Many Americans Went to Work Sick During Flu Outbreak

By Beth Mirza Feb 18, 2010

Workers with little access to paid sick leave might have gone to work sick and possibly spread the H1N1 flu virus among colleagues during the outbreak in fall 2009, researchers say.

After examining data from the U.S. Centers for Disease Control and Prevention (CDC) and the Bureau of Labor Statistics (BLS) on rates of illness and work attendance during September through November 2009, researchers with the Institute for Women’s Policy Research say they believe that nearly a quarter of the workers who were sick with H1N1 flu did not take any time off work. The institute supports paid sick leave for all U.S. workers.

Almost 26 million employed Americans age 18 and over might have been infected with the flu, wrote study co-authors Kevin Miller, Ph.D., senior research associate at the institute, and Robert Drago, Ph.D., professor of labor studies and women’s studies at Pennsylvania State University. However, nearly 8 million of those employees took no time off from work.

“Work attendance by infected employees is a public health issue due to contagion,” said Drago in a news release about the briefing paper, titledSick at Work: Infected Employees in the Workplace During the H1N1 Pandemic. Citing research by Vicki Lovell, also with the institute, conducted in 2005, the authors note that 10 infected employees who attend work while ill will infect nine co-workers. “Employees who attended work while infected with H1N1 are estimated to have caused the infection of as many as 7 million co-workers.”

Proportionally, many more public-sector workers stayed home while sick than did private-sector workers. The study authors say this is because nearly all public-sector workers have paid sick leave, while two out of five private-sector workers do not.

“The data suggests that only two-thirds of private-sector employees took time away from work when infected with H1N1, despite advice to stay home. Workers without paid sick days must choose whether to go to work sick or lose pay, a choice that many can’t afford to make,” said Miller in the news release.

Private-sector employees make up about three-quarters of workers in the United States, public employees make up 15 percent and the self-employed make up 10 percent, wrote study authors. During the H1N1 pandemic in fall 2009, proportionally more public-sector workers were absent because of illness, and their absence was more short-lived than private-sector workers’ absence, the authors wrote. That might indicate that private-sector employees who went to work sick continued the spread of the disease to colleagues, the authors added.

Absence Rates Attributable to Illness During H1N1 Pandemic Peak


Private Sector

Public Sector










Source: BLS data 2009

“The absence rate in the private sector in November decreased by only 8.9 percent (0.3 percentage point) of the October rate, while in the public sector the relative drop in absence between October and November was more than twice as steep, at 21.8 percent (0.9 percentage point),” wrote Miller and Drago. “The discrepancy in the drop-off may indicate that infections in the private sector continued at a higher rate than in the public sector as a result of … [less] access to paid sick days.”

Absence rates from the previous two flu seasons mirror the 2009 data, researchers said.

For the complete report, including the researchers’ methodology, click here.

Beth Mirza is senior editor for HR News. She can be reached at


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