Shan P. Tsai

A preliminary investigation: effect of a corporate fitness program on absenteeism and health care cost

A random sample of 517 employees was studied to determine differences in health care costs and absenteeism among exercisers and nonexercisers during the start-up of a corporate health and fitness program. Exercise was associated with decreased illness absence among female exercisers (47 v 69 hours, P less than .05) and there was a trend for illness absence to be inversely related to advancing age among exercisers, whereas illness absence increased among nonexercisers. Total health care costs among exercisers was lower (male

Mortality, morbidity, and haematological results from a cohort of long-term workers involved in 1,3-butadiene monomer production.

561, females

The relationship between work-related and non-work-related injuries

639) than among nonexercisers (male

Injury prevalence and associated costs among participants of an employee fitness program

1,003, females

Prospective morbidity surveillance of Shell refinery and petrochemical employees

1,535). Due to the large variation in the individual cost, the differences between exercisers and nonexercisers were not statistically significant. Ambulatory health care cost for nonexercisers (males

Morbidity prevalence study of workers with potential exposure to epichlorohydrin

486, females

A prospective study of morbidity patterns in a petroleum refinery and chemical plant.

883) were significantly higher than the costs for exercisers (males

Health care utilization and costs for diseases of the circulatory system in a corporate setting

408, females

Effect of curtailed insurance benefits on use of mental health care: The tenneco health plan

243). Because the differences were found upon program initiation, they were thought to be characteristics of exercisers and not due to exercise itself.

Analysis of a corporation's health care experience: implications for cost containment and disease prevention

A retrospective mortality analysis and prospective morbidity and haematological analyses were performed for Shell Deer Park Manufacturing Complex (DPMC) male employees who worked in jobs with potential exposure to 1,3-butadiene from 1948 to 1989. 614 employees qualified for the mortality study (1948-89), 438 of those were still employed during the period of the morbidity study (1982-9), and 429 of those had haematological data available for analysis. Industrial hygiene data from 1979 to 1992 showed that most butadiene exposures did not exceed 10 ppm (eight-hour time weighted average (8 hour TWA)), and most were below 1 ppm, with an arithmetic mean of 3.5 ppm. 24 deaths occurred during the mortality study period. For all causes of death, the standardised mortality ratio (SMR) was 48 (95% confidence interval (95% CI) = 31-72), and the all cancer SMR was 34 (95% CI = 9-87). There were only two deaths due to lung cancer (SMR 42, 95% CI = 5-151) and none due to lymphohaematopoietic cancer (expected = 1.2). Morbidity (illness absence) events of six days or more for the 438 butadiene employees were compared with the rest of the complex. No cause of morbidity was in excess for this group; the all cause standardised morbidity ratio (SMbR) was 85 (95% CI = 77-93) and the all neoplasms SMbR was 51 (95% CI = 22-100). Haematological results for the 429 with laboratory data were compared with results for the rest of the complex. No significant differences occurred between the two groups and the distributions of results between butadiene and non-butadiene groups were virtually identical. These results suggest that butadiene exposures at concentrations common at DPMC in the past 10-20 years do not pose a health hazard to employees.