Blog | Friday, July 19, 2013

Infection control rule #1: If you're sick, stay home.

A new study from the University of Pittsburgh Graduate School of Public Health uses epidemic modeling to determine the impact of reducing presenteeism on workplace transmission of influenza during a pandemic, such as the one we experienced with H1N1 in 2009.

The investigators compared the status quo (72% of employees with paid sick days stay home with flu, while 52% of those without sick days do not) to three other scenarios: (1) all employees have access to paid sick days, (2) all also have access to 1 flu day, or (3) all also have access to 2 flu days. The concept here is that employees are specifically paid to stay home when ill with influenza.

The findings:
--Universal paid sick days resulted in a 6% reduction in workplace transmission (applied to Allegheny County, Pa. [population 1.2 million] that is equivalent to nearly 4,000 fewer infections).
--Adding 1 flu day resulted in a 25% decrease in workplace transmission (15,000 infections averted)
--Adding 2 flu days resulted in a 39% decrease in workplace transmission (26,000 infections averted)

Bottom line: Efforts to reduce presenteeism (a horizontal infection prevention strategy) can have significant impact.

Implication: If we're really serious about reducing infections transmitted to patients in hospitals from staff, we must start thinking about how to reduce presenteeism. And that's a lot harder than firing health care workers who refuse to take their flu shot.

Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. This post originally appeared at the blog Controversies in Hospital Infection Prevention.