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The Assessment of Chronic Health Conditions on Work Performance, Absence, and Total Economic Impact for Employers

Collins, James J. PhD; Baase, Catherine M. MD; Sharda, Claire E. RN, MBA; Ozminkowski, Ronald J. PhD; Nicholson, Sean PhD; Billotti, Gary M. MS; Turpin, Robin S. PhD; Olson, Michael PhD; Berger, Marc L. MD

Journal of Occupational and Environmental Medicine: June 2005 - Volume 47 - Issue 6 - p 547-557
doi: 10.1097/01.jom.0000166864.58664.29
Fast Track Article

Objective: The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow).

Methods: Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported “primary” chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type.

Results: Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone.

Conclusion: For all chronic conditions studied, the cost associated with performance based work loss or “presenteeism” greatly exceeded the combined costs of absenteeism and medical treatment combined.

From the The Dow Chemical Company, Midland, Michigan (Dr Collins, Dr Baase, Mr Billotti); Outcomes Research and Management, Merck & Co., Inc. (Ms Sharda, Dr Turpin, Dr Berger); The Medstat Group, Inc. (Dr Ozminkowski); The Wharton School (Dr Nicholson); and Personnel Research Associates, Inc. (Dr Olson).

Address correspondence to: Catherine Baase, MD, Global Director, Health Services, The Dow Chemical Company, EDC Building, Midland, MI; E-mail:

©2005The American College of Occupational and Environmental Medicine