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BACKGROUND: During an influenza pandemic, information about the industry and occupation (I&O) of persons with likely influenza infection is important to guide key policy decisions regarding vaccine prioritization and exposure control measures. To identify groups of workers who may be at increased risk for novel influenza infection, data from the 2009 National H1N1 Flu Survey (NHFS) were analyzed.
METHODS: The NHFS was a random-digit-dialed telephone designed to produce population-based estimates of the prevalence of ILI and seasonal and pH1N1 influenza vaccination coverage during the 2009-2010 influenza season, when the novel influenza A (H1N1) pdm09 strain was circulating at pandemic levels. ILI was defined as having been sick with fever and cough or sore throat in the past month. Adjusted prevalence (%) and adjusted prevalence ratios (APR) for ILI among various I&O groups were calculated based on predicted marginals from logistic regression models. Groups with relatively low prevalence and relatively high sample sizes were used as reference categories. Vaccination coverage estimates were calculated using the Kaplan–Meier survival analysis procedure. Results were weighted and analyzed with SAS and SUDAAN statistical software to account for the complex survey design.
RESULTS: Among 28,710 employed adults, 5.5% reported ILI symptoms in the month prior to the interview and 23.7% received the pandemic H1N1 (pH1N1) influenza vaccine. Among employed adults, the highest prevalence of ILI was reported by those employed in the industry groups “Real estate and rental and leasing” (10.5%) and “Accommodation and Food service” (10.2%), and in the occupation groups “Food preparation and serving related” (11.0%) and “Community and social services” (8.3%). Both seasonal influenza and pH1N1 vaccination coverage were relatively low in all of these groups of workers. Adults not in the labor force (i.e., homemakers, students, retired persons, and persons unable to work) had ILI prevalence and pH1N1 vaccination coverage similar to those found in all employed adults combined; in contrast, ILI prevalence was higher and pH1N1 vaccination coverage was lower among unemployed adults (i.e., those looking for work).
CONCLUSIONS: Employed adults with high exposure to the public, in addition to those employed in healthcare, may have increased risk of infection with novel influenza, and the majority of these workers did not receive seasonal or pH1N1 influenza vaccine. Unemployed adults might also be considered a high risk group for novel influenza. Policymakers and public health providers should consider workplace risk when setting priorities for novel influenza prevention measures.