Catherine M. Baase

The assessment of chronic health conditions on work performance, absence, and total economic impact for employers.

Objective: The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow). Methods: Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported “primary” chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type. Results: Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone. Conclusion: For all chronic conditions studied, the cost associated with performance based work loss or “presenteeism” greatly exceeded the combined costs of absenteeism and medical treatment combined.

Health-related workplace productivity measurement: General and migraine-specific recommendations from the ACOEM expert panel

An establishment of health-related productivity measurements and critical evaluation of health-related productivity tools is needed. An expert panel was created. A literature search was conducted to identify health-related productivity measurement tools. Each instrument was reviewed for: 1) supporting scientific evidence (eg, reliability and validity); 2) applicability to various types of occupations, diseases, and level of severity of disease; 3) ability to translate data into a monetary unit; and 4) practicality. A modified Delphi technique was used to build consensus. The expert panel recommended absenteeism, presenteeism, and employee turnover/replacement costs as key elements of workplace health-related productivity measurement. The panel also recommended that productivity instruments should: 1) have supporting scientific evidence, 2) be applicable to the particular work setting, 3) be supportive of effective business decision-making, and 4) be practical. Six productivity measurement tools were reviewed. The panel recommended necessary elements of workplace health-related productivity measurement, key characteristics for evaluating instruments, and tools for measuring work loss. Continued research, validation, and on-going evaluation of health-related productivity instruments are needed.

Reliability and validity of the Stanford Presenteeism Scale.

Objective: This study reports the reliability and validity of the 13-item Stanford Presenteeism Scale (SPS). The SPS differs from similar scales by focusing on knowledge-based and production-based workers. Methods: Data were obtained from administrative and medical claims databases and from a survey that incorporated the SPS, SF-36, and the Work Limitations Questionnaire. Results: Sixty-three percent (7797) of employees responded. Cronbachs alpha (0.83) indicates adequate reliability. Factor analysis identified two underlying factors, “completing work” and “avoiding distraction.” Knowledge-based workers load on “completing work” (&agr; = 0.97), whereas production-based workers load on “avoiding distraction” (&agr; = 0.98). There were significant and positive relationships between the SPS, SF-36, and Work Limitations Questionnaire. Conclusions: The SPS demonstrates a high degree of reliability and validity and may be ideal for employers who seek a single scale to measure health-related productivity in a diverse employee population.

Workplace health protection and promotion: a new pathway for a healthier--and safer--workforce.

Traditionally, health protection and health promotion activities have operated independently of each other in the workplace. Health protection has usually been viewed as encompassing the activities that protect workers from occupational injury and illness ranging from basic safety training to the us

Mindfulness goes to work: impact of an online workplace intervention.

Objective: The objective of this study was to determine whether a mindfulness program, created for the workplace, was both practical and efficacious in decreasing employee stress while enhancing resiliency and well-being. Methods: Participants (89) recruited from The Dow Chemical Company were selected and randomly assigned to an online mindfulness intervention (n = 44) or wait-list control (n = 45). Participants completed the Perceived Stress Scale, the Five Facets of Mindfulness Questionnaire, the Connor-Davidson Resiliency Scale, and the Shirom Vigor Scale at pre- and postintervention and 6-month follow-up. Results: The results indicated that the mindfulness intervention group had significant decreases in perceived stress as well as increased mindfulness, resiliency, and vigor. Conclusions: This online mindfulness intervention seems to be both practical and effective in decreasing employee stress, while improving resiliency, vigor, and work engagement, thereby enhancing overall employee well-being.

Second-year results of an obesity prevention program at the Dow Chemical Company.

Objective: Evaluate innovative, evidence-based approaches to organizational/supportive environmental interventions aimed at reducing the prevalence of obesity among Dow employees after 2 years of implementation. Methods: A quasi-experimental study design compared outcomes for two levels of intervention intensity with a control group. Propensity scores were used to weight baseline differences between intervention and control subjects. Difference-in-differences methods and multilevel modeling were used to control for individual and site-level confounders. Results: Intervention participants maintained their weight and body mass index, whereas control participants gained 1.3 pounds and increased their body mass index values by 0.2 over 2 years. Significant differences in blood pressure and cholesterol values were observed when comparing intervention employees with controls. At higher intensity sites, improvements were more pronounced. Conclusions: Environmental interventions at the workplace can support weight management and risk reduction after 2 years.

Estimating the return-on-investment from changes in employee health risks on the Dow Chemical Company's health care costs.

Objective: We sought to estimate the impact of corporate health-management and risk-reduction programs for The Dow Chemical Company by using a prospective return-on-investment (ROI) model. Methods: The risk and expenditure estimates were derived from multiple regression analyses showing relationships between worker demographics, health risks, and medical expenditures. Results: A “break-even” scenario would require Dow to reduce each of 10 population health risks by 0.17% points per year over the course of 10 years. More successful efforts at reducing health risks in the population would produce a more significant ROI for the company. Conclusions: Findings from this study were incorporated into other components of a business case for health and productivity management, and these supported continued investments in health improvement programs designed to achieve risk reduction and cost savings.

Mortality study update of acrylamide workers

Objective: The authors examined the long-term health effects of occupational exposure to acrylamide among production and polymerisation workers. Methods: An earlier study of 371 acrylamide workers was expanded to include employees hired since 1979. In this updated study, 696 acrylamide workers were followed from 1955 through 2001 to ascertain vital status and cause of death. Exposure to acrylamide was retrospectively assessed based on personal samples from the 1970s onwards and area samples over the whole study period. Results: Fewer of the acrylamide workers died (n = 141) compared to an expected number of 172.1 (SMR 81.9, 95% CI 69.0 to 96.6). No cause-specific SMR for any of the investigated types of cancer was exposure related. The authors did, however, find more pancreatic cancer deaths than expected (SMR 222.2, 95% CI 72.1 to 518.5). With respect to non-malignant disease, more diabetes deaths were observed than expected (SMR 288.7, 95% CI 138.4 to 531.0). To assess the influence of regional factors, the analysis was repeated with an internal reference population. The elevated SMR for diabetes persisted. Conclusion: This study provides little evidence for a cancer risk from occupational exposure to acrylamide at production facilities. However, the increased rates of pancreatic cancer in this study and another larger study of acrylamide production workers indicate that caution is needed to rule out a cancer risk. The authors believe that the excess of diabetes mortality in this study is most likely not related to acrylamide exposure, because a larger study of acrylamide workers reported a deficit in this cause of death. The authors conclude that the increased SMR for diabetes mortality is probably not related to regional influences.

Workplace Wellness Recognition for Optimizing Workplace Health A Presidential Advisory From the American Heart Association

The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life’s Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research.

Using formative research to develop environmental and ecological interventions to address overweight and obesity.

Objective: This paper presents the formative research phase of a large multi‐site intervention study conducted to inform the feasibility of introducing environmental and ecological interventions.