Alyssa B. Schultz

Employee Health and Presenteeism: A Systematic Review

Introduction Many employers focus on their large and easily measured cost of health care, yet until recently they have ignored the impact of health on productivity. Studies of some chronic conditions and some health risk factors suggest that costs of lost productivity exceed costs of medical care. This review will examine the literature to explore the link between employee health and on-the-job productivity, also known as presenteeism. Methods Searches of Medline, CINAHL and PubMed were conducted in October 2006, with no starting date limitation with “presenteeism” or “work limitations” as keywords. A total of 113 studies were found using this method. Each study was evaluated based on the strength of the study design, statistical analyses, outcome measurement, and controlling of confounding variables. Results Literature on presenteeism has investigated its link with a large number of health risks and health conditions ranging from exercise and weight to allergies and irritable bowel syndrome. As expected, the research on some topic areas is stronger than others. Conclusions Based on the research reviewed here, it can be said with confidence that health conditions such as allergies and arthritis are associated with presenteeism. Moreover, health risks traditionally measured by a health risk appraisal (HRA), especially physical activity and body weight, also show an association with presenteeism. The next step for researchers is to tease out the impact of individual health risks or combinations of risks and health conditions on this important outcome measure.

The association of health risks with on-the-job productivity.

Objective: Decreased on-the-job productivity represents a large yet poorly characterized indirect cost to employers. We studied the impact of employee health risk factors on self-reported worker productivity (presenteeism). Methods: Using a brief version of the Work Limitation Questionnaire incorporated into a Health Risk Appraisal, 28,375 employees of a national company responded to the survey. The association between health risks and work limitation and each of the four domains was examined. Percentage of lost productivity also was estimated. Results: Ten of 12 health risk factors studied were significantly associated with self-reported work limitations. The strength of the associations varied between risks and the four domains of work limitation. Perception-related risk factors such as life dissatisfaction, job dissatisfaction, poor health, and stress showed the greatest association with presenteeism. As the number of self-reported health risk factors increased, so did the percentage of employees reporting work limitations. Each additional risk factor was associated with 2.4% excess productivity reduction. Medium and high-risk individuals were 6.2% and 12.2% less productive than low-risk individuals, respectively. The annual cost of lost productivity in this corporation was estimated at between

The Cost and Impact of Health Conditions on Presenteeism to Employers: A Review of the Literature

99M and

The association between health risk change and presenteeism change.

185M or between

The impact of allergies and allergy treatment on worker productivity

1392 and

Presenteeism: critical issues.

2592 per employee. Conclusions: Health risk factors represent additional causes of lost productivity.

The economic burden of lost productivity due to migraine headache: A specific worksite analysis

Employers are becoming concerned with the costs of presenteeism in addition to the healthcare and absenteeism costs that have traditionally been explored. But what is the true impact of health conditions in terms of on-the-job productivity? This article examines the literature to assess the magnitude of presenteeism costs relative to total costs of a variety of healthSearches of MEDLINE, CINAHL and PubMed were conducted in July 2008, with no starting date limitation, using ‘presenteeism’ or ‘work limitations’ as keywords. Publications on a variety of health conditions were located and included if they assessed the total healthcare and productivity cost of one or more health conditions.Literature on presenteeism has investigated its link with a large number of health conditions ranging from allergies to irritable bowel syndrome. The cost of presenteeism relative to the total cost varies by condition. In some cases (such as allergies or migraine headaches), the cost of presenteeism is much larger than the direct healthcare cost, while in other cases (such as hypertension or cancer), healthcare is the larger component. Many more studies have examined the impact of pharmaceutical treatment on certain medical conditions and the resulting improvement in on-the-job productivity.Based on the research reviewed here, health conditions are associated with on-the-job productivity losses and presenteeism is a major component of the total employer cost of those conditions, although the exact dollar amount cannot be determined at this time. Interventions, including the appropriate use of pharmaceutical agents, may be helpful in improving the productivity of employees with certain conditions.

Influence of participation in a worksite health-promotion program on disability days

Objective: This prospective study investigates whether changes in health risks are associated with changes in presenteeism (on-the-job productivity loss). Method: A total of 7026 employees of a national financial services company responded to a health risk appraisal (HRA), which included a modified version of the Work Limitation Questionnaire (WLQ) in both 2002 and 2004. The association between changes in health risks and changes in self-reported presenteeism was examined. Results: Changes in perceptual/psychologic health risks had a strong association with changes in presenteeism. Individuals who reduced their risks generally saw an improvement in productivity, whereas those who gained risks or remained high-risk status saw deterioration in productivity. Each risk factor increased or reduced was associated with a commensurate change in 1.9% productivity loss over time and estimated to be

The Relationship between National Heart, Lung, and Blood Institute Weight Guidelines and Concurrent Medical Costs in a Manufacturing Population

950 per year per risk changed. Conclusions: Positive and negative changes in health risks are associated with same-direction changes in presenteeism.

Financial costs due to excess health risks among active employees of a utility company.

Allergic disorders are a chronic and highly prevalent condition in the general population and the workforce. Their effect on workers and corporate costs go beyond the direct cost of treatment, as the condition can lower a worker’s productivity. Previous research includes estimates of the decrease in productivity associated with allergic disorders. None of these studies, however, offered an objective measure of how worker productivity is affected by allergic disorders. In the present study, the productivity of telephone customer service representatives suffering from allergic disorders is examined before, during, and after the ragweed pollen season. In addition, these workers were surveyed as to the type of medication they used in response to their condition. A significant correlation was observed between an increase in pollen counts and a decrease in productivity for workers with allergies. Compared with workers without allergies, employees with allergies who reported using no medication showed a 10% decrease in productivity. No differences were observed among workers with allergies using different types of medications, although the medication groups had significantly higher productivity than the no-medication group. The expected lowered productivity of those workers with allergies who used sedating antihistamines may have been offset by their relatively lower level of symptom severity and by the nature of the job and the productivity measures used.