Examining the impact of access to sick leave on influenza incidence in the workplace

Paid sick leave access varies by workplace size and wages earned in the United States (US). Bills under consideration at multiple levels—city and state legislatures—would provide universal access to paid sick leave for employees. We used an Agent-based model of Allegheny County, Pennsylvania, to examine the impact of access to sick leave and stay-at-home behavior on the influenza attack rate in a pandemic. Augmenting standard influenza epidemic parameters with the probability of staying home when ill from the literature, we found that an employee had higher odds (p<0.001) of contracting illness from a colleague who did not have sick leave and was at work sick than from a colleague who was at work sick in spite of having access to sick leave. Because even those with paid sick leave do not always stay home for the duration of the illness, we also examined the impact of providing access to “flu days”—paid leave designed to encourage employees with influenza to stay away from work. We found that a universal provision of 1 or 2 flu days would reduce the number of cases due to presenteeism (going to work when ill) by 21% and 34% respectively for a virus with R₀=1.4. We will report model sensitivity to parameters and discuss the impact of universal sick leave and flu day policies on influenza incidence in the workplace. Our study enables a novel, modeling-based health impact assessment of legislations that propose to provide universal access to paid sick leave in the US.