A coronavirus causes Sars
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Coping with the Sars outbreak had a significant impact on hospital workers' own health, a study has found.
A third of staff at a Toronto hospital which treated patients in the 2003 Sars outbreak showed signs of emotional distress, it found.
And two-thirds said they had been concerned about their family's health.
Researchers writing in the Canadian Medical Association Journal said staff working during disease outbreaks needed more support and education.
They questioned 2,000 workers at the Sunnybrook and Women's College Health Sciences Centre completed a questionnaire about their experiences and emotions during the Sars outbreak.
Nurses and part-time workers were the most likely groups to show signs of emotional distress.
People in managerial or supervisory positions were found to be the least likely to report concerns.
The researchers say having some level of control over a situation reduces the likelihood someone will be concerned about what might happen.
Screening
The hospital admitted 71 patients with Sars - Severe Acute Respiratory Syndrome - between March and May 2003, 23 of whom were healthcare workers.
Over 1,000 patients were seen at the centre's Sars assessment clinic.
During the outbreak three Toronto hospitals were closed, healthcare staff were quarantined, and many new infection control guidelines were issued.
All healthcare workers entering the hospital were screened to ensure they were not infected.
The study revealed many healthcare staff changed their life outside work, avoiding interaction with friends and family, and not going to public places such as restaurants and shopping centres.
Dr Leslie Nickell, of the Department of Family and Community Medicine at Sunnybrook, who carried out the research, told BBC News Online: "The outbreak had a major impact on people's lifestyles and their families, particularly for people who had children living with them.
"They were very concerned about their families' health."
She said the hospital had worked hard to keep staff informed.
"Managers were giving out information daily, and were putting on forums which staff could attend."
But she said the research showed more would need to be done during any future outbreaks.
She added: "I don't think this will be the last time we're going to face something like this."
Lessons for the future
Judy Breuer, professor of virology at Barts and the London NHS Trust, treated the only confirmed Sars patient in the UK who needed hospital care.
She said "front-line" staff at the hospital, such as A&E workers, had received detailed briefings about how to treat suspected Sars cases.
But Professor Breuer added: "People were obviously worried and concerned.
"We didn't know much about Sars, but we knew it seemed to be spread by respiratory contact, so we were able to advise on what precautions staff should take."
She said the experience had enabled hospitals to learn lessons about how to deal with future outbreaks of new diseases.
"The one that we're much more worried about is a flu pandemic. Sars was a sort of test bed for procedures for that."