Image of nurses' hands at computer keyboard

A large Canadian study has found that doctors and others who work most directly with patients are the least likely to take a sick day or leave early at the onset of symptoms.

Up to 95% of healthcare workers have risked transmitting respiratory viruses to patients and co-workers, according to research published Tuesday in Infection Control & Hospital Epidemiology.

“Managers and senior staff need to both model and insist on workers staying home when symptomatic as it protects both patients and coworkers from infection,” said lead author Brenda Coleman, Ph.D., clinical scientist in the Infectious Disease Epidemiology Research Unit at Mount Sinai Hospital in Toronto.

Coleman’s study focused on a cohort of nine Canadian hospitals and tracked flu and other respiratory illnesses. The researchers noted that Canada and the U.S. follow similar disease-prevention techniques — including standard, droplet and contact precautions — and would likely feel the same impacts.

For the study, employees who worked more than 20 hours a week were asked to complete online illness diaries if they developed symptoms. Analysis of 5,281 diaries found that 69% of participants said that they worked during an illness because they had mild symptoms and felt well enough to work, while 8% “felt obligated,” and 3% could not afford to stay home.

Almost 80% of the participating employees were allowed paid sick leave.

These findings suggest the need to educate employees, managers, infection control staff and administrators about the risk of transmission associated with respiratory viral infection and to clarify what symptoms require exclusion from work, Coleman said.