Survey findings: 4 in 10 healthcare professionals work while sick

Hospital-based providers are among the most likely to opt from staying home when sick

Arlington, VA, November 1, 2017

A new study suggests that healthcare professionals (HCPs) should heed to their own advice: stay home when sick.

Some four in 10 HCPs work while experiencing influenza-like illness (ILI), according to findings published in the November issue of the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology (APIC). As in all workplaces, contagious employees risk infecting others when they turn up for work. But with higher concentrations of older patients and individuals with immunosuppression or severe chronic diseases in healthcare facilities, ILI transmission by HCPs presents a grave public health hazard.

“The statistics are alarming. At least one earlier study has shown that patients who are exposed to a healthcare worker who is sick are five times more likely to get a healthcare-associated infection,” said lead researcher Sophia Chiu, MD, MPH, CDC’s National Institute for Occupational Safety and Health. “We recommend all healthcare facilities take steps to support and encourage their staff to not work while they are sick.”

The annual study, conducted via a national online survey, collected data from from 1,914 HCPs during the 2014-2015 influenza season. Respondents self-reported ILI, defined as the combination of a fever and cough or sore throat, and listed factors that prompted them to turn up for work.

The survey assessed a variety of health occupations across multiple institutions: physicians; nurse practitioners and physician assistants; nurses; pharmacists; assistants/aides; other clinical HCP; nonclinical HCPs; and students. Four types of work settings were assessed: hospitals; ambulatory care or physician offices; long-term care facilities; or other clinical settings.

Among the findings:

  • Of the 1,914 HCPs surveyed, 414 reported ILI. Of these, 183—or 41.4 percent—reported working for a median duration of three days while experiencing influenza-like symptoms.
  • Hospital-based HCPs had the highest frequency of working with ILI (49.3 percent), compared to HCPs at long-term care facilities (28.5 percent). Clinical professional HCPs were the most likely to work with ILI (44.3 percent), with pharmacists (67.2 percent) and physicians (63.2 percent) among those with the highest frequency.
  • In contrast, the survey found that assistants and aides (40.8 percent), nonclinical HCPs (40.4 percent), nurse practitioners/physician assistants (37.9 percent), and other clinical HCPs (32.1 percent) worked while sick.
  • The most common reasons for HCPs to opt from taking sick leave included feeling that s/he could still preform his/her job duties; not feeling “bad enough” to stay home; feeling as if s/he were not contagious; sensing a professional obligation to be present for coworkers; and difficulty finding a coworker to cover for him/her. Among the HCPs who felt they could still preform their job duties, 39.0 percent sought medical attention for their ILI symptoms, as did 54.0 percent of those who did not think they were contagious. 49.8 percent of HCPs in long-term care settings who reported for work when sick reported doing so because they couldn’t afford to lose the pay.
  • Previously published results from this survey described that only 77.3 percent of respondents reported receiving a flu shot. The U.S. Department of Health and Human Services’ Healthy People 2020 aims to reach a 90 percent influenza vaccination rate for HCPs.
  • HCPs with self-reported ILI missed a median number of two work days. Of this cohort, 57.3 percent visited a medical provider for symptom relief; 25.2 percent were told they had influenza. The Centers for Disease Control and Prevention recommends that anyone with ILI wait 24-hours after a fever breaks before returning to work.

“Patients’ health and wellbeing are at stake when contagious HCPs opt not to stay home. Tailored strategies per occupation and health institution, including updating paid sick leave policies, can empower HCPs to make healthy choices not only for themselves, but for their coworkers and patients,” said Linda Greene, RN, MPS, CIC, FAPIC, 2017 APIC president.

From 1976-2007, influenza-associated fatalities accounted for up to 16.7 (ranged between 1.4 and 16.7) deaths per 100,000 people in the U.S. Flu-related deaths predominantly impact individuals 65 years and older. Influenza may be transmissible from one day before, and up to seven days after, symptoms onset.

Visit to learn more information about preventing infections in healthcare facilities.


Notes for Editors
The article is “Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season,” by Sophia Chiu, MD, MPH; Carla L. Black, PhD; Xin Yue, MPS, MS; Stacie M. Greby, DVM, MPH; A. Scott Laney, PhD; Angela P. Campbell, MD, MPH; and Marie A. de Perio, MD ( It appears in the American Journal of Infection Control, volume 45, issue 11 (November 2017) published by Elsevier.

About AJIC: American Journal Of Infection Control
AJIC: American Journal of Infection Control covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. AJIC is included in MEDLINE and CINAHL.

About APIC
APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at Follow APIC on Twitter: and Facebook: For information on what patients and families can do, visit APIC’s Infection Prevention and You website at

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.

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