IN APRIL 2009, H1N1 influenza was confirmed to pass from human to human in Mexico. On 11 June 2009, the World Health Organization declared the H1N1 influenza infection a pandemic. In Japan, the H1N1 influenza pandemic plunged the public into confusion and anxiety in May 2009. Every day, the media reported the number of infected patients in each prefecture.
On 16 May, Kobe City Medical Center General Hospital (hospital X) admitted the first patient to have been domestically infected with the H1N1 influenza virus in Japan. This attracted a great deal of public attention. On that day, hospital X, Kobe City Medical Center West hospital (hospital Y) and Nishi-Kobe Medical Center (hospital Z) started fever consultation centers that attended to patients suspected of having H1N1 influenza. In the following 2 weeks, 1831 people who suspected that they had H1N1 influenza infection came to these hospitals. Among them, 1687 were released as outpatients. The remaining 144 patients were suspected of having H1N1 and were admitted. Forty-nine of these patients were later diagnosed as having an H1N1 influenza infection. Although the number of outpatients was similar among the three hospitals, hospital X had 122 admissions in which H1N1 positivity was suspected (confirmed in 31), and hospital Z had 22 admissions (confirmed in 18). The peak occurred on 17 May when 211 patients came to the fever consultation centers. On 27 May, the mayor of Kobe City declared that the emergency had subsided. On 3 June, the fever consultation centers were closed, and by 8 June 2009, the hospitals had returned to normal practice. During these 2 weeks, the hospital workers would have experienced huge physical and psychological stress.
To clarify the impact of the influenza pandemic on hospital workers, we distributed questionnaires to hospital workers at the three hospitals (hospitals X, Y and Z) that compose the Kobe Municipal Hospital Group. Several studies have examined the stress that hospital workers experienced in the HIN1 and in other pandemics.1–9 But to our knowledge, no study has investigated the effects of sociodemographic characteristics including place of employment on the stress of hospital workers in a pandemic. There is a possibility that hospital workers' psychological response to pandemic is associated with work environment or characteristics of the hospital. In this study we investigated the psychological impact of the H1N1 influenza pandemic on hospital workers and how the impact was affected by the characteristics of the hospital, gender, age, job and work environment.