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PubMed2006

The economic impact of bipolar disorder in an employed population from an employer perspective.

OBJECTIVE: To determine the economic impact of bipolar disorder on health benefit costs and health-related work absences from an employer perspective. METHOD: Data on health benefit costs and health-related absences during 2001 and 2002 were retrieved from a database and retrospectively examined. Regression modeling measured the cost differences while controlling for potentially confounding factors. The study population consisted of employees at multiple large employers who were widely dispersed throughout the United States. These employees were grouped into 2 cohorts: (1) employees with a bipolar disorder diagnosis (primary, secondary, or tertiary ICD-9 code of 296.0x, 296.1x, 296.4x, 296.5x, 296.6x, 296.7x, or 296.8x) in 2001 and (2) employees with no bipolar disorder diagnosis during 2001 or 2002 (comparison cohort). Specific outcome measures included annual health benefit claim costs and salary-replacement payments for the following employee health benefits: health care insurance, prescription drug, sick leave, short- and long-term disability, and workers' compensation. Additional outcome measures included annual absence days due to workers' compensation, short- and long-term disability, and sick leave (separately). RESULTS: The analysis identified 761 employees (0.3%) with bipolar disorder and 229,145 eligible employees without bipolar disorder. Employees with bipolar disorder annually cost $6836 more than employees without bipolar disorder (p < .05) and were more costly in every health benefit cost category. Employees with bipolar disorder missed an average of 18.9 workdays annually, while employees without bipolar disorder missed 7.4 days annually (p < .05). CONCLUSION: The impact of bipolar disorder can be costly in the workplace, leading to increased health benefit costs and increased absenteeism.

Absenteeism↗
PubMed1986

Impact of guinea worm disease on children in Nigeria.

School attendance records of all primary schools in a guinea worm-endemic village in southwestern Nigeria were examined to determine the cause of missed school days and school drop-outs. At the time of the survey, 1,495 pupils (768 boys and 727 girls were registered in the 4 primary schools in the village, of which 21% of the pupils were infected with guinea worm disease (GWD). Female pupils had a higher infection rate than their male counterparts. Guinea worm-infected pupils missed up to 25% of school year days compared to a non-guinea worm-infected absence of 2.5%. At the height of guinea worm season in the study area, guinea worm-related absences contributed virtually all of the absenteeism recorded in the schools. Implications of the findings within the context of educational attainment of the pupils are discussed.

Absenteeism↗
PubMedDate not supplied

A review of health-related outcomes of multi-component worksite health promotion programs.

PURPOSE: The purpose of this article is to critically review evaluation studies of the health-related effects (i.e., health risk modification and reduction in worker absenteeism) of multicomponent worksite health promotion programs. SEARCH METHOD: A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 36 articles that examined health-related outcomes of multi-component programs. The authors identified 11 additional articles through manual searches of recent journal issues and through personal contacts with worksite health promotion researchers. Forty-seven studies describing the results of 35 worksite health promotion programs were reviewed. IMPORTANT FINDINGS: The worksite health promotion programs reviewed for this article varied tremendously in the comprehensiveness, intensity, and duration of the intervention activities. All of the programs provided health education to employees. In a majority of the programs, opportunities to learn and practice new skills were also offered. A smaller number of programs incorporated modifications in organizational policy or the physical work environment. Results from well-conducted randomized trials suggest that providing opportunities for individual risk reduction counseling for high risk employees within the context of comprehensive programming may be the critical component of an effective worksite health promotion program. Just offering low intensity, short duration programs aimed at increasing awareness of health issues for the entire employee population may not be sufficient to achieve desired outcomes. MAJOR CONCLUSIONS: The results of the studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and some general guidance as to the critical components and characteristics of successful programs. Overall, the evidence suggests that a rating of indicative/acceptable may best characterize this literature.

Absenteeism↗
PubMedDate not supplied

Carrots and sticks: impact of an incentive/disincentive employee flexible credit benefit plan on health status and medical costs.

PURPOSE: Employee wellness programs aim to assist in controlling employer costs by improving the health status and fitness of employees, potentially increasing productivity, decreasing absenteeism, and reducing medical claims. Most such programs offer no disincentive for nonparticipation. We evaluated an incentive/disincentive program initiated by a large teaching hospital in western Michigan. METHODS: The HealthPlus Health Quotient program is an incentive/disincentive approach to health promotion. The employer's contribution to the cafeteria plan benefit package is adjusted based on results of an annual appraisal of serum cholesterol, blood pressure, tobacco use, body fat, physical fitness, motor vehicle safety, nutrition, and alcohol consumption. The adjustment (health quotient [HQ]) can range from -$25 to +$25 per pay period. We examined whether appraised health improved between 1993 and 1996 and whether the HQ predicted medical claims. RESULTS: Mean HQ increased slightly (+$0.47 per pay period in 1993 to +$0.89 per pay period in 1996). Individuals with HQs of less than -$10 per pay period incurred approximately twice the medical claims of the other groups (test for linear trend, p = .003). After adjustment, medical claims of employees in the worst category (HQ < -$10 per pay period) were $1078 (95% confidence interval $429-$1728) greater than those for the neutral (HQ between -$2 and +$2 per pay period) category. A decrease in HQ of at least $6 per pay period from 1993 to 1995 was associated with $956 (95% confidence interval $264-$1647) greater costs in 1996 than was a stable HQ. CONCLUSIONS: The HealthPlus Health Quotient program is starting to yield benefits. Most employees are impacted minimally, but savings are accruing to the employer from reductions in medical claims paid and in days lost to illness and disability.

Absenteeism↗
PubMed1994

Psychosocial stressors at work and musculoskeletal problems.

OBJECTIVES: This paper examines the relationship between work stressors and the following health indicators: psychosomatic complaints, health behavior, and musculoskeletal problems. METHODS: Secondary analyses were performed on data from the National Work and Living Condition Survey, which provides a representative sample of the working population in The Netherlands. The survey was made in 1977, 1983, and 1986 by The Netherlands Central Bureau of Statistics. By means of factor analysis the following three risk dimensions were identified in the survey: work pace, intellectual discretion, and physical stressors. RESULTS: High work pace, low intellectual discretion, and physical stressors were associated with increased health complaints (both psychosomatic and musculoskeletal) and musculoskeletal disorders after adjustment for gender, age, education, and sports participation. Low intellectual discretion, but not high work pace, was associated with poor general health and health behavior indicative of poor health. Physical stressors were associated with general health as well, but not with health behavior, except for reported absenteeism. CONCLUSIONS: Psychosocial stressors are not only associated with psychosomatic complaints and health indicators, but also with musculoskeletal problems, both acute and chronic. Especially the relation between intellectual discretion and musculoskeletal problems can be partly attributed to physical load. Even after adjustment for physical stressors and moderating personal characteristics, the relationships between the psychosocial stressors and musculoskeletal problems remained significant and comparable in strength to the relationship between psychosocial stressors and several other health outcomes, such as psychosomatic complaints.

Absenteeism↗
PubMed1991

Preemployment medical examinations in a large occupational health service.

Several hundreds of thousands of preemployment medical examinations are performed in The Netherlands each year, with the objective of screening for obvious risks for the applicants or others. Neither the efficacy of these examinations nor determinants for rejection are known. Altogether 101,754 preemployment medical examinations of applicants for governmental functions were analyzed. For one-fifth of the applicants some medical diagnosis was recorded. The overall rejection percentage was 0.6%, being highest for job categories involving public safety and high physical demands, but never exceeding 4%. Age was positively correlated with rejection percentage. Except for the diagnostic category "disorders of the musculoskeletal system" no relation between diagnostic category and job demands was apparent. Medical diagnoses frequently encountered among rejected applicants were also common among successful applicants. If selection aiming at reducing absenteeism or work disablement is considered to be the only goal of preemployment medical examinations, then their efficacy appears to be low for many job categories.

Absenteeism↗
PubMed2006

Cost of obesity in the workplace.

As the prevalence of obesity increases, its economic consequences must be understood. This review summarizes published literature on the costs and resource use associated with obesity in the workplace. A Medline literature search was conducted for English-language publications. References from identified articles were also reviewed for relevance. The identified studies evaluated several cost components, including absenteeism, sick leave, disability, injuries, and claims data. Overall, overweight or obese employees had higher sick leave or disability use. Workplace injuries were higher among overweight or obese employees. Health care costs, based on claims data analyses, were also consistently higher for employees with higher body mass indices. Obesity is an important driver of costs in the workplace. These findings quantify the costs and can help employers consider whether to introduce workplace interventions or provide coverage for weight loss programs.

Absenteeism↗
PubMed2006

Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?

OBJECTIVES: This study investigates whether an imbalance between physical capacity and exposure to work-related physical factors is associated with low-back, neck, or shoulder pain. METHODS: Data of the longitudinal study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), with a follow-up of 3 years (N=1789), were used. At baseline, physical capacity (isokinetic lifting strength, static muscle endurance, and mobility of the spine) and exposure to work-related physical factors were assessed. During the follow-up, low-back, neck, and shoulder pain were self-reported annually. "Imbalance" was defined as lower than median capacity combined with higher than median exposure, "high balance" was high capacity and high exposure, and "low balance" was low capacity and low exposure. RESULTS: For both the low-back and neck, imbalance between static endurance and working with flexed postures was a risk factor for pain [relative risk (RR) 1.35, 95% confidence interval (95% CI) 1.08-1.68, and RR 1.36, 95% CI 0.96-1.91, respectively]. Low balance was also associated with low-back pain (RR 1.29, 95% CI 1.04-1.68). Furthermore, low balance between isokinetic lifting strength and lifting exposure was a risk factor for low-back and neck pain [RR between 1.22 (95% CI 0.99-1.49) and 1.35 (95% CI 1.03-1.79)]. No associations were found with shoulder pain. CONCLUSIONS: Some relationship between low-back and neck pain and combined measures of physical capacity with exposure to work-related physical factors seems to exist, but an imbalance between physical capacity and exposure was not found to yield higher risks than high balance or low balance.

Absenteeism↗
PubMed1993

Diabetes in the workplace. Employment experiences of young people with diabetes mellitus.

OBJECTIVE: To assess some of the employment experiences of people with diabetes mellitus and to compare their experiences with those of a non-diabetic sibling control group. DESIGN: A questionnaire about employment experiences was administered to diabetic subjects aged 16-39 years, and an abbreviated questionnaire was administered to their eligible siblings. SETTING: The Illawarra area of New South Wales. PARTICIPANTS: The names of diabetic subjects were obtained from the Illawarra diabetes register. RESULTS: Interviews were conducted with 184 of 226 (81.4%) eligible diabetic subjects and with 70 eligible siblings. There were no significant differences between the diabetic subjects and their siblings with respect to educational achievements and rates of employment. Siblings reported a mean of 2.6 days sickness absenteeism in the year prior to the survey. Diabetics were absent from work for a mean of 4.5 days for reasons not related to their diabetes and for a mean of 2.6 days for diabetic causes. Within the diabetic group, 50% felt that having diabetes would make it more difficult to find another job, 33.7% felt that diabetes would influence their search for alternative employment and 19.6% felt that at some stage they had been refused employment because of their diabetes. Fifteen per cent of diabetics were aware of an example of discrimination and 24.2% of diabetics in employment had at some stage tried to hide their diagnosis from their employer. CONCLUSIONS: Diabetics do not appear disadvantaged compared with their siblings with respect to employment participation but are more likely to be absent from work due to sickness. However, many diabetic subjects had experienced a job refusal, had tried to hide their diagnosis from employers, were aware of examples of discrimination and were very negative about future employment prospects.

Absenteeism↗
PubMed2000

The alcohol hangover.

PURPOSE: To review the cause, pathophysiologic characteristics, cost, and treatment of alcohol-induced hangover. DATA SOURCES: A MEDLINE search of English-language reports (1966 to 1999) and a manual search of bibliographies of relevant papers. STUDY SELECTION: Related experimental, clinical, and basic research studies. DATA EXTRACTION: Data in relevant articles were reviewed, and relevant clinical information was extracted. DATA SYNTHESIS: The alcohol hangover is characterized by headache, tremulousness, nausea, diarrhea, and fatigue combined with decreased occupational, cognitive, or visual-spatial skill performance. In the United States, related absenteeism and poor job performance cost $148 billion annually (average annual cost per working adult, $2000). Although hangover is associated with alcoholism, most of its cost is incurred by the light-to-moderate drinker. Patients with hangover may pose substantial risk to themselves and others despite having a normal blood alcohol level. Hangover may also be an independent risk factor for cardiac death. Symptoms of hangover seem to be caused by dehydration, hormonal alterations, dysregulated cytokine pathways, and toxic effects of alcohol. Physiologic characteristics include increased cardiac work with normal peripheral resistance, diffuse slowing on electroencephalography, and increased levels of antidiuretic hormone. Effective interventions include rehydration, prostaglandin inhibitors, and vitamin B6. Screening for hangover severity and frequency may help early detection of alcohol dependency and substantially improve quality of life. Recommended interventions include discussion of potential therapies and reminders of the possibility for cognitive and visual-spatial impairment. No evidence suggests that alleviation of hangover symptoms leads to further alcohol consumption, and the discomfort caused by such symptoms may do so. Therefore, treatment seems warranted. CONCLUSIONS: Hangover, a common disorder, has substantial morbidity and societal cost. Appropriate management may relieve symptoms in many patients.

Absenteeism↗
PubMed2004

Clinical characteristics and functional outcomes of West Nile Fever.

BACKGROUND: West Nile fever, considered a nonsevere manifestation of West Nile virus infection, has not been clinically well described in the United States. In 2002, Illinois had 884 documented cases of West Nile virus infection with 66 associated deaths. OBJECTIVE: To describe the symptoms and functional outcomes of West Nile fever. DESIGN: Case series. SETTING: Illinois. PATIENTS: 98 community-dwelling patients with laboratory evidence of West Nile virus infection but no history of clinical evidence of meningitis, encephalitis, or acute flaccid paralysis. INTERVENTION: Outpatient interviews. MEASUREMENTS: Presence and duration of patient-reported symptoms of infection, symptom-associated absenteeism, health care use, and impact on daily activities. RESULTS: Of 98 patients, 96% had fatigue for a median of 36 days, 81% had fever for a median of 5 days, 71% had headache for a median of 10 days, 61% had muscle weakness for a median of 28 days, and 53% had difficulty concentrating for a median of 14 days. Thirty respondents reported hospitalization, with a median stay of 5 days. At 30 days after onset, 63% of respondents continued to have symptoms. Duration did not vary significantly with increased age. Among the 72 patients who normally attended work or school, 57 (79%) could not attend because of illness (median absence, 10 days). LIMITATIONS: Recall bias could have been introduced by the delay between illness onset and interview and by self-reporting of illness information. CONCLUSIONS: West Nile fever is a more severe illness than has previously been documented. Mandatory reporting of West Nile fever cases in addition to West Nile meningoencephalitis cases could allow more accurate and timely recognition of the geographic distribution of West Nile virus infections and could inform public health interventions.

Absenteeism↗
PubMed1997

Sexual harassment in health care: a major productivity problem.

Sexual harassment in health care is a problem because of exorbitant legal costs, lost productivity, poor morale, and nonproductive absenteeism or turnover. Sexual harassment is more prevalent in health care. Health care organizations often do little to prevent it and do not respond properly when it occurs. In this article, legal precedents are reviewed, and a model of sexual harassment is developed to illustrate the phenomenon and identify interventions. Harassing and stereotyping behavior can be changed. Victims' responses and willingness to report incidents can be changed. Policies, sanctions, accountability, training, the type of investigations, and changed organizational culture help reduce sexual harassment. It is argued that reduction of sexual harassment in health care is important because it is a major productivity issue.

Absenteeism↗
PubMed1998

When worlds collide: elder caregiving poses new challenges for balancing work and life.

Nearly one in four U.S. households (an estimated 22.4 million) are caring for elderly family members or friends; as the nation's population ages, more and more workers will take on elder caregiving responsibilities. As this trend continues, employers will face increasing concerns about lost productivity and many employees will struggle to balance the demands of work and caregiving responsibilities. To help resolve the situation, many employers may look to a comprehensive work/life program, which incorporates an intensive focus on elder-care issues, to help boost morale, improve employee productivity and job performance, and reduce stress and absenteeism associated with caregiving.

Absenteeism↗
PubMed1986

Beyond the Steers and Rhodes model of employee attendance.

This paper presents a causal model of employee absenteeism which modifies and extends the Steers and Rhodes (1978) process model of employee attendance. A summary and critique of the Steers and Rhodes model is offered. The proposed model integrates diverse literatures regarding organization behavior and occupational health. Sources are provided for the acceptable operationalization of variables.

Absenteeism↗
PubMed1989

A supervisor asks: motivational implications.

In summary, to hold absenteeism to the lowest practical level: Watch attendance closely, and let your employees know you are watching; keep accurate attendance records, and again let your employees know you do so; talk with and otherwise counsel individual offenders; and apply your organization's policy faithfully, fairly, and consistently.

Absenteeism↗
PubMed1999

Antibacterial management of acute and chronic sinusitis.

Sinusitis is a common disorder in both children and adults. It is responsible for significant absenteeism from school and work. Up to 10% of upper respiratory infections in children are complicated by acute sinusitis. Since antibacterial therapy is most often empirically chosen to treat the disorder, knowledge of the typical etiologic agents as well as awareness of the antibacterial susceptibility profiles in a given community are of paramount importance. The need for consistently bactericidal antibacterials, the recognition of the importance of nontypable Hemophilus influenzae unresponsive to first-generation cephalosporins, tetracyline-resistant Gram-positive cocci, and the increasing emergence of beta-lactamase-positive respiratory pathogens such as H. influenzae and Moraxella catarrhalis, now mandate the use of newer therapeutic agents for acute and chronic sinusitis.

Absenteeism↗
PubMed1999

[Market effect on social security and occupational health services].

Between 1993 and 1998 a fundamental reform of the social security system and Occupational Health Services (OHSs) in the Netherlands was implemented in order to lower the relatively high sickness and disability rates. The principle of the government policy is to impose the financial consequences of incapacity for work as much as possible on those who cause it: employers and employees. The reform implies the creation of a market in both fields. Joining an OHS was made mandatory for all employers by ultimately the first of January 1998. Price and product competition between different suppliers of OHSs is promoted. This implies an explosive increase of the target population and the rise of commercial OHSs (which in 1997 provided for 570,000 employees). Other OHSs originated from industrial insurance boards (over 2 million) or from industrial health services (over 3 million). The change of system has increased the economic importance of sickness and health. The number of persons incapable for work has meanwhile grown, risk avoidance by enterprises being one of the causes. Owing to the enhanced interference of employers with absenteeism, the health care system is being asked for specific measures for employees and better contacts between industrial physicians and treating physicians.

Absenteeism↗
PubMed1999

Nurses' well-being in a primary nursing care setting in The Netherlands.

A study was conducted in a Dutch hospital to evaluate the effects of the implementation of a Dutch form of Primary Nursing on nurses' well-being in the work situation. The variables used as indicators of well-being at work were job satisfaction, experienced job significance, health complaints and absenteeism. The study included three measuring periods: one pre-intervention (t1) and two post-intervention periods (t2, 8 months after t1, and t3, 14 months after t1). Primary Nursing was implemented in group 1 (consisting of two nursing units) after t1. At this time no changes were introduced into group 2 (three nursing units) but after t2. Primary Nursing was also implemented in group 2. The research variables were measured by means of questionnaires. The results of the study indicate that most of the expected effects of Primary Nursing did not occur. Some methodological and practical explanations for this outcome are given.

Absenteeism↗