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Volume 8, Number 10—October 2002
THEME ISSUE
Bioterrorism-related Anthrax

Bioterrorism-related Anthrax

Adherence to Antimicrobial Inhalational Anthrax Prophylaxis among Postal Workers, Washington, D.C., 2001

Mariaelena D. Jefferds*Comments to Author , Kayla Laserson*, Alicia M. Fry*, Sharon L. Roy*, James Hayslett*, Laurence Grummer-Strawn*, Laura Kettel-Khan*, Anne Schuchat*, and selected members of the Centers for Disease Control and Prevention Anthrax Adherence Team1
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

Table 4

Characteristics of postal workers who discontinued or were fully adherent to prophylaxis for anthrax, Washington, D.C., 2001a

Characteristics Discontinued (n=45)
n (%) Full adherence
(n=98), n (%) RR (95% CI) p value
Sexb
Female 25 (56) 52 (54) 1.0 (0.7, 1.4) n.s.
Male 20 (44) 45 (46) Ref -
Ageb
18–44 y 25 (56) 16 (16) 3.4 (2.0, 5.7) p<0.05
>45 y 20 (44) 81 (84) Ref -
Race/ethnicityb
Black 36 (80) 88 (91) 0.9 (0.7, 1.04) n.s.
Other 3 (7) 3 (3) 2.2 (0.4, 10.4) n.s.
White 6 (13) 6 (6) Ref -
Work description at interviewc
Driver 6 (13) 8 (8) 1.6 (0.6, 4.4) n.s.
Government mail 3 (7) 21 (21) 0.3 (0.1, 0.99) p<0.05
Administration 12 (27) 6 (6) 4.3 (1.7, 10.9) p<0.05
Plant floor 24 (53) 63 (64) Ref -
Worked on sorter or in government mail sectiond
Yes 18 (43) 70 (75) 0.6 (0.4, 0.8) p<0.05.
No 24 (57) 23 (25) Ref -
Perceived riske
High 16 (35) 60 (61) 0.6 (0.4, 0.9) p<0.05
Some 25 (56) 35 (36) 1.5 (1.1, 2.2) p<0.05
None 4 (9) 3 (3) Ref -
Adverse effectsf
A lot 11 (25) 9 (9) 2.7 (1.2, 6.0) n.s.
Some 19 (42) 48 (49) 0.9 (0.6, 1.3) n.s.
Not at all 15 (33) 41 (42) Ref -
Physical signs of stressg
5–11 signs 7 (16) 28 (29) 0.5 (0.2, 1.1) n.s.
1–4 signs 29 (64) 57 (58) 1.1 (0.8, 1.4) n.s.
0 signs 9 (20) 13 (13) Ref -
Anxietyh
Yes 17 (38) 33 (34) 1.1 (0.7, 1.8) n.s.
No 28 (62) 65 (66) Ref -
Trouble remembering pillsi
Yes 23 (51) 44 (45) 1.1 (0.8, 1.6) n.s.
No 22 (49) 54 (55) Ref -
Worse work performancej
Yes 9 (20) 15 (15) 1.3 (0.6, 2.7) n.s.
No 36 (80) 83 (85) Ref -

aRR, relative risk; 95% CI, 95% confidence interval; n.s., not statistically significant.
bOne missing value for full adherence.
cWork location during the survey interview, December 18–20, 2001.
dWorked close to these areas for more than half of the normal workdays during exposure period of October 12–21, 2001. Responses of “don’t know” excluded from analysis (n=13).
ePerceived risk of breathing in Bacillus anthracis spores during exposure period of October 12–21, 2001.
fReported how much side effects affected their lives.
gPhysical signs of stress included fatigue, headaches, chest pain, rapid heartbeat, unplanned changes in weight, less sleep or difficulty in sleeping, muscle tremors or twitches, difficulty or rapidity in breathing, elevated blood pressure, nausea or vomiting, and dizziness or lightheadedness.
hReported they experienced anxiety since anthrax events started. Anxiety was one of 22 listed physical, emotional, mental, and behavioral signs of stress on our questionnaire.
iReported they sometimes or almost always had trouble remembering their pills.
jReported side effects negatively affected their work performance.

Main Article

1 The following members of the team were involved in the Washington, D.C., area response: Theodies Mitchell, Charlie Chamberlain, Arlene Shaw, Margaret Patterson, Chang Lee, Daryle Hardge, Veronica McCant, Robert Fireall, Colleen Crowley, Sandra Mattson, Margaret Tipple, Suzanne Lebovit, Pat Cook, Valerie J. Curry, Kelly Holton, Susan L. Lukacs, Julia C. Rhodes, Cindy R. Friedman, Holly A. Williams, Michelle G. Goveia, Leigh Winston, Heather Burke, Veronica Alvarez, Gail M. Stennies, Ernest E. Smith, Brigette Finkelstein, Julia Smith, Bobbie Person, Ian Williams, Wanda Walton, Nick Deluca, Regina Bess, Gabrielle Benenson, Kathleen Hutchins, and Luetta Schneider.

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