title: Risk factors for influenza among health care workers during 2009 pandemic, Toronto, Ontario, Canada.
abstract: This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.1%) non-HCWs were positive for influenza. Influenza infection was associated with contact with family members who had acute respiratory illnesses (adjusted odds ratio [AOR]: 6.9, 95% CI 2.2-21.8); performing aerosol-generating medical procedures (AOR 2.0, 95% CI 1.1-3.5); and low self-reported adherence to hand hygiene recommendations (AOR 0.9, 95% CI 0.7-1.0). Contact with persons with acute respiratory illness, rather than workplace, was associated with influenza infection. Adherence to infection control recommendations may prevent influenza among HCWs.
authors: Department of Microbiology, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada. spkuster@gmail.com
authors: Stefan P
authors: SP
authors: Kuster
authors: Brenda L
authors: BL
authors: Coleman
authors: Janet
authors: J
authors: Raboud
authors: Shelly
authors: S
authors: McNeil
authors: Gaston
authors: G
authors: De Serres
authors: Jonathan
authors: J
authors: Gubbay
authors: Todd
authors: T
authors: Hatchette
authors: Kevin C
authors: KC
authors: Katz
authors: Mark
authors: M
authors: Loeb
authors: Donald
authors: D
authors: Low
authors: Tony
authors: T
authors: Mazzulli
authors: Andrew
authors: A
authors: Simor
authors: Allison J
authors: AJ
authors: McGeer
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D063373:Hand Hygiene / Q000706:statistics & numerical data; D006282:Health Personnel; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000821:virology; D009864:Ontario / Q000453:epidemiology; D058873:Pandemics; D012307:Risk Factors
chemical_list: D007252:Influenza Vaccines
keywords: Canada; Influenza; aerosol; hand hygiene; health care worker; pandemic; respiratory; risk; transmission; ventilation; virus; viruses
references: Occup Med (Lond). 2002 Aug;52(5):249-53
references: 12181372
references: Clin Vaccine Immunol. 2011 Mar;18(3):520-2
references: 21228145
references: J Clin Microbiol. 2010 Sep;48(9):3340-2
references: 20610685
references: Clin Infect Dis. 2011 Aug 1;53(3):280-3
references: 21765076
references: Emerg Infect Dis. 2011 Feb;17(2):287-91
references: 21291608
references: Jpn J Infect Dis. 2006 Dec;59(6):377-9
references: 17186956
references: Emerg Infect Dis. 2011 Apr;17(4):619-25
references: 21470450
references: Virus Res. 2004 Jul;103(1-2):125-32
references: 15163500
references: BMC Infect Dis. 2011 May 23;11:140
references: 21605362
references: PLoS One. 2011;6(6):e21335
references: 21731708
references: Virol J. 2011 Jul 13;8:349
references: 21752272
references: Ann Pharmacother. 2006 Sep;40(9):1635-9
references: 16835314
references: Emerg Infect Dis. 2011 Jun;17(6):1000-6
references: 21749760
references: MMWR Recomm Rep. 2006 Feb 24;55(RR-2):1-16
references: 16498385
references: J Hosp Infect. 2009 Jan;71(1):1-14
references: 18952319
references: Infect Control Hosp Epidemiol. 2005 Nov;26(11):882-90
references: 16320984
references: BMC Infect Dis. 2010 Jan 12;10:8
references: 20067628
references: BMJ. 1996 Nov 16;313(7067):1241-2
references: 8939114
references: Lancet Infect Dis. 2002 Mar;2(3):145-55
references: 11944184
references: Crit Care Med. 2010 Aug;38(8 Suppl):S306-14
references: 20647788
references: BMJ. 2001 Jan 20;322(7279):138
references: 11159569