Risk of Seasonal Influenza by Occupation in a Railway Company in a Metropolitan Area of Japan during Three Influenza Seasons.

Station staff may be at high risk for influenza due to high frequency contact with other people. We examined the risk of influenza by occupational group in a railway company. A retrospective observational study was conducted among employees at a branch office of a railway company in eastern Japan, located in a metropolitan area, for 2012/13, 2013/14, and 2014/15 influenza seasons. The study population included employees who had received influenza vaccination for the season in question and the previous season. Outcome was defined as self-reported influenza illness during the respective season, identified through the vaccine screening questionnaire in the following season. Study participants included employees whose outcome information could be obtained. Standardized morbidity ratios (SMRs) by occupational group (station staff, engineers, train crew) for each season were calculated. For 2012/13, 2013/14, and 2014/15 seasons, attack rates were 4.7% (19/403), 5.2% (21/407), and 7.8% (31/397), respectively. Among the participants, SMRs of station staff were lower in the 2012/13 (SMR = 57; 95% confidence intervals [CI] = 18-133) and 2014/15 (SMR = 75; 95%CI = 36-138) seasons and similar to other groups in the 2013/14 season. Enhanced countermeasures, regardless of occupational group, may be effective in preventing the spread of influenza infection.