Collaboration in Civic Spheres

Janitors, secretaries most flu-prone workers in Washington

by Matt Rosenberg November 19th, 2012

On the one hand, getting the flu is considered fairly mundane, so long as there’s no pandemic and nobody dies. On the other hand, this common winter nuisance carries a hefty price tag. The annual bill in the United States for seasonal influenza is estimated at $87.1 billion in lost productivity, lost wages, and medical costs. We may suspect workers in certain occupations – such as health care or education – are more prone to get the flu, but there’s been little research on its prevalence across a range of occupations. Now, though, newly-reported data from Washington state provide some clues. A scientific survey of more than 8,700 Washington state workers showed that among 29 different categories it is janitors and cleaners, and secretaries who report the highest occurrence of flu-like symptoms, and truck drivers, technicians and construction laborers the lowest.

Just published in the open access scientific journal PLoS One, the findings from researchers at the Washington State Department of Labor and Industries and the University of Washington analyze frequency of key flu symptoms by occupation other than just those in the health care industry. Indicators are respiratory illness with fever and cough or sore throat within the last month. Cases were those which did not require hospitalization. The data gathered from Washington non-military workers from September 2009 through August 2010 was part of the broader annual nationwide Behavioral Risk Factor Surveillance System Survey funded by the U.S. Centers for Disease Control, and included special added questions on occupation.

The study says the higher rates in Washington state of flu-like symptoms for secretaries may be be due to greater likelihood of exposure to co-workers or others who are already infected, and that for Washington state janitors and cleaners, a key factor may be increased exposure to contaminated work surfaces and materials, compared to workers in other professions. The new report also stresses that past research indicates work related stress and lack of access to paid sick leave may increase the likelihood of flu-like symptoms among workers generally.

Despite working conditions seen as increasing the likelihood of flu symptoms, Washington state registered nurses had only a 5.7 percent prevalence of influenza like illness, less than the 6.8 percent overall among the 8,758 Washington workers surveyed. Secondary school teachers were only slightly above the overall level, at 7.7 percent. In contrast, 12 percent of cashiers reported flu symptoms within a month prior to being surveyed, as did 13 percent of financial managers, 16.6 percent of secretaries and 17.1 percent of janitors and cleaners. At the very low end of the scale were truck drivers, just 0.2 percent of whom reported flu symptoms in the last month, construction laborers (0.3) and technicians (0.4). Relative lack of contact with other individuals during work hours was a factor here, researchers said.

Overall, a higher percentage of female workers reported recent flu symptoms than men, 8 percent to 5.8 percent. Differences were also apparent by age and race. Prevalence was 7.6 percent among workers 50-89 years old versus 5.1 percent for workers 18-49. It was 6.5 percent among non-Hispanic whites, 8.1 percent among Hispanics and 9 percent among all other races.

The study’s authors recommend similar data on penetration of recent flu symptoms be collected in more states to add weight to results by occupation, race and gender. They also suggest their Washington state results may underscore the need, in occupations most at risk of flu symptoms, for broader adoption of personal protective equipment (such as face masks and surgical gloves), and more hand-washing. Use of personal protective equipment by nurses and hand hygiene help limit their exposure to influenza, and most teachers are protected by lack of close physical proximity to students, the study says. It adds that the Occupational Safety and Health Administration recommends maintaining a six-foot distance from other people in the workplace whenever possible, to minimize flu transmission risk.

The study also provided a look at Washington state flu vaccination in the last 12 months by occupation versus frequency among all workers surveyed, which was 20.8 percent. If you thought that nearly all registered nurses would report they’d been vaccinated against the flu in the last year, think again. More than 4 of 10 didn’t, though they did have the highest rate – at 58.9 percent. They were followed by secretaries at 37 percent, managers in medicine and health professions (35 percent) and general office clerks (34.9 percent). Least likely to be vaccinated were farmers (7.1 percent), computer programmers (11.5 percent) and management analysts (12.2 percent).

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