Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit
Abstract
Learning Objectives Recall the overall magnitude of lsot productive time (LPT) and its dollar cost as found in the American Productivity Audit, and the respective contributions of absenteeism and decreased producitivity at work. Be aware of how LPT varies with a number of demographic and workrelated factors. Compare the factors predisposing to LPT for personal and family-related reasons. The American Productivity Audit (APA) is a telephone survey of a random sample of 28,902 U.S. workers designed to quantify the impact of health conditions on work. Lost productive time (LPT) was measured for personal and family health reasons and expressed in hours and dollars. Health-related LPT cost employers $225.8 billion/year ($1685/employee per year); 71% is explained by reduced performance at work. Personal health LPT was 30% higher in females and twice as high in smokers (≥1 pack/day) versus nonsmokers. Workers in high-demand, low-control jobs had the lowest average LPT/week versus the highest LPT for those in low-demand, high-control jobs. Family health-related work absence accounted for 6% of all health-related LPT. Health-related LPT costs are substantial but largely invisible to employers. Costs vary significantly by worker characteristics, suggesting that intervention needs vary by specific subgroups.
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From The Costs of Depression (2012) · cites this paper as [79]
Cites
The American Journal of Managed Care
(2020) · The American Journal of Managed Care · doi:10.37765/ajmc · Cited by 3,238 · see citing works
Stewart, W. F. (1992) · JAMA · doi:10.1001/jama.267.1.64 · Cited by 1,592 · see citing works
Self-citationCost of Lost Productive Work Time Among US Workers With Depression
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.289.23.3135 · Cited by 1,421 · see citing works
Self-citationGreenberg, P. E., Stiglin, L. E., Finkelstein, S. N., & Berndt, E. R. (1994) · PharmacoResources · doi:10.1007/bf03289581 · Cited by 974 · see citing works
Burden of Migraine in the United States
Hu, X., Markson, L. E., Lipton, R. B., Stewart, W. F., & Berger, M. L. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.8.813 · Cited by 907 · see citing works
Self-citationHandling missing data in survey research
Brick, J. M., & Kalton, G. (1996) · Statistical Methods in Medical Research · doi:10.1177/096228029600500302 · Cited by 535 · see citing works
Depression In The Workplace: Effects On Short-Term Disability
Kessler, R. C., Barber, C. W., Birnbaum, H. G., Frank, R. G., Greenberg, P. E., Rose, R. M., Simon, G. E., & Wang, P. (1999) · Health Affairs · doi:10.1377/hlthaff.18.5.163 · Cited by 388 · see citing works
Healthcare Resource and Lost Labour Costs of Migraine Headache in the US
Osterhaus, J. T., Gutterman, D. L., & Plachetka, J. R. (1992) · PharmacoEconomics · doi:10.2165/00019053-199202010-00008 · Cited by 354 · see citing works
Long-term psychosocial work environment and cardiovascular mortality among Swedish men.
Johnson, J. V., Stewart, W. F., Hall, E. M., Fredlund, P., & Theorell, T. (1996) · American Journal of Public Health · doi:10.2105/ajph.86.3.324 · Cited by 341 · see citing works
Self-citationImpact of Migraine in the United States: Data from the National Health Interview Survey
Stang, P., & Osterhaus, J. T. (1993) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.1993.hed3301029.x · Cited by 335 · see citing works
Work-Related Disability: Results From the American Migraine Study
Stewart, W., Lipton, R., & Simon, D. (1996) · Cephalalgia · doi:10.1046/j.1468-2982.1996.1604231.x · Cited by 268 · see citing works
Self-citationRecovery from depression, work productivity, and health care costs among primary care patients
Simon, G. E., Revicki, D. A., Heiligenstein, J. H., Grothaus, L. C., VonKorff, M., Katon, W. J., & Hylan, T. R. (2000) · General Hospital Psychiatry · doi:10.1016/s0163-8343(00)00072-4 · Cited by 267 · see citing works
Lost Workdays and Decreased Work Effectiveness Associated With Headache in the Workplace
Schwartz, B. S., Stewart, W. F., & Lipton, R. B. (1997) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-199704000-00009 · Cited by 251 · see citing works
Self-citationSex Differences in the Use of Health Care Services
Mustard, C., Kaufert, P., Kozyrskyj, A. L., & Mayer, T. (1998) · New England Journal of Medicine · doi:10.1056/nejm199806043382307 · Cited by 233 · see citing works
Migraine and reduced work performance
Korff, M. V., Stewart, W. F., Simon, D. J., & Lipton, R. B. (1998) · Neurology · doi:10.1212/wnl.50.6.1741 · Cited by 220 · see citing works
Self-citationThe economic impact of depression in a workplace
Conti, D. J., & Burton, W. N. (1995) · Journal of Safety Research · doi:10.1016/0022-4375(95)98077-d · Cited by 202 · see citing works
Depression and Work Productivity: The Comparative Costs of Treatment Versus Nontreatment
Simon, G. E., Barber, C., Birnbaum, H. G., Frank, R. G., Greenberg, P. E., Rose, R. M., Wang, P. S., & Kessler, R. C. (2001) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-200101000-00002 · Cited by 193 · see citing works
The work impact of asthma and rhinitis
Blanc, P. D., Trupin, L., Eisner, M., Earnest, G., P Katz, P., Israel, L., & Yelin, E. H. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00349-8 · Cited by 188 · see citing works
The cost of productivity losses associated with allergic rhinitis.
Crystal-Peters, J., Crown, W. H., Goetzel, R. Z., & Schutt, D. C. (2000) · PubMed · Cited by 174 · see citing works
Alternative Valuations of Work Loss and Productivity
Berger, M. L., Murray, J. F., Xu, J., & Pauly, M. V. (2001) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-200101000-00005 · Cited by 151 · see citing works
Haque, M. E., Wyeth, J. W., Stace, N. H., et al. (2000) · PubMed · Cited by 128 · see citing works
Productivity Losses Associated With Diabetes in the U.S.
Ng, Y. C., Jacobs, P., & Johnson, J. A. (2001) · Diabetes Care · doi:10.2337/diacare.24.2.257 · Cited by 119 · see citing works
Henke, C. J., Levin, T. R., Henning, J. M., & Potter, L. P. (2000) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.01861.x · Cited by 114 · see citing works
Job strain and ambulatory blood pressure profiles.
Theorell, T., Fairé, U. D., Johnson, J. G., et al. (1991) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.1690 · Cited by 112 · see citing works
The Impact of Allergies and Allergy Treatment on Worker Productivity
Burton, W. N., Conti, D. J., Chen, C., Schultz, A. B., & Edington, D. W. (2001) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-200101000-00013 · Cited by 107 · see citing works
The Multinational Impact of Migraine Symptoms on Healthcare Utilisation and Work Loss
Gerth, W. C., Carides, G. W., Dasbach, E. J., Visser, W. H., & Santanello, N. C. (2001) · PharmacoEconomics · doi:10.2165/00019053-200119020-00006 · Cited by 99 · see citing works
Cognitive, Social, and Economic Costs of Allergic Rhinitis
Blaiss, M. S. (2000) · Allergy and Asthma Proceedings · doi:10.2500/108854100778248953 · Cited by 95 · see citing works
Wahlqvist, P. (2001) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(01)02590-4 · Cited by 89 · see citing works
Cost of illness studies in rheumatic diseases
Fautrel, B., & Guillemin, F. (2002) · Current Opinion in Rheumatology · doi:10.1097/00002281-200203000-00008 · Cited by 80 · see citing works
Schulman, E. A., Cady, R. K., Henry, D. C., Batenhorst, A. S., Putnam, D. G., Watson, C. B., & O’Quinn, S. (2000) · Mayo Clinic Proceedings · doi:10.4065/75.8.782 · Cited by 68 · see citing works
Pollen and mold exposure impairs the work performance of employees with allergic rhinitis
Kessler, R. C., Almeida, D. M., Berglund, P. A., & Stang, P. (2001) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)62242-9 · Cited by 64 · see citing works
Stang, P., Cady, R. K., Batenhorst, A. S., & Hoffman, L. H. (2001) · PharmacoEconomics · doi:10.2165/00019053-200119030-00002 · Cited by 58 · see citing works
Health Care Use And At-Work Productivity Among Employees With Mental Disorders
Berndt, E. R., Bailit, H. L., Keller, M. B., Verner, J. C., & Finkelstein, S. N. (2000) · Health Affairs · doi:10.1377/hlthaff.19.4.244 · Cited by 51 · see citing works
Health and Productivity: A Role for Occupational Health Professionals
McCunney, R. J. (2001) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-200101000-00007 · Cited by 48 · see citing works
Work and Productivity Loss in the Rizatriptan Multiple Attack Study
Dasbach, E. J., Carides, G. W., Gerth, W. C., Santanello, N., Pigeon, J. G., & Kramer, M. (2000) · Cephalalgia · doi:10.1046/j.1468-2982.2000.00126.x · Cited by 48 · see citing works
Burton, W. N., & Connerty, C. M. (1998) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-199808000-00007 · Cited by 32 · see citing works
The Effect of using Household as a Sampling Unit
Clark, R. G., & Steel, D. G. (2002) · International Statistical Review · doi:10.1111/j.1751-5823.2002.tb00364.x · Cited by 21 · see citing works
Gender differences in gastroesophageal reflux disease.
Ter, R. B. (2001) · PubMed · Cited by 17 · see citing works
Occupational and Allergic Rhinitis: Impact on Worker Productivity and Safety
Slavin, R. G. (1998) · Allergy and Asthma Proceedings · doi:10.2500/108854198778557700 · Cited by 15 · see citing works
Employee productivity and gastroesophageal reflux disease: the payer?s viewpoint
BORCHARDT, P. (2001) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(01)02585-0 · Cited by 11 · see citing works
Calculating the workplace cost of chronic disease.
Pe, G., Finkelstein, S., & Berndt, E. R. (1995) · PubMed · Cited by 11 · see citing works
When antihistamines go to work.
Cockburn, I., Bailit, H. L., Berndt, E. R., & Finkelstein, S. N. (1999) · PubMed · Cited by 10 · see citing works
Straub, R. H., & Cutolo, M. (2001) · Arthritis & Rheumatism · doi:10.1002/1529-0131(200103)44:3
Flagged first, then by citations
Cited by
Sorted by citations
The Epidemiology of Depression Across Cultures
Kessler, R. C., & Bromet, E. J. (2013) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031912-114409 · Cited by 2,657 · see citing works
Lost productive time and cost due to common pain conditions in the US workforce
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.290.18.2443 · Cited by 1,570 · see citing works
Self-citationTime for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104 · see citing works
Kessler, R. C. (2012) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.11.005 · Cited by 871 · see citing works
Weintraub, W. S., Daniels, S. R., Burke, L. E., Franklin, B. A., Goff, D. C., Hayman, L. L., Lloyd-Jones, D., Pandey, D. K., Sanchez, E. J., Schram, A. P., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182285a81 · Cited by 541 · see citing works
Merikangas, K. R., Ames, M., Cui, L., Stang, P. E., Ustun, T. B., Von Korff, M., & Kessler, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.10.1180 · Cited by 464 · see citing works
Stratton, E., Lampit, A., Choi, I., Calvo, R. A., Harvey, S. B., & Glozier, N. (2017) · PLOS ONE · doi:10.1371/journal.pone.0189904 · Cited by 252 · see citing works
“Overall pooled eHealth interventions showed a small significant positive effect at post intervention and follow-up for reducing overall mental health (depression, anxiety and stress) in both universal and selected employees which is similar to a recent review of eHealth interventions for general population [19], provi…”
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Bonell, C., Humphrey, N., Fletcher, A., Moore, L., Anderson, R., & Campbell, R. (2014) · BMJ · doi:10.1136/bmj.g3078 · Cited by 169 · see citing works
Meghani, S. H., Polomano, R. C., Tait, R. C., Vallerand, A. H., Anderson, K. O., & Gallagher, R. M. (2012) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01289.x · Cited by 124 · see citing works
Mental and Physical Comorbid Conditions and Days in Role Among Persons With Arthritis
Stang, P. E., Brandenburg, N. A., Lane, M. C., Merikangas, K. R., Von Korff, M. R., & Kessler, R. C. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000195821.25811.b4 · Cited by 108 · see citing works
The economic cost of physical inactivity and excess weight in American adults
Chenoweth, D., & Leutzinger, J. (2006) · Journal of Physical Activity and Health · doi:10.1123/jpah.3.2.148 · Cited by 99 · see citing works
Ahmad, S., & Franz, G. A. (2008) · Public Health · doi:10.1016/j.puhe.2007.02.020 · Cited by 73 · see citing works
Shiftwork and sickness absence among police officers: the BCOPS study
Fekedulegn, D., Burchfiel, C. M., Hartley, T. A., Andrew, M. E., Charles, L. E., Tinney-Zara, C. A., & Violanti, J. M. (2013) · Chronobiology International · doi:10.3109/07420528.2013.790043 · Cited by 73 · see citing works
Herman, P. M., Mahrer, N. E., Wolchik, S. A., Porter, M. M., Jones, S., & Sandler, I. N. (2015) · Prevention Science · doi:10.1007/s11121-014-0527-6 · Cited by 50 · see citing works
Causes and prevention of chronic postsurgical pain
Van de Ven, T. J., & John Hsia, H.-L. (2012) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e3283557a7f · Cited by 44 · see citing works
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Cicolini, G., Della Pelle, C., Cerratti, F., Franza, M., & Flacco, M. E. (2016) · Journal of Nursing Management · doi:10.1111/jonm.12362 · Cited by 38 · see citing works
- Authors
- Stewart, W. F., Ricci, J. A., Chee, E., & Morganstein, D.
- Affiliations
- Westat (United States) (US)
- Corresponding author
- Stewart, Walter F.
- ORCID
- Stewart, Walter F.
- Venue
- Journal of Occupational and Environmental Medicine
- Published
- 2003-12
- Volume
- 45
- Issue
- 12
- Pages
- 1234-1246
- ISSN
- 1076-2752 (ISSN-L)
- OpenAlex
- W2093663279
- Cited by
- 427
- References
- 43
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 14 · 2023: 14 · 2022: 17 · 2021: 24 · 2020: 23 · 2019: 13 · 2018: 18 · 2017: 18 · 2016: 23 · 2015: 29 · 2014: 29 · 2013: 44 · 2012: 17
- FWCI
- 19.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Occupational and Environmental Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety Management
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Keywords
- absenteeism, labor productivity, smoking, job demands, job control, family health, gender differences, employer costs
- MeSH terms
- Absenteeism, Adolescent, Adult, Aged, Demography, Employment, Female, Humans, Interviews as Topic, Male, Middle Aged, Telephone, United States, Poisson Distribution, Linear Models, Cost of Illness, Efficiency, Organizational
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