The assessment of chronic health conditions on work performance, absence, and total economic impact for employers

J Occup Environ Med. 2005 Jun;47(6):547-57. doi: 10.1097/01.jom.0000166864.58664.29.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adult
  • Chronic Disease / classification
  • Chronic Disease / economics*
  • Chronic Disease / epidemiology
  • Employee Performance Appraisal*
  • Employment
  • Female
  • Humans
  • Industry / economics*
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Prevalence
  • Surveys and Questionnaires
  • Texas / epidemiology
  • United States / epidemiology