1. H5N1 Knowledge, Attitudes and Practices of Poultry Workers in Hong Kong during the H1N1 Pandemic Jean H. KIM, Fiona LO, Elizabeth KWONG, Ka-Kin CHEUK, S.S. LEE, William GOGGINS, S.S. LEE and Sian GRIFFITHS The School of Public Health & Primary Care, The Chinese University of Hong Kong --
Background & Objectives: Live poultry workers represent a high-risk group for H5N1 Avian influenza due to their high-level of exposure to birds and their body parts. Few studies have been done on the knowledge, attitudes and behaviors of live poultry workers in Hong Kong, despite the fact that Hong Kong has experienced a number of H5N1 outbreaks in poultry workers. These workers represent a high-risk group for infection by H5N1 and should be examined to determine whether there are knowledge gaps, attitudinal barriers or prevalent risk behaviors that are amenable to intervention. Methods: An anonymous, self-administered questionnaire was completed by 250 poultry workers who worked in wet-markets and local poultry farms in 2009 (response rate=67%). In order to examine the relationship between worker-related characteristics, knowledge of H5N1, attitudes towards avian influenza and health-related behaviors. Preliminary results of the study are shown below as % of respondents self-reporting various knowledge, attitudes and behaviors.
Results: The majority of respondents were males (56.4%) over the age of 45 (72.5%), full-time poultry workers (76%) and the median number of years in a poultry occupation was 20 years.
PERCEIVED BENEFITS
High perceived benefits from:
Hand-washing with soap (70%)
Using gloves (60%)
Vaccination of poultry (56%)
Low perceived benefits from:
Antibiotic use (18%)
N95 mask use (32%)
Goggle use (11%)
Sterilizing cutting boards (32%)
Keeping distance from birds (23%)
CUES TO ACTION FOR H5N1 PREVENTION
58% see public announcements as effective reminders
Most receive H5N1 info from TV (92%) or papers (69%)
Less than a third get their info from posters (31%) or API (28%)
8% get info from doctors, internet (16%), employers (13%)
SELF-EFFICACY
78% believe that they can protect themselves from H5N1
MAIN BARRIERS TO PREVENTIVE BEHAVIORS:
61% believe that wearing face mask will reduce business % said following hygiene measures is difficult during peak hrs 36% reported insufficient cleaning facilities wet market % never received any infection control training % believed that influenza vaccination is too costly
PERCEIVED SEVERITY OF H5N1
88% believe H5N1 has lower fatality than SARS
20% H5N1 causes permanent disability
PERCEIVED SUSCEPTIBILITY TO H5N1
86% believe that they are NOT susceptible to H5N1
59% believe that they have antibodies to H5N1
KNOWLEDGE
% correct:
Hair loss is a Sx of human H5N1 infection?
98% (No)
Fever is a Sx of human H5N1 infection?
86% (Yes)
Diarrhea is a Sx of human H5N1 infection?
13% (Yes)
Vomiting is a Sx of human H5N1 infection?
23% (Yes)
Breathing problems is a Sx of human H5N1 infection?
59% (Yes)
Nose bleeds is a Sx of human H5N1 infection?
1.2% (Yes)
How long can H5N1 survive outside the body?
24% (>1 wk)
H5N1 is transmissible to humans fr/ breathing near infected birds
20.4% (Yes)
H5N1 is transmissible fr/ uncooked eggs?
14.3% (Yes)
BEHAVIORS in PAST MONTH %
Handled live birds with bare hands
65%
Handled dead birds with bare hands
32%
Wear face mask when handling birds
52%
Wear PPE when handling chicken
77%
Wash with soap after killing birds
88%
IN THE EVENT of HUMAN H5N1 OUTBREAK
Would wear mask during work hrs
Would get influenza vaccination?
66%
Would reduce work hours?
20%
CONCLUSIONS: Live poultry workers should engage in a dialogue with the government to determine the realistic H5N1-prevention regulations that insure worker safety while allowing efficient work practices. Health promotion among this occupational group shows promise for preventing future H5N1 outbreaks. Further analyses will be conducted to determine the factors associated with higher H5N1 risk behaviors.