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 modelling 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 healthcare workers who refuse to take their flu shot. 

Photo:  Man by Virgil Cantini, 1965, bronze and steel sculpture on Parran Hall at the University of Pittsburgh Graduate School of Public Health.