Annual bouts of flu still top the charts for sick days

Sickness absence cost British business £12 billion sterling in 1996, an average loss to every business of £533 per employee. …

Sickness absence cost British business £12 billion sterling in 1996, an average loss to every business of £533 per employee. Meanwhile, more than nine million days were lost through certified sickness in Irish workplaces according to a pertinent 1993 IBEC report.

An IBEC spokesperson told Health Matters that the "dominant reason" for sickness absence remains "the flu".

It's estimated that outbreaks of influenza in the US costs consumers - let alone businesses - at least $12 billion (£8 billion) annually in direct and indirect expenses. When influenza or an influenza-Like Illness (ILI) strikes with its fever, chills, headache, dry cough and sore throat, a person is likely to be out of work - if not out for the count - for at least a week. As well as spreading this highly infectious viral disease, those who go to work are likely to suffer impaired attention, under-perform and be at greater risk of an accident.

So what's the latest thinking and practice on workplace influenza vaccination programmes? Mr Gabriel Greene, human resources officer at the EBS, explains that for more than 10 years they've offered a free flu jab to permanent staff. They've just completed this year's immunisation programme at the "negligible" cost of £10-£12 per jab.

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But only a small number of staff availed of it. Although offered on-site, only 24 of some 250 head office staff were immunised while as few as eight out of 200 employees travelled in from the Dublin branches.

Colleagues at country branches were invited to attend their local GP and send an invoice. But only three out of some 100 country staff elected to do so.

Most who availed of it were aged 3545. Only six were younger than 30.

Dr Darina O'Flanagan, a specialist in public health medicine with the Eastern Health Board, doesn't want to be construed as "recommending" it but says it can be given to almost anyone who wants to reduce their chances of getting the flu. (See panel for those who shouldn't be vaccinated.) However, she says, the flu jab won't protect people from flu-like viral illnesses.

Dr Dermot Halpin, an occupational medical consultant in Dublin, disagrees. He says US studies have shown a 43 per cent reduction in absenteeism due to colds and flus in vaccinated workers.

The study, published in the reputable New England Journal of Medicine in 1995, shows that immunisation against flu decreased the frequency of upper respiratory illnesses - head colds - by 25 per cent; absenteeism from work due to head colds by 43 per cent; absenteeism due to "all illnesses" by 36 per cent; and visits to doctors' surgeries for head colds by 44 per cent.

Other studies show conflicting results. One 1987 study showed no difference in the attendance rates of vaccinated and unvaccinated workers.

But many studies contradict this. Moreover, they show that workplace vaccination can be cost effective for businesses.

A 1991 Canadian study showed that during a flu epidemic overall absence rates rose by 35 per cent but increased by only 6-11 per cent among vaccinated workers.

Cost-benefit analyses for these US and Canadian studies showed the benefits were high because of flu epidemics. But benefits decreased during winters with low influenza activity.

Bearing in mind the EBS's "£10-12" per jab, businesses planning a vaccination programme should consider these costs: the vaccine itself; administering the vaccine; employee time to visit the vaccination room and receive the jab; minimal sickness absence caused by vaccine side-effects (an estimated three days per 100 employees vaccinated); and the costs of promoting the programme.

Benefits to the business will be determined by: the number who accept vaccination; the gamble of whether or not there will be an epidemic; the severity of an epidemic; the financial impact on the business if employees are absent; and losses suffered if key personnel or several staff simultaneously contract the flu.

Workplace Vaccination Programmes [SBX]

Programmes need to be offered soon - before the winter flu season arrives. [SBX]

Vaccination usually prevents flu in between 60 and 90 per cent of healthy adults [SBX]

Uptake of vaccination tends to be low [SBX]

It can be cost effective [SBX]

It's most cost effective when followed by flu epidemics [SBX]

The more who are vaccinated, the greater the net savings. [SBX]

Some studies suggest vaccination will reduce the number of head colds; absences due to head colds; and total absences due to all illnesses [SBX]

Vaccination is strongly recommended for anyone with chronic lung disease; chronic heart disease; chronic kidney failure; diabetes; suppressed immune system; and the over 65s

[SBX]

The vaccine must not be given to: pregnant women; those with an anaphylactic hypersensitivity to eggs; or with rare neurological conditions like Guillain-Barr syndrome [SBX]

The final decision about immunisation should be made by one's GP.