Socioeconomic Factors Associated With an Intention to Work While Sick From COVID-19.

OBJECTIVE: We sought to understand barriers to staying home from work when sick from COVID-19 (COVID-19 presenteeism) to understand COVID-19 health disparities and transmission and guide workplace and social policy. METHODS: We used logistic regression models to assess which socioeconomic factors were associated with intended COVID-19 presenteeism among an online study population working outside their home in March 2020 (N = 220). RESULTS: Overall, 34.5% of participants reported intended COVID-19 presenteeism. Younger individuals and individuals making over $90,000 per year were less likely to report COVID-19 presenteeism. Individuals who were worried about having enough food had 3-fold higher odds of intended COVID-19 presenteeism. CONCLUSION: Current policies around food access, paid sick leave, and other workplace protections need to be expanded and made more accessible to reduce health disparities as well as the transmission of COVID-19 and other infections.

Occupational Stress and Its Economic Cost in Hong Kong: The Role of Positive Emotions.

There has been less research on the costs of occupational stress attributed to certain job stressors in Chinese contexts. This study identified and validated common job stressors and estimated the economic cost in Hong Kong. The role of positive emotions in alleviating the economic costs of job stressors was also examined. Both qualitative and quantitative approaches were adopted. The findings obtained from five focus group discussions and a survey validated five common job stressors: Job insecurity; quantitative workload; organizational constraints; interpersonal conflicts; and work/home interface. A total of 2511 employees were surveyed, with 2032 valid questionnaires returned (925 males, 1104 females, and 3 unidentified, whose ages ranged from 18 to 70 years). The economic costs were estimated by combining the costs of absenteeism, presenteeism, and medical expenses. Absenteeism mainly caused by job stressors of the work/home interface, job insecurity, and quantitative workload accounted for an annual economic cost of HK$550 million to HK$860 million. The annual economic cost due to presenteeism mainly caused by job stressors of job insecurity, interpersonal conflict, quantitative workload, and organizational constraints ranged from HK$1.373 billion to HK$2.146 billion. The cost of medical treatments associated with occupational stress was HK$2.889 billion to HK$4.083 billion. Therefore, the total annual economic cost of occupational stress was approximately HK$4.81 billion to HK$7.09 billion. Positive emotions, representing a less explored individual factor in the cost of occupational stress studies, was found to be negatively correlated with presenteeism and buffered the negative impact of job stressors on absenteeism. The theoretical contributions and practical implications of findings are discussed.

Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy.

INTRODUCTION: Asthma, allergic rhinitis, atopic dermatitis, and food allergy affect approximately 20% of the global population. Few studies describe the burden of the totality of these diseases and only a handful studies provide a comprehensive overview of the socioeconomic impact of these diseases. AREAS COVERED: For this narrative review, we searched Pubmed using selected keywords and inspected relevant references using a snowballing process. We provide an overview of the socioeconomic burden of allergic diseases (in particular, asthma, allergic rhinitis, atopic dermatitis, and food allergy). The focus of this review is on their epidemiology (incidence, prevalence), burden (disability-adjusted life years, quality of life), and direct and indirect costs (absenteeism and presenteeism). We have put special emphasis on differences between countries. EXPERT COMMENTARY: Both the prevalence and the burden of allergic diseases are considerable with prevalence varying between 1% and 20%. We identified a plethora of studies on asthma, but studies were generally difficult to compare due to the heterogeneity in measures used. There were only few studies on the burden of food allergy; therefore, more studies on this allergy are required. For future studies, we recommend standardizing epidemiologic, socioeconomic impact, and quality of life measures of allergic diseases.

Cardiovascular and cerebrovascular diseases risk associated with the incidence of presenteeism and the costs of presenteeism.

OBJECTIVES: The objective of this study was to estimate a risk of cardiovascular and cerebrovascular diseases for each worker and to determine whether this risk is associated with the incidence and costs of presenteeism, absenteeism, and medical/drug treatments. METHODS: Established risk equations were used to estimate the 10-year probability of developing coronary artery disease and ischemic stroke in male workers aged 40-65 years who were recruited from four pharmaceutical companies in Japan. The incidence of presenteeism was defined as existence of presenteeism for the past a month, and the incidence of absenteeism was defined as existence of sick-leave for the past three months by a self-administered questionnaire. Each cost was calculated based on the human capital method. Data on medical/drug treatments were collected from health insurance claims. RESULTS: The risks were calculated for 6047 workers. Individuals at moderate and high risk of coronary artery disease had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Workers at moderate and high risk of ischemic stroke also had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Mean costs for absenteeism and medical/drug treatments increased with the risk of developing coronary artery disease or ischemic stroke, while costs for presenteeism did not. CONCLUSIONS: To prevent the costs of presenteeism, workers not only at high risk but also at low and moderate risk of developing cardiovascular and cerebrovascular diseases should receive health care services.

A longitudinal exploration of the relationship between obesity, and long term health condition with presenteeism in Australian workplaces, 2006-2018.

BACKGROUND: Obesity and long term health condition (LTHC) are major public health concerns that have an impact on productivity losses at work. Little is known about the longitudinal association between obesity and LTHC with impaired productivity. OBJECTIVE: This study aims to explore the longitudinal association between obesity and LTHC with presenteeism or working while sick. DESIGN: Longitudinal research design. SETTING: Australian workplaces. METHODS: This study pooled individual-level data of 111,086 employees collected in wave 6 through wave 18 from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The study used a Generalized Estimating Equation (GEE) model with logistic link function to estimate the association. RESULTS: The findings suggest that overweight (Odds Ratios [OR]: 1.09, 95% Confidence Interval [CI]: 1.05-1.14), obesity (OR: 1.38, 95% CI: 1.31-1.45), and LTHC (OR: 3.03, 95% CI: 2.90-3.16) are significantly positively associated with presenteeism. CONCLUSIONS: The longitudinal association between obesity and LTHC with presenteeism among Australian employees implies that interventions to improve workers' health and well-being will reduce the risk of presenteeism at work.

Moving to productivity: The benefits of healthy buildings.

Health is a critical factor for the generation of value by workers. Companies bear substantial costs associated with absenteeism and presenteeism among their employees. This study investigates the impact of the environmental conditions in the workplace on the health and job satisfaction of employees, as core factors of productivity. We provide evidence based on a natural experiment, in which 70% of the workforce of a municipality in the Netherlands was relocated to a building with a design focused on sustainability and health and well-being. We construct a longitudinal dataset based on individual surveys of the entire municipality workforce and include measures before and after the move. The estimation results show a significant improvement in the perceived environmental conditions, as well as in the health and well-being of the relocated workers, measured by the drop in incidence of sick building syndrome symptoms. Results are heterogeneous based on age: older groups of employees enjoy larger health impacts. The relocation effects remain persistent in the medium term (two years after the moving date). Importantly, a mediation analysis suggests that the achieved improvements in health and well-being lead to significantly enhanced job satisfaction and a 2% reduction in the prevalence of sick leave.

The Economic Burden of Lost Productivity due to Presenteeism Caused by Health Conditions Among Workers in Japan.

OBJECTIVE: To identify the primary health conditions that cause presenteeism, and to estimate the economic cost of lost productivity due to presenteeism in Japan. METHODS: We conducted an Internet survey among 10,000 Japanese workers. Participants were asked to answer the health condition most affecting their work. Presenteeism was evaluated using the Quantity and Quality methods, and we estimated an annualized cost per capita and nation. RESULTS: The common health conditions most interfering with work were neck pain or stiff shoulders, low back pain, and mental illnesses. The annualized costs of presenteeism per capita for each were $414.05, $407.59, and $469.67, respectively. The estimated national costs for each were all above $27 billion. CONCLUSIONS: Mental illnesses and musculoskeletal symptoms were the leading causes of presenteeism in Japan, and the economic burden of presenteeism was considerably large.

Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia.

BACKGROUND/OBJECTIVE: Productivity and monetary loss due to migraine in the workplace may be substantial. This study aimed to determine the impact of migraine on productivity and monetary lost among employees in the banking sectors, in a multiethnic middle income country. METHODS: A cross-sectional online survey was conducted among employees in two multinational banks in Malaysia between April and July 2019. Screening for migraine was conducted using the self-administered ID-Migraine™ questionnaire. Migraine-related disability (MIDAS) and headache frequency were recorded. Impact of migraine on work productivity and activities were evaluated using the Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS: Of the 1268 employees who submitted complete responses, 47.2% (n = 598) were screened positive for migraine. Strikingly, the mean percent productivity loss at work (presenteeism) was almost 20-fold higher than the mean percent work time missed due to migraine (absenteeism) (39.1% versus 1.9%). The mean percent productivity loss in regular activity (activity impairment) and overall work productivity loss (work impairment) was 38.4% and 39.9%, respectively. It was also found that the costs related to presenteeism (MYR 5392.6) (US$1296) was 3.5-fold higher than absenteeism (MYR1,548.3) (US$370). Highest monetary loss related to presenteeism was reported in migraineurs with frequency of headache of above 3 days (MYR 25,691.2) (US$6176), whereas highest monetary loss related to absenteeism was reported in migraineurs with MIDAS grade IV (MYR 12,369.1) (US$2973). Only 30% of migraineurs of MIDAS grade IV reported taking prescribed medication. Notably, a vast majority (96%) of migraineurs who had three or lower episodes of migraine per month did not seek treatment. CONCLUSION: The significant impact of migraine on work productivity and regular activity, appears to lead to substantial monetary loss attributed to not only absenteeism, but more importantly to presenteeism. This study also highlights the unmet needs in migraine management among employees in the banking sector.

Costs of Workplace Productivity Loss in Patients with Connective Tissue Disease-associated Interstitial Lung Disease.

Rationale: Interstitial lung disease (ILD) develops in a large percentage of patients with connective tissue disease (CTD) and is associated with increased morbidity and mortality. Patients with CTD-associated ILD (CTD-ILD) often present at a young age, suggesting that ILD likely impacts workplace productivity.Objectives: We aimed to determine the employment rate and workplace productivity loss, along with its associated factors and estimated costs, in patients with fibrotic CTD-ILD.Methods: Patients with fibrotic CTD-ILD from the six centers of the Canadian Registry for Pulmonary Fibrosis were eligible. Health-related productivity loss was assessed using the Work Productivity and Activity Impairment questionnaire. Proposed factors associated with low workplace productivity were forced into a multivariable regression model. Average productivity loss in hours/week was used to calculate the costs of productivity loss based on hourly wages obtained from national census data matched for age and sex. Workplace productivity loss outcomes were compared between patients with CTD-ILD and patients with a non-CTD fibrotic ILD.Results: Of 375 eligible patients with fibrotic CTD-ILD, 113 (30%) were employed. Productivity loss was reported by 59% of employed patients, with a mean loss of 9.4 ± 1.2 hours/week, including 3.9 ± 0.9 hours/week from absenteeism and 5.5 ± 0.7 hours/week from presenteeism. Employment among patients 25-54 years of age with fibrotic CTD-ILD was 27% lower than that in the matched general Canadian population (56% vs. 83%; P < 0.001). Employment among patients ≥55 years of age with CTD-ILD was 17% lower than that in the matched population (19% vs. 36%; P < 0.001). Workplace productivity loss was not associated with respiratory symptoms or lung physiology. Annual costs of productivity loss were calculated at 13,593 Canadian dollars per employee with fibrotic CTD-ILD. Workplace productivity loss was similar in patients with fibrotic CTD-ILD and those with non-CTD fibrotic ILD.Conclusions: Patients with fibrotic CTD-ILD frequently report workplace productivity loss, which is unexplained by respiratory symptoms or lung physiology and is associated with significant costs.

Direct non-medical and indirect costs of diabetes and its associated complications in Vietnam: an estimation using national health insurance claims from a cross-sectional survey.

OBJECTIVE: The prevalence of diabetes in Vietnam has increased from 2.5% in 2007 to 5.5% in 2017, but the burden of direct non-medical and indirect costs is unknown. The objective of this study was to estimate the direct non-medical costs and indirect costs due to type 2 diabetes mellitus (T2DM) and its associated complications among Vietnam Health Insurance System (VHIS) enrollees in Vietnam. DESIGN: The first phase was a cross-sectional survey of patients with T2DM. In the second phase, data from the previous phase were used to predict direct non-medical costs and presenteeism costs of VHIS enrollees diagnosed with T2DM based on demographic and clinical characteristics in 2017. The human-capital approach was used for the calculation of indirect costs. SETTING AND PARTICIPANTS: This study recruited 315 patients from a national hospital, a provincial hospital and a district hospital aged 18 or above, diagnosed with T2DM, enrolled in VHIS, and having at least one visit to hospitals between 1 June and 30 July 2018. The VHIS dataset contained 1,395,204 patients with T2DM. OUTCOME MEASURES: The direct non-medical costs and presenteeism were collected from the survey. Absenteeism costs were estimated from the VHIS database. Costs of premature mortality were calculated based on the estimates from secondary sources. RESULTS: The total direct non-medical and indirect costs were US$239 million in 2017. Direct non-medical costs were US$78 million, whereas indirect costs were US$161 million. Costs of absenteeism, presenteeism and premature mortality corresponded to 17%, 73% and 10% of the indirect costs. Patients incurred annual mean direct non-medical costs of US$56. Annual mean absenteeism and presenteeism costs for patients in working age were US$61 and US$267, respectively. CONCLUSIONS: The impact of T2DM on direct non-medical and indirect costs on diabetes is substantial. Direct non-medical and absenteeism costs were higher in patients with complications.

Opioid Use Disorder and Employee Work Presenteeism, Absences, and Health Care Costs.

OBJECTIVE: To measure the prevalence of opioid use disorder (OUD) and employee health care and productivity costs with and without OUD and to assess whether utilization of pharmacotherapy for OUD reduces those costs. METHODS: We conducted a cross-sectional analysis of 2016 to 2017 commercial enrollment, health care, and pharmacy claims and health risk assessment data using the IBM MarketScan Databases (Ann Arbor, MI). We estimated regression models to assess the association between OUD and annual employee health care and productivity costs. RESULTS: Health care and productivity costs for employees with OUD who did and did not receive pharmacotherapy were approximately $6294 and $21,570 more than for other employees, respectively. CONCLUSIONS: Employers can make a business case for expanding access to pharmacotherapy treatment for OUD based on our finding that receipt of pharmacotherapy significantly reduces overall health care costs.

Paid Leave and Access to Telework as Work Attendance Determinants during Acute Respiratory Illness, United States, 2017-2018.

We assessed determinants of work attendance during the first 3 days after onset of acute respiratory illness (ARI) among workers 19-64 years of age who had medically attended ARI or influenza during the 2017-2018 influenza season. The total number of days worked included days worked at the usual workplace and days teleworked. Access to paid leave was associated with fewer days worked overall and at the usual workplace during illness. Participants who indicated that employees were discouraged from coming to work with influenza-like symptoms were less likely to attend their usual workplace. Compared with workers without a telework option, those with telework access worked more days during illness overall, but there was no difference in days worked at the usual workplace. Both paid leave benefits and business practices that actively encourage employees to stay home while sick are necessary to reduce the transmission of ARI and influenza in workplaces.

Medical and productivity costs after trauma.

BACKGROUND: Well-advised priority setting in prevention and treatment of injuries relies on detailed insight into costs of injury. This study aimed to provide a detailed overview of medical and productivity costs due to injury up to two years post-injury and compare these costs across subgroups for injury severity and age. METHODS: A prospective longitudinal cohort study followed all adult (≥18 years) injury patients admitted to a hospital in Noord-Brabant, the Netherlands. Patients filled out questionnaires 1 week, 1, 3, 6, 12 and 24 months after trauma, including items on health care consumption from the medical consumption questionnaire (iMCQ) and productivity loss from the productivity cost questionnaire (PCQ). Furthermore, injury severity was defined by Injury Severity Score (ISS). Data on diagnostics was retrieved from hospital registries. We calculated medical costs, consisting of in-hospital costs and post-hospital medical costs, and productivity costs due to injury up to two years post-injury. RESULTS: Approximately 50% (N = 4883) of registered patients provided informed consent, and 3785 filled out at least one questionnaire. In total, the average costs per patient were €12,190. In-hospital costs, post-hospital medical costs and productivity costs contributed €4810, €5110 and €5830, respectively. Total costs per patient increased with injury severity, from €7030 in ISS1-3 to €23,750 in ISS16+ and were lowest for age category 18-24y (€7980), highest for age category 85 years and over (€15,580), and fluctuated over age groups in between. CONCLUSION: Both medical costs and productivity costs generally increased with injury severity. Furthermore, productivity costs were found to be a large component of total costs of injury in ISS1-8 and are therefore a potentially interesting area with regard to reducing costs.

Direct and Indirect Cost of Obesity Among the Privately Insured in the United States: A Focus on the Impact by Type of Industry.

OBJECTIVE: To evaluate obesity-related costs and body mass index (BMI) as a cost predictor among privately insured employees by industry. METHODS: Individuals with/without obesity were identified using the Optum Health Reporting and Insights employer claims database (January, 2010 to March, 2017). Direct/indirect costs were reported per-patient-per-year (PPPY). Multivariate models were used to estimate the association between obesity and high costs (more than or equal to 80th percentile) by industry. RESULTS: Overall (N = 86,221), direct and absenteeism/disability cost differences between class I obesity (BMI 30.0 to 34.9) and reference were $1,775 and $617 PPPY, respectively (P < 0.05). Among employees with obesity (BMI more than or equal to 30), highest total costs were observed in the government/education/religious services, food/entertainment services, and technology industries. Class I obesity increased the odds of high costs (more than or equal to 80th percentile) within each industry (odds ratios vs reference = 1.09-5.17). CONCLUSIONS: Obesity (BMI more than or equal to 30) was associated with high costs among employees of major US industries.

Presenteeism as a predictor of disability pension: A prospective study among nursing professionals and care assistants in Sweden.

OBJECTIVES: The aim of the present study was to examine how presenteeism affects the risk of future disability pension among nursing professionals and care assistants (assistant nurses, hospital ward assistants, home-based personal care workers, and child care assistants). A specific objective was to compare health and social care employees with all other occupations. METHODS: The study was based on a representative sample of working women and men (n = 43 682) aged 16-64 years, who had been interviewed between 2001 and 2013 for the Swedish Work Environment Survey conducted every second year since 1989. Information on disability pension was obtained from the Social Insurance Agency's database (2002-2014). The studied predictors were related to disability pension using Cox's proportional hazard regression with hazard ratios (HR) and 95% confidence interval (CI) and selected confounders were controlled for. The follow-up period was 6.7 years (SD 4.2). RESULTS: Health and social care employees with frequent presenteeism showed a particularly elevated risk of future disability pension after adjusting for sex, sociodemographic variables, physical and psychosocial working conditions, and self-rated health symptoms. In the amalgamated occupational group of nursing professionals and care assistants, the impact on disability pension of having engaged in presenteeism four times or more during the prior year remained significant (HR = 3.72, 95% CI = 2.43-5.68). CONCLUSIONS: The study suggests that frequent presenteeism contributes to an increased risk of disability pension among nursing professionals and care assistants as well as among all other occupations.

Who gains the most from improving working conditions? Health-related absenteeism and presenteeism due to stress at work.

Work stress-related productivity losses represent a substantial economic burden. In this study, we estimate the effects of social and task-related stressors and resources at work on health-related productivity losses caused by absenteeism and presenteeism. We also explore the interaction effects between job stressors, job resources and personal resources and estimate the costs of work stress. Work stress is defined as exposure to an unfavorable combination of high job stressors and low job resources. The study is based on a repeated survey assessing work productivity and workplace characteristics among Swiss employees. We use a representative cross-sectional data set and a longitudinal data set and apply both OLS and fixed effects models. We find that an increase in task-related and social job stressors increases health-related productivity losses, whereas an increase in social job resources and personal resources (measured by occupational self-efficacy) reduces these losses. Moreover, we find that job stressors have a stronger effect on health-related productivity losses for employees lacking personal and job resources, and that employees with high levels of job stressors and low personal resources will profit the most from an increase in job resources. Productivity losses due to absenteeism and presenteeism attributable to work stress are estimated at 195 Swiss francs per person and month. Our study has implications for interventions aiming to reduce health absenteeism and presenteeism.

Workplace Indirect Cost Impacts of Nasal and Sinus Symptoms and Related Conditions.

OBJECTIVE: Evaluate associations of nasal and sinus and related symptoms, as well as selected health conditions which produce those symptoms, with total lost productive time (LPT) at work in the past 2 weeks. METHODS: We used a cross-sectional analysis of 2402 currently working subjects. Self-reported physician diagnoses, condition statuses measured with standardized instruments, and symptom-based factor scores from an exploratory factor analysis were used in survey weighted log-binomial regression. RESULTS: Pain and pressure, nasal blockage and discharge, and asthma and constitutional symptom factor scores as well as self-reported allergic rhinitis were associated with higher total LPT. Individuals who met operationalized criteria for multiple health conditions, especially chronic rhinosinusitis, had the greatest total LPT. CONCLUSIONS: Better management of these symptoms, and awareness of how they impact an individual's ability to perform job-functions in the workplace, could improve overall productivity.

The hidden costs of employee drinking: A quantitative analysis.

INTRODUCTION AND AIMS: Alcohol use impacts workplace productivity in terms of absence and reduced performance by employees. This study's aims were to estimate the cost of lost productivity associated with alcohol use in New Zealand and to describe and quantify its impact on employers. DESIGN AND METHODS: An online survey was completed by 800 New Zealand employees and 227 employers across a range of industries. The costs of lost productivity directly attributable to alcohol use were estimated using days off work (absenteeism), lost hours of productive time while at work (presenteeism) and hours spent by employers dealing with alcohol-related issues. Ordinal logistic regression was used to explore the association between employee characteristics and reduced workplace productivity associated with alcohol consumption. RESULTS: The estimated annual average cost of lost productivity per employee was NZ$1097.71 (NZ$209.62 absenteeism, NZ$888.09 presenteeism) and NZ$134.62 per employer. At a population level this equates to approximately NZ$1.65 billion per year. The significant predictors of reduced workplace performance were being younger (less than 25 years), male, having a stressful job and drinking more than the recommended standard number of drinks per session. DISCUSSION AND CONCLUSIONS: Considering absenteeism costs alone will substantially underestimate the total productivity loss associated with alcohol use. Designing and effectively targeting a set of multifaceted policies to engineer change at both the workplace and societal levels will assist in reducing the costs of lost productivity.

Impact of a Caregiver-Friendly Workplace Policies Intervention: A Prospective Economic Evaluation.

OBJECTIVE: We estimate the potential cost-benefit of a caregiver-friendly workplace policies (CFWPs) educational intervention to facilitate uptake of supports for carer-employees (CEs) at a post-secondary institution. METHODS: We identified CEs through a voluntary survey and estimated the economic burden of caregiving activities from the CEs' and employer's perspective. The latter is used as the baseline of comparison for evaluating the cost-benefit of the intervention. RESULTS: The economic cost of caregiving-related activities for the "no intervention" scenario was estimated at $33,841,789 ($32,922 per-case) and $8,916,342 ($8,674 per-case) from the CEs' and employer's perspectives, respectively. We find the educational intervention is a cost-beneficial program with the net benefit ranging from $48,010 to $676,657, based on six scenarios of effectiveness. CONCLUSION: This study provides practical information for human resources and operations management decision-making in terms of a CFWPs educational intervention.

Indirect Economic Impact of Chronic Pain on Education Workers: A Company Perspective.

OBJECTIVE: The aim of this study was to estimate indirect cost (IC) related to chronic pain (CP) from an employer's perspective. METHODS: A cost-of-illness study was performed on active workers and retirees due to CP, between October 2017 and March 2018, in one of the Brazilian public universities. IC was measured as a sum of absenteeism, presenteeism, and disability pensions. The analysis of factors associated with IC was based on Tweedie model. RESULTS: CP had an average IC of R$9258.20 [95% confidence interval (95% CI) = 6907.37 to 11,950.17], which generates an impact of 6.42 million (95% CI = 4.37 to 10.99) per year, corresponding to 3.42% (95% CI = 2.33 to 5.85) of the payroll. The position (Measure of 2.00, 95% CI = 1.19 to 3.38) and pain intensity (Measure of 1.15; 95% CI = 1.02 to 1.30) presented independent association. CONCLUSION: CP generates the high levels of IC for the education's employer. There is an urgent need to implement prevention programs aimed at improving CP control in the workplace.