title: Effect of Occupational Exposure on A(H1N1)pdm09 Infection and Hospitalization.
abstract: OBJECTIVE
  To analyze relationships between occupational exposure and influenza infection and hospitalization during the 2009-2010 pandemic wave and the 2010-2011 influenza seasonal epidemic in Spain.
  
  
  METHODS
  Occupations were classified as high, medium, or low risk of influenza exposure. To assess the risk of infection, 588 outpatient cases of influenza confirmed by reverse-transcription polymerase-chain-reaction (RT-PCR) were compared with 588 outpatients without influenza symptoms. To assess the risk of hospitalization, 337 outpatient influenza cases were compared with 337 inpatient influenza cases.
  
  
  RESULTS
  The high risk of occupational exposure group was composed only of health care workers. After adjustment for age, sex, vaccination status, and predictive variables of influenza infection, patients with a high risk of occupational exposure had an aOR of 2.14 (95%CI: 1.25-3.66) of being an outpatient influenza case and an aOR of 0.43 (95%CI: 0.20-0.95) of being an inpatient influenza case, compared with those with a low risk.
  
  
  CONCLUSIONS
  A high risk of occupational exposure is a risk factor for influenza infection but not for hospitalization.
authors.affiliation: Departament de Cirurgia, Universitat de Lleida, Lleida, Spain; Departament de SalutPública, Universitat de Barcelona, Barcelona, Spain; jesus.pujol@cirurgia.udl.cat.
authors.forename: Jesús
authors.initials: J
authors.lastname: Pujol
authors.affiliation: Public Health Agency, Generalitat de Catalunya, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;
authors.forename: Pere
authors.initials: P
authors.lastname: Godoy
authors.affiliation: Departament de Cirurgia, Universitat de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;
authors.forename: Núria
authors.initials: N
authors.lastname: Soldevila
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Salud Pública, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain;
authors.forename: Jesús
authors.initials: J
authors.lastname: Castilla
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; UnidadMixta "Infección y Salud Pública" FISABIO-Universidad de Valencia, Valencia, Spain;
authors.forename: Fernando
authors.initials: F
authors.lastname: González-Candelas
authors.affiliation: Servicio de Vigilancia de Andalucia, Sevilla, Spain;
authors.forename: Jose M
authors.initials: JM
authors.lastname: Mayoral
authors.affiliation: Área de Epidemiología, Consejería de Sanidad de Madrid, Madrid, Spain;
authors.forename: Jenaro
authors.initials: J
authors.lastname: Astray
authors.affiliation: Unidad de Investigación, Hospital Galdakao-Usansolo, Bizkaia, Redissec, Spain;
authors.forename: Susana
authors.initials: S
authors.lastname: García
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; MedicinaPreventiva y Salud Pública, Universidad de Leon, León, Spain;
authors.forename: Vicente
authors.initials: V
authors.lastname: Martín
authors.affiliation: Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, Spain;
authors.forename: Sonia
authors.initials: S
authors.lastname: Tamames
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universidad de Jaén, Jaén, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado
authors.affiliation: Departament de SalutPública, Universitat de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;
authors.forename: Ángela Domínguez
authors.initials: ÁD
authors.lastname: García
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D058873:Pandemics; D012307:Risk Factors; D013030:Spain
keywords: A(H1N1)pdm09; health care worker and influenza; occupation; occupational exposure; risk of hospitalization; risk of infection.