Workplace productivity losses related to acute upper respiratory tract infections among Health Care Workers in Hong Kong

Abstract

Background: Acute respiratory infections (ARIs) are the most common infectious causes of sickness absenteeism and productivity loss among health care workers (HCWs) . While sickness-related productivity loss has traditionally been measured in terms of sickness absences, the importance of impaired productivity associated with attending work when sick, termed presenteeism, is also being increasingly recognised . The temporal pattern of ARI-associated productivity loss among HCWs over the course of an influenza epidemic is also poorly understood . Method: A series of 9 rounds of self-administered questionnaire surveys were conducted over a period of 19 months (from Oct 2013-May 2015), covering two winter influenza epidemics and 3 non-epidemic periods, in the Hong Kong West Cluster of Hospital Authority in Hong Kong . The timing of each round of the surveys was informed by the influenza disease activity reflected from the Centre for Health Protection, the Department of Health, aiming to match the timing to 3 non-epidemic periods, and the up-going phase, peak, and down-going phase of the winter influenza epidemics of 2013-2014 and 2014-2015 in the local community . Each survey intended to assess participants’ health condition and productivity loss in the past two weeks before the date of completing the questionnaire . Absenteeism was assessed by self reported days of sick leave as listed by questions from the Health and Work Performance Questionnaire (HPQ) of World Health Organization . The Work- Limitation Questionnaire (WLQ) was used to assess the presence and degree of workforce productivity loss; and the Standard Form of the Short Form-36, version 2 (SF-36v2) was used for a detailed assessment on the Health-related quality of life (HRQOL) . Results: Comparing with HCWs reporting no ARI, those reporting an episode of ARI had increases in productivity loss by 130% (p<0 .01) and a 31% (p<0 .01) in the form of sickness absence and on-job presenteeism respectively, with a 17% and 16% reduction respectively in the physical and mental component of HRQOL (p<0 .01) . The proportion of total productivity loss and the HRQOL impairment contributed by ARI started to increase sharply during the rising phase of community influenza activity, which maintained at the peak, and gradually declined during the downwards phase of seasonal influenza epidemics . Conclusion: We demonstrated that ARI was associated with a significant increase in productivity loss with substantial impairment in HRQOL among HCWs. These findings highlighted the importance of effective sickness absence surveillance, a proactive workforce redistribution plan and newer approaches for improving uptake of influenza vaccination among HCWs