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The Association Between Health Risk Change and Presenteeism Change

Burton, Wayne N. MD; Chen, Chin-Yu PhD; Conti, Daniel J. PhD; Schultz, Alyssa B. MS; Edington, Dee W. PhD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/
Original Articles

Objective: This prospective study investigates whether changes in health risks are associated with changes in presenteeism (on-the-job productivity loss).

Method: A total of 7026 employees of a national financial services company responded to a health risk appraisal (HRA), which included a modified version of the Work Limitation Questionnaire (WLQ) in both 2002 and 2004. The association between changes in health risks and changes in self-reported presenteeism was examined.

Results: Changes in perceptual/psychologic health risks had a strong association with changes in presenteeism. Individuals who reduced their risks generally saw an improvement in productivity, whereas those who gained risks or remained high-risk status saw deterioration in productivity. Each risk factor increased or reduced was associated with a commensurate change in 1.9% productivity loss over time and estimated to be $950 per year per risk changed.

Conclusions: Positive and negative changes in health risks are associated with same-direction changes in presenteeism.

Author Information

From the Department of Environmental and Occupational Sciences (Dr Burton), University of Illinois at Chicago, Chicago, Illinois; The University of Michigan Health Management Research Center (Dr Chen, Ms Schultz, Dr Edington), Ann Arbor, Michigan; and DePaul University (Dr Conti), Chicago, Illinois.

Wayne N. Burton, MD has no financial interest associated with this research.

Address correspondence to: Dee W. Edington, PhD, Health Management Research Center, University of Michigan, 1027 East Huron Street, Ann Arbor, MI 48104-1688; E-mail:

©2006The American College of Occupational and Environmental Medicine