their shift or felt they had a professional obligation to their coworkers to show up.

In long-term care facilities, HCPs most commonly explained they couldn’t afford to lose the pay associated with sick leave.

“Patients’ health and wellbeing are at stake when contagious HCPs opt not to stay home,” Linda Greene, RN, MPS, said in the Elsevier release. Greene is the president of the Association for Professionals in Infection Control and Epidemiology, which publishes AJIC. “Tailored strategies per occupation and health institution, including updating paid sick leave policies, can empower HCPs to make healthy choices not only for themselves, but for their coworkers and patients."