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Presenteeism: Critical Issues

Brooks, Ambyr MA; Hagen, Susan E. MS; Sathyanarayanan, Sudhakar PhD; Schultz, Alyssa B. PhD; Edington, Dee W. PhD

Journal of Occupational and Environmental Medicine: November 2010 - Volume 52 - Issue 11 - p 1055–1067
doi: 10.1097/JOM.0b013e3181f475cc
Original Articles: CME Available for this Article at

Objective: The objective of this commentary is to discuss the issues surrounding the concept of presenteeism, including the measurement of lost work time per individual, the conversion of the scores attained by the instruments into expressions of productivity loss, and the translation of productivity losses into economic outcomes.

Methods: Literature searches using PubMed and MEDLINE were conducted using “presenteeism” and “productivity” as keywords and combined with other studies known to the authors. Publications on presenteeism instruments and their applications were included.

Results: Substantive questions remain about the measurement of presenteeism, its conversion into lost productivity, and the translation of presenteeism into financial equivalents.

Conclusions: Many aspects of presenteeism still warrant caution, especially when using presenteeism measurements to quantify economic outcomes. Focusing on productivity at the population level, rather than the individual level, may be more appropriate.

From the Health Management Research Center, University of Michigan, Ann Arbor, Mich.

Address correspondence to: Dee W. Edington, PhD, Health Management Research Center, University of Michigan, 1015 East Huron Street, Ann Arbor, MI 48104-1688; E-mail:

The authors have no financial interest related to this research.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2010The American College of Occupational and Environmental Medicine