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Volume 19, Number 4—April 2013
CME ACTIVITY - Research

Risk Factors for Influenza among Health Care Workers during 2009 Pandemic, Toronto, Ontario, Canada

Stefan P. KusterComments to Author , Brenda L. Coleman, Janet Raboud, Shelly McNeil, Gaston De Serres, Jonathan Gubbay, Todd Hatchette, Kevin C. Katz, Mark Loeb, Donald Low, Tony Mazzulli, Andrew Simor, Allison J. McGeer, Stefan P. KusterComments to Author , Brenda L. Coleman, Janet Raboud, Shelly McNeil, Gaston De Serres, Jonathan Gubbay, Todd Hatchette, Kevin C. Katz, Mark Loeb, Donald Low, Tony Mazzulli, Andrew Simor, Allison J. McGeer, on behalf of the Working Adult Influenza Cohort Study Groupon behalf of the Working Adult Influenza Cohort Study Group
Author affiliations: Mount Sinai Hospital, Toronto, Ontario, Canada (S.P. Kuster, B.L. Coleman, D. Low, T. Mazzulli, A.J. McGeer); University of Toronto, Toronto (B.L. Coleman, J. Raboud, K.C. Katz, D. Low, T. Mazzulli, A. Simor, A.J. McGeer); Dalhousie University, Halifax, Nova Scotia, Canada (S. McNeil, T. Hatchette); Laval University Québec, Québec City, Québec, Canada (G. De Serres); Ontario Agency for Health Protection and Promotion, Toronto (J. Gubbay, D. Low); North York General Hospital, Toronto (K.C. Katz); McMaster University, Hamilton, Ontario, Canada (M. Loeb); Sunnybrook Health Sciences Centre, Toronto (A. Simor).; Mount Sinai Hospital, Toronto, Ontario, Canada (S.P. Kuster, B.L. Coleman, D. Low, T. Mazzulli, A.J. McGeer); University of Toronto, Toronto (B.L. Coleman, J. Raboud, K.C. Katz, D. Low, T. Mazzulli, A. Simor, A.J. McGeer); Dalhousie University, Halifax, Nova Scotia, Canada (S. McNeil, T. Hatchette); Laval University Québec, Québec City, Québec, Canada (G. De Serres); Ontario Agency for Health Protection and Promotion, Toronto (J. Gubbay, D. Low); North York General Hospital, Toronto (K.C. Katz); McMaster University, Hamilton, Ontario, Canada (M. Loeb); Sunnybrook Health Sciences Centre, Toronto (A. Simor).

Main Article

Table 4

Characteristics of 563 health care workers in acute care hospitals during 2009 pandemic, Toronto, Ontario, Canada*

Characteristic Influenza test status
No. negative or not ill, n = 550† No. positive, n = 13‡ p value
Mean age, y (± SD) 42.2 (11.4) 42.5 (10.1) 0.91
Female sex
 467/550 (84.9)
 11/13 (84.6)
 1.00
Occupation
Nurse 180/539 (33.4) 3/13 (23.1) 0.55
Physician, physiotherapist, respiratory therapist 103/539 (19.1) 5/13 (38.5) 0.15
Other§
 256/539 (47.5)
 5/13 (38.5)
 0.52
Potential exposure conditions
Received A(H1N1)pdm09 vaccine¶ 467/541 (86.3) 2/13 (15.4) <0.001
Child <18 y in household 203/550 (36.9) 9/13 (69.2) 0.02
Child attending day care in household 74/542 (13.7) 3/13 (23.1) 0.40
Cares for >1 patient with ARI per week 141/539 (26.2) 5/12 (41.7) 0.32
Working in high-risk area# 227/461 (49.2) 7/11 (63.6) 0.35
Present during aerosol-generating medical procedure >1/wk** 66/521 (12.7) 5/13 (38.5) 0.02
Performs aerosol-generating medical procedure >1/wk 49/540 (9.1) 3/13 (23.1) 0.11
Years’ experience, mean (± SD) 13.6 (11.4) 14.0 (9.3) 0.91
% adherence to hand hygiene, median (IQR) 95.0 (80.0–100) 77.5 (60.0–92.5) 0.02
Adherence to facial protection, %, median (IQR) 80 (50–99) 50 (30–75) 0.16
Hours worked per week, no. median (IQR) 40.0 (37.5–45.0) 37.5 (32.0–40.0) 0.22

*Data are no./total (%) unless otherwise specified. A(H1N1)pdm09, pandemic influenza A(H1N1) 2009 virus; ARI, acute respiratory illness; IQR, interquartile range.
†Participants who either did not report any illness or whose nasal swab samples tested negative for influenza.
‡All participants who tested positive were symptomatic.
§The distribution of other persons working in acute care hospitals was: administrative personnel: 30.4%; patient attendant/health care aide/service assistant: 0.4%; housekeeper/porter/central sterile supply/dispatch: 0.5%; medical imaging technologist/technician: 1.6%; pharmacist/pharmacy technician: 2.0%; ward clerk/unit coordinator: 1.4%; psychologist/social worker: 1.6%; laboratory technologist/technician: 4.7%; nutritionist/other food service staff: 1.1%; other: 3.4%.
¶Participants who had acquired A(H1N1)pdm09 <7 d of vaccination were considered unprotected.
#Emergency room, medical inpatient ward, intensive care unit, or pediatric ward.
**Aerosol-generating medical procedures are defined as any one of: administration of nebulized therapy or humidified oxygen at >40%, use of bag-valve mask, manual ventilation, non-invasive ventilation, open airway suctioning, bronchoscopy or other upper airway endoscopy, tracheostomy, endotracheal intubation, cardiopulmonary resuscitation, oscillatory ventilation, any procedure performed that involves manipulation of open ventilator tubing in a mechanically ventilated patient, sputum induction or other deliberate induction of coughing.

Main Article

1Additional members of the Working Adult Influenza Cohort Study Group are listed at the end of this article.

1Additional members of the Working Adult Influenza Cohort Study Group are listed at the end of this article.

Page created: March 18, 2013
Page updated: March 18, 2013
Page reviewed: March 18, 2013
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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