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PubMed2002

Productivity losses related to the common cold.

Health-related productivity assessments typically focus on chronic conditions; however, acute conditions, particularly colds, have the potential to cause substantial health-related productivity losses because of their high prevalence in working-age groups. This article presents the findings of a study conducted to estimate productivity loss due to cold by using a telephone-administered survey that measured three sources of loss: absenteeism, on-the-job productivity, and caregiver absenteeism. Each cold experienced by a working adult caused an average of 8.7 lost work hours (2.8 absenteeism hours; 5.9 hours of on-the-job loss), and 1.2 work hours were lost because of attending to children under the age of 13 who were suffering from colds. We conclude that the economic cost of lost productivity due to the common cold approaches $25 billion, of which $16.6 billion is attributed to on-the-job productivity loss, $8 billion is attributed to absenteeism, and $230 million is attributed to caregiver absenteeism.

Absenteeism↗

PubMed2003

Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys.

Associations between chronic conditions and work performance (absenteeism, presenteeism, and critical incidents) were studied in reservation agents, customer service representatives, executives, and railroad engineers. Conditions and work performance were assessed with the World Health Organization's Health and Work Performance Questionnaire. Analysis of covariance was used to estimate associations. More work performance was lost from presenteeism than absenteeism. However, chronic conditions more consistently had negative impacts on absenteeism than presenteeism. Conditions with significant effects included arthritis, asthma, chronic obstructive pulmonary disease-emphysema, depression, and chronic headaches. Arthritis had the largest aggregate effect on absenteeism-presenteeism. Only depression affected both absenteeism-presenteeism and critical incidents. Some chronic conditions have substantial workplace effects. Disease management programs for these conditions might have a positive return on investment (ROI). Health and productivity tracking surveys are needed to evaluate ROI and provide quality assurance.

Absenteeism↗

PubMed2006

Professional correlates of insomnia.

STUDY OBJECTIVES: Insomnia is a highly prevalent disorder that affects daytime functioning, behavior, and quality of life. Several reports have shown that insomnia impacts on the workforce and is associated with an increased risk of absenteeism. However, few workplace studies have been performed. Our study attempted to evaluate the professional correlates of insomnia by comparing a group of workers with insomnia to a matched group of good sleepers. The main objective measure was absenteeism. Accidents, self-esteem at work, job satisfaction, and efficiency at work were also investigated. DESIGN: Pairs of workers with insomnia (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition definition) and good sleepers, matched by age, sex, and occupational status, were interviewed by their occupational physician and also answered a self-administered questionnaire on work-related criteria. Objective data on absenteeism (number of days absent from work) were provided by the employers' health resource databases. SETTING: Paris and the Ile de France region (France). MEASUREMENTS AND RESULTS: Seven hundred eighty-five subjects completed the questionnaire. We retained 369 pair (ie, 738 subjects) for analysis. Insomniacs missed work twice as often as good sleepers. The difference between insomniacs and good sleepers in terms of absenteeism was particularly high for blue-collar workers (odds ratio = 3.0) and men (odds ratio = 2.31). Insomniacs had also a higher accident rate while driving and, strikingly, a 3-fold greater risk of having 2 or 3 serious road accidents. They also reported poor self-esteem at work, less job satisfaction, and less efficiency at work, compared with good sleepers. CONCLUSIONS: Our study found an objective increase in absenteeism in insomniacs compared with good sleepers.

Absenteeism↗

PubMed1990

[The effect of social and biological factors on work disability in an industrial population].

The authors analyze the influence of various factors on the work absenteeism in an industrial population. The work absenteeism changes significantly with age. Short, frequent incapacities, in particular on account of respiratory diseases, are typical for young age (approximately under 25 years). Least numbers of sickness days per year were recorded in workers in the fourth decade of life. Absenteeism on account of cardiovascular disease rises with age. The total work absenteeism is higher in manual workers, as compared with administrative workers and higher in women than in men. The differences depend also on the mean monthly income--the lowest rate of work absenteeism was recorded in people with a gross income above 4,500 Kcs. The influence of these factors in such that it is not possible to detect a relationship between work incapacity and biological factors, e.g. blood pressure, body weight, lipidogram, blood sugar level and others. It is beyond doubt, however, that the morbidity and mortality rate from non-infectious diseases depend on these factors. The causes of work incapacity are complex and are mostly influenced by circumstances beyond the health services.

Absenteeism↗

PubMed1994

[Criteria for chronification of diseases of the musculoskeletal system].

Musculoskeletal disorders, especially low back pain, are responsible for most of the days of work absenteeism in western industrial countries. Part of these disorders will get chronic in course of time. The question is, which criteria could be used to identify persons with chronic complaints. In the present study were selected persons with degenerative disorders and persons with idiopathic low back pain. As criterion for chronic complaints we used accumulated days of work absenteeism in two different ways. The first method identified persons with chronic complaints by percentiles of days of work absenteeism in 1990 leading to four groups (Q1-4). The second method used as the relevant criteria the number of years with days of work absenteeism for rheumatic complaints identifying three groups (Q1-3). Both suggested methods were compared for plausibility and validity with relevant parameters (progress of days of work absenteeism, sociodemographic variables, health status). Any method could identify persons with chronic disorders, so we propose to integrate subjective data to get a more valid index.

Absenteeism↗

PubMed1992

Elementary school absences and PM10 pollution in Utah Valley.

This study assessed the association between school absenteeism and respirable particulate pollution (PM10) in Utah Valley for the six school years of 1985 to 1990. Weekly absenteeism data from the Provo School District and daily data from a single elementary school in the Alpine School District were analyzed for kindergarten through sixth grade. PM10 concentrations during the study period averaged approximately 50 micrograms/m3 with the 24-hr maximum equal to 365 micrograms/m3. Absenteeism was regressed on PM10 pollution levels, temperature, snowfall, and variables indicating day of week, month of school year, and days preceding and following holidays and extended weekends. Estimated associations between absenteeism and PM10 pollution in both data sets were positive, statistically significant (P less than 0.01), and robust to different model specifications. PM10 effects persisted for up to 3 or 4 weeks. Regression results from both data sets indicated that an increase in 28-day moving average PM10 equal to 100 micrograms/m3 was associated with an increase in the absence rate equal to approximately two percentage points, or an increase in overall absences equal to approximately 40%. Similar relationships were observed for all grade levels, although the response of absences to air pollution was generally greater for grades 1-3 compared with grades 4-6. Associations between absenteeism and PM10 pollution were observed even for levels below 150 micrograms/m3.

Age Factors↗

PubMed2006

Design of the Jerusalem Handwashing Study: meeting the challenges of a preschool-based public health intervention trial.

BACKGROUND: Rates of communicable disease among young children are considerably higher in Israel than in other western countries. Strategies for reducing the disease rates are needed. PURPOSE: The goal of the Jerusalem Handwashing Study (JHS) was to evaluate a preschool-based hygiene programme aimed at reducing illness absenteeism. METHODS: The trial employed cluster randomization of preschools to intervention or control. The intervention programme was multifaceted, including various educational activities and environmental changes. The control group received the programme at the end of the study. A supplementary home component was tested using the innovative design strategy of an embedded individually-randomized trial. All-cause absenteeism and illness-related absenteeism was assessed by daily phone calls to the teachers, supplemented with phone calls to the parents to identify the cause of the absence. The primary endpoint was illness-related absenteeism. In an attempt to avoid bias, survey staff were blinded to the study design and the main outcome as well as intervention status. Validity checks were incorporated to assess the accuracy of educator absenteeism reports and were analysed for differences between the study arms. Observation of handwashing behaviour allowed assessment of behavioural change in the intervention group and spontaneous handwashing changes in the control group. RESULTS: Cluster randomization with delayed implementation in the control group was a feasible and efficient strategy. The individually-randomized embedded sub-trial proved to be an efficient way to test a supplemental intervention component, and is particularly well-suited to programmes run in educational or other group settings, including workplaces, clinics, and community centres. LIMITATIONS: The trial design did not permit analysis of the intervention effect on illness. CONCLUSIONS: The techniques used in this trial made it possible for a rigorous study of a complex community-based health intervention to be carried out successfully. They should prove helpful to future researchers.

Child, Preschool↗

PubMedDate not supplied

The costs of obesity among full-time employees.

PURPOSE: To quantify annual costs attributable to obesity, including both increased medical expenditures and absenteeism, separately for overweight and three categories of obesity (i.e., obesity grades I, II, and III) among men and women with full-time employment. DESIGN: Standard econometric methods were used to separately estimate overweight and obesity-attributable medical expenditures and absenteeism. SETTING: The civilian noninstitutionalized population of the United States. SAMPLE: Two nationally representative and publicly available datasets (with response rates of at least 60%) were restricted to participants 18 to 64 years old and employed full-time for the entire year. The final datasets used to estimate obesity-attributable medical expenditures and absenteeism included 20,329 and 25,427 adults, respectively. MEASURES. Annual medical expenditures and missed work days due to illness or injury. ANALYSIS RESULTS: Overweight and obesity-attributable costs range from dollar 175 per year for overweight male employees to dollar 2485 per year for grade-II obese female employees. The costs of obesity (excluding overweight) at a firm with 1000 employees are estimated to be dollar 285,000 per year CONCLUSIONS: Obesity results in significant increases in medical expenditures and absenteeism among full-time employees. Approximately 30% of the total costs result from increased absenteeism, and although those with grade-III obesity represent only 3% of the employed population, they account for 21% of the costs due to obesity. These estimates do not consider other potential costs associated with obesity, including disability and presenteeism.

Adult↗

PubMed2001

Health economics benefits following autologous chondrocyte transplantation for patients with focal chondral lesions of the knee.

Autologous chondrocyte transplantation (ACT) for the treatment of cartilage injuries has been in clinical use for several years. Since this new technique is potentially more costly and invasive than traditional conservative therapies, we evaluated the effect of ACT on clinical outcome, absenteeism, disability status, and total direct economic burden in 57 patients with full-thickness chondral lesions of the knee treated between 1987 and 1996. Patients graded good or excellent following ACT in the treatments groups were: femoral condyles (28/33), femoral condyles with anterior cruciate ligament (ACL) repair (5/5), osteochondritis dissecans (7/8), and patellar lesions (9/11). Pre-ACT, 57/57 patients were disabled and post-ACT (mean follow-up 7.3 years) 44/57 had no sickness, 10/57 had minor disability, and 1/57 was disabled. Two of the 57 patients suffered re-injury during the follow-up time. In the 10-year period prior to ACT, the average cost of absenteeism and surgery was SEK 982,457 ($ 122,807) and SEK 47,000 ($ 5,875), respectively, compared to the post-ACT period where both absenteeism and medical costs were dramatically reduced: SEK 9,508 ($ 1,189) and SEK 7,050 ($ 881), respectively. In conclusion, 49 of the 57 patients improved clinically as a result of the ACT treatment. A dramatic cost-saving effect was demonstrated over a projected 10-year period due to reduced absenteeism and disability.

Absenteeism↗

PubMed1995

A cost-of-illness study of back pain in The Netherlands.

In this study we estimated the costs of back pain to society in The Netherlands in 1991 to be 1.7% of the GNP. The results also show that musculoskeletal diseases are the fifth most expensive disease category regarding hospital care, and the most expensive regarding work absenteeism and disablement. One-third of the hospital care costs and one-half of the costs of absenteeism and disablement due to musculoskeletal disease were due to back pain. The total direct medical costs of back pain were estimated at US$367.6 million. The total costs of hospital care due to back pain constituted the largest part of the direct medical costs and were estimated at US$200 million. The mean costs of hospital care for back pain per case were US$3856 for an inpatient and US$199 for an outpatient. The total indirect costs of back pain for the entire labour force in The Netherlands in 1991 were estimated at US$4.6 billion; US$3.1 billion was due to absenteeism and US$1.5 billion to disablement. The mean costs per case of absenteeism and disablement due to back pain were US$4622 and US$9493, respectively. The indirect costs constituted 93% of the total costs of back pain, the direct medical costs contributed only 7%. It is therefore concluded that back pain is not only a major medical problem but also a major economical problem.

Absenteeism↗

PubMed2006

Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study.

OBJECTIVE: In an earlier study, we found that cognitive-behavioral therapy (CBT) delivered by general practitioners (GPs) for fatigue among employees on sick leave was not effective after 12 months. In this study we aim to assess the long-term efficacy of CBT by GPs for fatigue. It was hypothesized that the intervention could prevent deterioration as well as relapse of fatigue complaints and relapse into absenteeism in the long term. METHODS: Patients who participated in the original randomized controlled trial were followed up 4 years later. Fatigue and absenteeism were the main outcomes. RESULTS: Fatigue and absenteeism were high in the intervention and control groups at the 4-year follow-up. There was no significant difference between the intervention group and the control group on fatigue and absenteeism. The intervention group however tended toward less-favorable outcomes as compared with the control group. CONCLUSIONS: Like that of chronic fatigue syndrome, the prognosis of less-advanced fatigue is rather poor. CBT delivered by GPs is not effective in the long term.

Absenteeism↗

PubMedDate not supplied

[Types of employment and health: analysis of the Second European Survey on Working Conditions].

OBJECTIVES: To investigate the relationships among types of employment and several health self-perceived outcomes in a sample of active workers from the 15 state members of the European Union. METHODS: Cross-sectional study with data drawn from the Second European Survey on Working Conditions (n = 15,146 individuals). The predictive variable was the types of employment aggregated in: permanent workers, sole traders, small employers (less than 10 employees) and temporary workers (full-and part-time). Unconditional logistic regression models were adjusted by age, gender and several indications of working conditions. Permanent workers was used as the baseline category. RESULTS: Employees with permanent (69,3%) and temporary (12,5%) contracts notified the highest level of a job absenteeism while temporary employees reported the highest level of job dissatisfaction. On the other hand, sole traders (12,2%) and small employees (6.1%) notified the most frequent level of overall fatigue, backache and muscular pains. Having permanent workers as baseline category, temporary employees was associated with high dissatisfaction (OR = 1.68), and and overall fatigue (OR = 1.16), but with lower frequency of stress (OR = 0.74) and job absenteeism (OR = 0.87). Small employers showed a low frequency of absenteeism (OR = 0.68), but a high stress (OR = 1.77) and overall fatigue (OR = 1.27). Finally, sole traders reported more frequently overall fatigue (OR = 1.40), and stress (OR = 1.33), but less job absenteeism (OR = 0.58). CONCLUSIONS: These findings suggest that types of employment may have an independent effect on several health self-perceive outcomes. Further research is necessary to overcome various shortcoming of this study, and to assess the role either job security or level of income and social protection.

Absenteeism↗

PubMed1984

Disability days associated with detection and treatment in a hypertension control program.

Labeling individuals as hypertensive has been associated with increased absenteeism from work. Distributions of disability days were compared for the years before and after screening for hypertension among 10,049 participants in a clinical trial of intensive antihypertensive therapy. Stepped care participants attended special clinics and referred care participants returned to their usual sources of medical care. For those unaware of their hypertension at screening, disability days increased between baseline and one year among referred care (n = 1805), while there was no change among stepped care (n = 1842) participants. Neither referred care (n = 1868) nor stepped care (n = 1906) participants who were aware but untreated at baseline reported a change in disability days over the following year. For those aware and treated at baseline, there was no change in disability days in referred care (n = 1275), but a decrease was reported in stepped care (n = 1353). Further descriptive analyses suggest that neither labeling alone nor treatment alone was associated with increased absenteeism. However, detection and treatment were associated with increased absenteeism among newly diagnosed referred care hypertensives, while management of previously treated hypertensives in stepped care clinics was associated with reduced absenteeism. Because these latter comparisons are made between groups stratified on a postrandomization variable, selection bias is possible and interpretations must be made with caution.

Absenteeism↗

PubMed2000

Agency orientation and chronic musculoskeletal pain: effects of a group learning program based on the personal construct theory.

OBJECTIVE: This study evaluated the effects of a group learning program on patients with chronic musculoskeletal pain and high absenteeism and investigates what characterizes those patients who may benefit from such a program. The learning program was based on personal construct theory. The theory included the following: (1) participation in an educational program is related to a favorable outcome across the outcome measures (pain, pain coping, management of daily life, absenteeism, and use of health care), (2) patients with high agency orientation (i.e., inner-directed) cope with their pain and manage daily life in a better manner than do patients with low agency orientation (i.e., outer-directed), and (3) patients with high personal control, measured in terms of agency orientation, in terms of health locus of control, or in both terms, will benefit more from the educational program than will patients with low personal control. DESIGN: The study was a randomized controlled study. PATIENTS: One hundred and sixteen patients with chronic musculoskeletal pain and high absenteeism answered a questionnaire before and after the intervention program. The intervention group (n = 61) consisted of nine subgroups geographically spread through the eastern part of Norway and met for four hours every 2 weeks from February 1997 to October 1997. A total of 12 meetings were held. RESULTS: The intervention group reported a significantly higher score for the variable "management of everyday life" (p <0.005) and for the variable "health care consumption" (p <0.001) than did the control group. Patients with high agency orientation benefited more from the program with regard to pain reduction and improved pain coping than did those patients with low agency orientation (p <0.05). Patients with high agency orientation also reported less absenteeism than did those patients with low agency orientation (p <0.05).

Absenteeism↗

PubMed1990

Identifying families at high risk of cardiovascular disease: alternative work site approaches.

By examining coverage, concordance, and costs, this project evaluated four methods of cardiovascular disease (CVD) risk screening at a work site with 1821 central office employees of an energy company in Houston, Tex. Screening methods included a health risk appraisal mail questionnaire (HRA), an HRA plus brief physical assessment, an analysis of medical claims data, and an analysis of absenteeism data. Coverage ranged from 99% of employees for the absenteeism method to about 30% for the HRA method. Combining the first three screening methods, 18% of families had at least one member with a CVD or related diagnosis or one of four major CVD risk factors. The absenteeism method yielded 12.1% of the central office employees with 9 or more days absent. Although the absenteeism method identified high-cost families, only 9% had a heart disease or related diagnosis. This lack of concordance also occurs with other methods. For example, only 9.4% of families identified with the claims data were also identified by the HRA. Therefore, the methods identify different groups of high-risk families. Findings are discussed in relation to costs and other factors important to firms' selection of screening methods.

Absenteeism↗

PubMed2005

School attendance in children with Type 1 diabetes.

AIMS: To determine whether children with Type 1 diabetes mellitus (DM) miss more school than their non-DM siblings and peers and to identify factors associated with school absenteeism in children with DM. METHODS: School absenteeism data for the 2000-01 school year were obtained for 78 children with DM, 38 non-DM siblings and 118,269 age-matched peers in Toronto, Ontario. Questionnaires and hospital records were utilized to evaluate child-, family- and diabetes-related factors associated with school absenteeism in children with DM. RESULTS: Children with DM missed only slightly, albeit significantly more school than both their non-DM siblings (mean +/-sd: 10.9 +/- 8.9 vs. 8.1 +/- 8.1 days, P < 0.001) and peers (median: 8.8 vs. 5.5 days, P = 0.0005). A multiple regression analysis indicated that school absenteeism in children with DM was associated with their parents' attitudes towards school attendance (P = 0.002), poorer metabolic control (P = 0.006), shorter disease duration (P = 0.006) and a lack of aggressive behaviour (P = 0.02). CONCLUSIONS: With current management strategies, near normal school attendance is a reasonable goal for all children with DM and should be strongly encouraged by parents, educators and health care professionals.

Absenteeism↗

PubMed2005

Childhood asthma and student performance at school.

To better understand what is known about the association between childhood asthma, school attendance, and academic outcomes, the authors reviewed published studies investigating this topic. Tables with brief descriptions of each study's research methodology and outcomes are included. Research reveals evidence that rates of absenteeism are higher among students with asthma. The exact magnitude of absenteeism is difficult to ascertain. However, the studies have helped to identify characteristics of children with asthma that are most likely to be associated with the highest absenteeism rates. Some interventions to improve rates of absenteeism among school-aged children with asthma show promise, but it cannot yet be concluded that students who adhere to medical routines for controlling asthma will as a result increase their rates of attendance. Studies thus far have shown that there is either only a weak or nonexistent association between asthma and school achievement. Further studies are required to verify if certain subpopulations of children with asthma (eg, those with severe and ongoing symptoms, those with disturbed sleep, kindergarten children) are at higher risk for poor school achievement.

Absenteeism↗

PubMed1994

Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice.

OBJECTIVE: To describe the natural course of recent acute low back pain in terms of both morbidity (pain, disability) and absenteeism from work and to evaluate the prognostic factors for these outcomes. DESIGN: Inception cohort study. SETTING: Primary care. PATIENTS: 103 patients with acute localised non-specific back pain lasting less than 72 hours. MAIN OUTCOME MEASURES: Complete recovery (disappearance of both pain and disability) and return to work. RESULTS: 90% of patients recovered within two weeks and only two developed chronic low back pain. Only 49 of 100 patients for whom data were available had bed rest and 40% of 75 employed patients lost no time from work. Proportional hazards regression analysis showed that previous chronic episodes of low back pain, initial disability level, initial pain worse when standing, initial pain worse when lying, and compensation status were significantly associated with delayed episode recovery. These factors were also related to absenteeism from work. Absenteeism from work was also influenced by job satisfaction and gender. CONCLUSIONS: The recovery rate from acute low back pain was much higher than reported in other studies. Those studies, however, did not investigate groups of patients enrolled shortly after the onset of symptoms and often mixed acute low back pain patients with patients with exacerbations of chronic pain or sciatica. Several sociodemographic and clinical factors were of prognostic value in acute low back pain. Factors which influenced the outcome in terms of episode recovery (mainly physical severity factors) were only partly predictive of absenteeism from work. Time off work and return to work depended more on sociodemographic and job related influences.

Absenteeism↗