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J Occup Health year 2008 volume 50 number 1 page 13 - 23
Classification Originals 
Title Perception in Relation to a Potential Influenza Pandemic among Healthcare Workers in Japan: Implications for Preparedness
Author Teppei IMAI1, Ken TAKAHASHI1, Miwako TODOROKI1, Hiroyuki KUNISHIMA2, Tsutomu HOSHUYAMA1, Reiko IDE1, Takashi KAWASAKI3, Nobuya KOYAMA4, Kazuo ENDO5, Hiroshi FUJITA6, Kentaro IWATA7, Gerald KOH8, Sin Eng CHIA8 and David KOH8
Organization 1University of Occupational and Environmental Health, Japan, 2Tohoku University Hospital, 3Osaka Medical College, 4Toho University Omori Medical Center, 5Okinawa Chubu Hospital, 6Tokyo Metropolitan Bokutoh Hospital, 7Kameda Medical Center, Japan and 8National University of Singapore, Singapore
Keywords Influenza, Human, Disease outbreaks, Occupational health, Health personnel, Infection control, Questionnaires, Epidemiology
Correspondence K. Takahashi, Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1- 1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555,
Japan (e-mail:
Abstract Due to the potential for an influenza pandemic, preparedness for infection control in healthcare settings is essential from the standpoint of occupational health for healthcare workers. We conducted questionnaire surveys among Japanese hospitals to assess preparedness at the individual and institutional levels and their inter-relationship. Questionnaires were administered at 7 tertiary hospitals in Japan during the spring of 2006. We analyzed 7,378 individual responses of the 10,746 questionnaires administered and all seven institutional responses by hospital infection control committees. Healthcare workers assigned low importance to personal protective equipment and showed mixed attitudes (anxious but accepting) to the potential risk. Institutional gaps existed in preparedness across hospitals and most hospitals lacked the specificity to cope with a pandemic. A higher level of institutional preparedness, as determined by expertise as well as general and specific countermeasures, was an important predictor of individual recognition of preventive measures, perception of institutional measures, and attitude toward coping with risk. A higher level of institutional preparedness stood out to be an important predictor of individual preparedness. Considering the risk of a future influenza pandemic, hospitals should improve preparedness at all levels.