Sick hospital workers often expose patients to contagious illness

Hospital workers often come to work with contagious respiratory illnesses, against the recommendations of public health regulators, a Canadian study suggests.

Nearly all of the 2,093 health care workers in the study who had such symptoms came to work at some point while sick.

For the study, published in the Journal of Infection Control & Hospital Epidemiology, nurses, doctors, and support staff at nine hospitals across Canada filled in online illness diaries during four flu seasons, recording symptoms such as a runny or stuffy nose, fever, cough or scratchy throat.

Of the 1,036 participants who had contagious respiratory illnesses during the study period, 52% reported working on every scheduled day of work and 94.6% reported working at least one day of their illness.

The most common reason given for working while sick was that the illness seemed mild and manageable. Compared to other health care workers, physicians were more likely to work while sick and nurses were less likely.

But nurses who thought their managers expected them to show up unless they were too sick were more likely to feel obligated to work.

For most people, in fact, feeling obligated was a driving factor behind their decision to come to work sick, as was their perceptions of what managers expected from them. Younger workers, and workers without paid sick leave, were more likely to say they could not afford to stay home.

“It is only by knowing these reasons that managers and employers can take steps to mitigate the risk of infection to other people,” said Brenda Coleman, senior study author of the study from the Dalla Lana School of Public Health, University of Toronto, in email to Reuters Health. Eleven percent of the hospital workers said they had come to work even while feeling miserable because they had “things to do.” Physicians were under-represented in the study, and self-reporting of the illnesses may also confound the results, the authors acknowledge in their report. 

The US Centers for Disease Control and Prevention advises healthcare workers to take seven days off or consider temporary reassignment if they have a fever and respiratory symptoms.

The research team suggests that changing sick leave policies and cultural norms could help reduce the risk of disease transmission from sick health care workers to patients.

Also needed, the researchers say, is an understanding of how to balance the costs and risks of absenteeism by sick workers against the costs and risks of illness transmission associated with working while ill.