Many health care workers are still on the job even if they have symptoms of a cold, flu or other respiratory infection, putting patients and coworkers at risk, a new study finds.

It included more than 2,700 health care workers at nine Canadian hospitals who completed online diaries whenever they had symptoms of a respiratory infection.

Half reported an acute respiratory viral illness during flu season. Of those, 95% worked one or more days of their illness, even though 79% said they were entitled to paid sick leave.

The diaries also revealed that 69% worked because their symptoms were mild; 11% said they had things to do at work; 8% said they felt obligated to show up, and 3% couldn't afford to stay home.

The study was published June 18 in the journal Infection Control & Hospital Epidemiology.

"We found that physicians and people working in areas that required the most intensive contact with patients were less likely than other workers to stay home or to leave work if symptoms progressed after the start of the day," said lead author Brenda Coleman. She's a clinical scientist in the Infectious Disease Epidemiology Research Unit at Mount Sinai Hospital in Toronto.

"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," Coleman said in a journal news release.

Hospital-acquired respiratory viral infections pose a significant risk to patients, the researchers noted.

The findings show the need to educate workers and their supervisors about the risk of spreading disease; to clarify what symptoms require workers to stay home, and to have policies for working while having symptoms, Coleman said.

Even though the study was conducted in Canada, the results also apply to the United States, since hospitals in both countries follow similar measures to prevent the spread of disease, according to the researchers.

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