title: Policies to reduce influenza in the workplace: impact assessments using an agent-based model.
abstract: OBJECTIVE
  We examined the impact of access to paid sick days (PSDs) and stay-at-home behavior on the influenza attack rate in workplaces.
  
  
  METHODS
  We used an agent-based model of Allegheny County, Pennsylvania, with PSD data from the US Bureau of Labor Statistics, standard influenza epidemic parameters, and the probability of staying home when ill. We compared the influenza attack rate among employees resulting from workplace transmission, focusing on the effects of presenteeism (going to work when ill).
  
  
  RESULTS
  In a simulated influenza epidemic (R0 = 1.4), the attack rate among employees owing to workplace transmission was 11.54%. A large proportion (72.00%) of this attack rate resulted from exposure to employees engaging in presenteeism. Universal PSDs reduced workplace infections by 5.86%. Providing 1 or 2 "flu days"-allowing employees with influenza to stay home-reduced workplace infections by 25.33% and 39.22%, respectively.
  
  
  CONCLUSIONS
  PSDs reduce influenza transmission owing to presenteeism and, hence, the burden of influenza illness in workplaces.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. supriya@pitt.edu
authors.forename: Supriya
authors.initials: S
authors.lastname: Kumar
authors.forename: John J
authors.initials: JJ
authors.lastname: Grefenstette
authors.forename: David
authors.initials: D
authors.lastname: Galloway
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albert
authors.forename: Donald S
authors.initials: DS
authors.lastname: Burke
mesh_terms: D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D017146:Models, Organizational; D016272:Occupational Health; D016134:Organizational Policy; D010414:Pennsylvania / Q000453:epidemiology; D018582:Sick Leave / Q000706:statistics & numerical data; D017132:Workplace