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The Association of Health Risks With On-the-Job Productivity

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

Journal of Occupational and Environmental Medicine: August 2005 - Volume 47 - Issue 8 - p 769-777
doi: 10.1097/01.jom.0000169088.03301.e4
Original Articles

Objective: Decreased on-the-job productivity represents a large yet poorly characterized indirect cost to employers. We studied the impact of employee health risk factors on self-reported worker productivity (presenteeism).

Methods: Using a brief version of the Work Limitation Questionnaire incorporated into a Health Risk Appraisal, 28,375 employees of a national company responded to the survey. The association between health risks and work limitation and each of the four domains was examined. Percentage of lost productivity also was estimated.

Results: Ten of 12 health risk factors studied were significantly associated with self-reported work limitations. The strength of the associations varied between risks and the four domains of work limitation. Perception-related risk factors such as life dissatisfaction, job dissatisfaction, poor health, and stress showed the greatest association with presenteeism. As the number of self-reported health risk factors increased, so did the percentage of employees reporting work limitations. Each additional risk factor was associated with 2.4% excess productivity reduction. Medium and high-risk individuals were 6.2% and 12.2% less productive than low-risk individuals, respectively. The annual cost of lost productivity in this corporation was estimated at between $99M and $185M or between $1392 and $2592 per employee.

Conclusions: Health risk factors represent additional causes of lost productivity.

From the University of Illinois at Chicago, Chicago, Illinois (Dr Burton); University of Michigan Health Management Research Center, Ann Arbor, Michigan (Dr Chen, Ms Schultz, Dr Edington); DePaul University, Chicago, Illinois (Dr Conti); Center for Disability Research, Liberty Mutual Research Institute, Hopkinton, Massachusetts (Dr Pransky); and Departments of Medicine and Family Medicine, University of Massachusetts Medical School, Boston (Dr Pransky).

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

Copyright © 2005 by the American College of Occupational and Environmental Medicine