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The Association Between Work Performance and Physical Activity, Cardiorespiratory Fitness, and Obesity

Pronk, Nicolaas P. PhD; Martinson, Brian PhD; Kessler, Ronald C. PhD; Beck, Arne L. PhD; Simon, Gregory E. MD, MPH; Wang, Philip MD, DrPH

Journal of Occupational & Environmental Medicine: January 2004 - Volume 46 - Issue 1 - pp 19-25

Learning Objectives:

* List the baseline characteristics of the nearly 700 individuals participating in this study of how modifiable lifestyle-related risk factors relate to job performance.

* Define whether, and in what ways, risk factor status was associated with work performance.

* Explain what these findings mean about choosing appropriate interventions to lessen absenteeism and improve job performance.

The purpose of this study was to test the association between lifestyle-related modifiable health risks (physical activity, cardiorespiratory fitness, and obesity) and work performance. Data were obtained from 683 workers. Dependent variables included number of work loss days, quantity and quality of work performed, overall job performance, extra effort exerted, and interpersonal relationships. Results indicated that higher levels of physical activity related to reduced decrements in quality of work performed and overall job performance; higher cardiorespiratory fitness related to reduced decrements in quantity of work performed, and a reduction in extra effort exerted to perform the work; obesity related to more difficulty in getting along with coworkers; severe obesity related to a higher number of work loss days. It is concluded that lifestyle-related modifiable health risk factors significantly impact employee work performance.

The scientific literature provides ample evidence that adverse modifiable health risks such as physical inactivity and obesity are related to morbidity. 1 In turn, these modifiable health risks have been associated with excess healthcare costs in both prospective and retrospective studies, many conducted on subjects representing employed populations. 2–5 A recent review on this subject concluded that sufficient evidence exists to support this contention 6; however, less clarity exists regarding the relationship between these modifiable health risk factors and the indirect costs, ie, impact on decrements in productivity or work performance. Another recent systematic review on the effectiveness of worksite-based physical activity programs on work-related outcomes generated only 8 studies of relatively low methodologic quality. Evidence of an effect was only supported for absenteeism as an outcome; evidence was judged inconclusive for job satisfaction, job stress, and employee turnover, and nil for productivity. 7

Decrements in productivity or work performance have also proven difficult to measure. 8 Whereas absenteeism could be used as one measure of work performance, 9 other measures could consider the performance of individual employees while at work 10 or monitor the impact associated with the state of health of a given employee on their coworkers. 11 Data has emerged indicating the negative impact of disease on work performance. 12 Many of the diseases studied are associated with modifiable behavior-related health risks as an underlying causal factor, including physical inactivity and obesity. 1 Obesity appears to have a significant positive association with absenteeism, 9 but the association between physical activity or exercise and absenteeism is as of yet unknown or ambiguous at best. 6,7,9 Data describing the relationship between these modifiable health risk factors and other measures of workplace performance are currently lacking.

It was the purpose of this investigation to test the association between 3 modifiable risk factors (physical activity, cardiorespiratory fitness, and obesity) and several components of work performance, including days absent from work, performance while at work, and interpersonal relationships with coworkers.

From the Center for Health Promotion, HealthPartners, Minneapolis, Minnesota (Dr. Pronk); HealthPartners Research Foundation, HealthPartners, Minneapolis, Minnesota (Drs. Pronk and Martinson); the Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Drs. Kessler and Wang); Kaiser Permanente, Denver, Colorado (Dr. Beck); and the Center for Health Studies, Group Health Cooperative, Seattle, Washington (Dr. Simon).

Address correspondence to: Nicolaas P. Pronk, PhD, Vice President, Center for Health Promotion, HealthPartners, 8100 34th Avenue South, Minneapolis, MN 55440-1309; E-mail address:

Nicolaas Pronk has no commercial interest related to this article.

©2004The American College of Occupational and Environmental Medicine