Days Of Absence Research Articles

Classroom Temperature and Learner Absenteeism in Public Primary Schools in the Eastern Cape, South Africa.

Children spend a significant proportion of their time at school and in school buildings. A healthy learning environment that supports children should be thermally conducive for learning and working. Here, we aimed to study the relations between indoor classroom temperatures and learner absenteeism as a proxy for children’s health and well-being. This one-year prospective study that spanned two calendar years (from June 2017 to May 2018) entailed measurement of indoor classroom temperature and relative humidity, calculated as apparent temperature (Tapp) and collection of daily absenteeism records for each classroom in schools in and around King Williams Town, Eastern Cape province, South Africa. Classroom characteristics were collected using a standardized observation checklist. Mean indoor classroom temperature ranged from 11 to 30 °C, while mean outdoor temperature ranged from 6 °C to 31 °C during the sample period. Indoor classroom temperatures typically exceeded outdoor temperatures by 5 °C for 90% of the study period. While multiple factors may influence absenteeism, we found absenteeism was highest at low indoor classroom Tapp (i.e., below 15 °C). Absenteeism decreased as indoor Tapp increased to about 25 °C before showing another increase in absenteeism. Classroom characteristics differed among schools. Analyses of indoor classroom temperature and absenteeism in relation to classroom characteristics showed few statistically significant relations—although not exceptionally strong ones—likely because of the multiple factors that influence absenteeism. However, given the possible relationship between indoor temperature and absenteeism, there is a learning imperative to consider thermal comfort as a fundamental element of school planning and design. Furthermore, additional research on factors besides temperature that affect learner absenteeism is needed, especially in rural areas.

The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS): Rationale, objectives, and design.

BackgroundInfluenza viruses pose significant disease burdens through seasonal outbreaks and unpredictable pandemics. Existing surveillance programs rely heavily on reporting of medically attended influenza (MAI). Continuously monitoring cause‐specific school absenteeism may identify local acceleration of seasonal influenza activity. The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS; Oregon, WI) implements daily school‐based monitoring of influenza‐like illness‐specific student absenteeism (a‐ILI) in kindergarten through Grade 12 schools and assesses this approach for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.MethodsStarting in September 2014, ORCHARDS combines automated reporting of daily absenteeism within six schools and home visits to school children with acute respiratory infection (ARI). Demographic, epidemiological, and symptom data are collected along with respiratory specimens. Specimens are tested for influenza and other respiratory viruses. Household members can opt into a supplementary household transmission study. Community comparisons are possible using a pre‐existing and highly effective influenza surveillance program, based on MAI at five family medicine clinics in the same geographical area.ResultsOver the first 5 years, a‐ILI occurred on 6634 (0.20%) of 3,260,461 student school days. Viral pathogens were detected in 64.5% of 1728 children with ARI who received a home visit. Influenza was the most commonly detected virus, noted in 23.3% of ill students.ConclusionORCHARDS uses a community‐based design to detect influenza trends over multiple seasons and to evaluate the utility of absenteeism for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.

Trajectories of sickness absence and disability pension days among people with multiple sclerosis by type of occupation

Background: Multiple sclerosis (MS) can impact working life, sickness absence (SA) and disability pension (DP). Different types of occupations involve different demands, which may be associated with trajectories of SA/DP among people with MS (PwMS). Objectives: To explore, among PwMS and references, if SA/DP differ according to type of occupation. Furthermore, to examine how trajectories of SA/DP days are associated with type of occupation among PwMS. Methods: A longitudinal nationwide Swedish register-based cohort study was conducted, including 6100 individuals with prevalent MS and 38,641 matched references from the population. Trajectories of SA/DP were identified with group-based trajectory modelling. Multinomial logistic regressions were estimated for associations between identified trajectories and occupations. Results: Increase of SA/DP over time was observed in all occupational groups, in both PwMS and references, with higher levels of SA/DP among PwMS. The lowest levels of SA/DP were observed among managers. Three trajectory groups of SA/DP were identified: Persistently Low (55.2%), Moderate Increasing (31.9%) and High Increasing (12.8%). Managers and those working in Science & Technology, and Economics, Social & Cultural were more likely to belong to the Persistently Low group. Conclusion: Results suggest that type of occupation plays a role in the level and course of SA/DP.

The Correlation between Clinical and Demographic Parameters and Sickness Absence in Diabetic Employees.

Objectives: Diabetes mellitus is one of the most significant and prevalent chronic diseases. Individuals with diabetes can still encounter substantial difficulties in finding and keeping their job because of their condition. The purpose of this study was to examine the scope of diabetes-related absence from work and its relationship with variables such as type of employer, workload, the severity of illness, and type of treatment. Materials and Methods: We conducted a case-control study, including 220 diabetic patients and 230 controls. Information regarding absence from work was obtained by reviewing medical records, and general patient information was retrieved by conducting telephone interviews. Results: Patients with diabetes had, annually, more days of absence than non-diabetic patients (8.5 vs. 2.7, respectively p and lt; 0.001). Among diabetic patients, public-sector employees were absent more than private-sector employees (9.0 vs. 7.2 days, respectively, p and lt; 0.05). A positive correlation was found between workload (measured by stamina) and absence (Pearson correlation = 0.098, p = 0.04). Concerning the clinical variables, we found that employees suffering from diabetic complications exhibited higher absence rates (15.5 vs. 5.7 days, respectively, p and lt; 0.003). Parameters like HbA1c levels, patient age, disease duration, and type of treatment did not differ significantly amongst the groups with regards to absence rates. Conclusions: The main variables affecting absence from work were not medical but rather sociodemographic: education, workload, and type of employer. The results of this study reinforce the perception that well-controlled diabetic employees can be combined in most types of occupations without fear of increased absence from work.

Individual and population level estimates of work loss and related economic costs due to mental and substance use disorders in Metropolitan São Paulo, Brazil

BackgroundWe estimate work loss and economic costs due to mental and substance use disorders in the economically active population of the São Paulo Metropolitan Area, Brazil. MethodsThe São Paulo Megacity Mental Health Survey assessed a population-based sample of 3,007 economically active residents using the Composite International Diagnostic Interview 3.0 and the World Health Organization Disability Assessment Schedule 2 to investigate, respectively, 12-month psychiatric disorders, work performance, and economic costs. ResultsAbsenteeism over the past 12 months was reported by 12.6%, and presenteeism by 14.7% (qualitative loss) and 13.1% (quantitative loss). Having any mental disorder was associated with 17.6 days of absenteeism and 37.7 days of reduced-qualitative and/or quantitative functioning. Fourteen mental disorders were significantly associated with work loss, with odds ratios ranging from 2.3 for adult separation anxiety to 40.4 for oppositional defiant disorder. At a population-level, oppositional defiant disorder, panic disorder, attention deficit disorder, and dysthymia contributed to the largest costs. The total annual economic costs were USD $83.2 billion/year, representing 6.1% of Brazil's Gross Domestic Product in 2007. LimitationsDiagnosis of mental disorders was based on self-reported symptoms. Work loss assessment was restricted to 30 days before the interview and may not fully represents the annual real experience and symptoms of the respondents which would lead to an overestimation of the burden. ConclusionsMental disorders impose a great negative impact on work performance and functioning, with a consequent high economic burden, pointing to the need of implementing cost-effective interventions to prevent work loss.

Healthcare use, sickness absence, and disability pension among colorectal cancer survivors and population references in Sweden

Background Colorectal cancer (CRC) has negative long-term impacts on survivors’ health and work capacity. We aimed to investigate specialized healthcare use and sickness absence and disability pension among CRC survivors and matched references. Material and methods In this longitudinal register-based cohort study, 6679 patients with a first primary CRC in 2008–2011 (when aged 18–62) and 26,716 CRC-free matched references were followed from 2 years before up to 5 years after diagnosis date. Mean numbers of hospital days and outpatient visits were illustrated for survivors and references for the 7-year period. Crude and adjusted mean numbers of sickness absence/disability pension net days were calculated for post-diagnosis Years 3 and 5. Results Survivors’ healthcare use was higher compared to their references throughout the 7 years around CRC diagnosis and was mostly due to CRC, secondary neoplasms, and digestive disorders. In Year 5, survivors had 1.94 mean outpatient visits and 2.13 mean inpatient days (compared to 1.00 and 0.82 for references, respectively). Survivors’ adjusted mean sickness absence/disability pension days amounted to 85 d in Year 3 and 77 in Year 5 (compared to 57 and 54 d in the references). Higher mean number of future days was found among women, lower-educated, foreign-born, with previous comorbidities or previous mental disorders. Those with many sickness absence days in 2 years pre-diagnosis had the highest number of future sickness absence/disability pension days. Conclusions Post-diagnostic healthcare use remained high among CRC survivors, mostly due to cancer (CRC and other neoplasms) and digestive diagnoses. Their sickness absence and disability pension decreased gradually over the period but remained higher than among references. Pre-morbid characteristics may be used in early work-related clinical planning for the survivors.

Impact of Medication Adherence on Healthcare Resource Utilization, Work Loss, and Associated Costs in a Privately Insured Employed Population Treated With Adalimumab in the United States.

Objective:The aim of this study was to evaluate the impact of adherence to adalimumab on all-cause work loss, healthcare resource utilization (HRU), and direct medical and indirect costs over 2 years using real-world data.Methods:This was a retrospective cohort study using a large, United States administrative claims database. Adult patients treated with adalimumab were grouped into adherent and non-adherent cohorts and followed for up to 2 years. Outcomes were compared between cohorts.Results:Over 2 years, adherent patients had $10,214 lower per patient medical and indirect costs compared to non-adherent patients, resulting from lower HRU, fewer days of absenteeism, and lower rates of work loss events.Conclusion:Patient and societal benefits of adherence to adalimumab are significant over 2 years. These findings highlight the importance of policies aimed at improving adherence to self-administrated medications.

Association between self-reported binge drinking and absenteeism in the Baltic countries.

Objective:Substantial loss of productivity due to absenteeism is associated with alcohol use. This study examined the associations between absenteeism in the workplace and in schools and binge drinking across various beverage types in the Baltic countries.Methods:We utilised a dataset of 3,778 individuals compiled from 2015 to 2016 and performed multiple negative binomial regression analysis with multiple imputations to deal with missing data. Self-reported measures were used for both absenteeism and binge drinking.Results:We found evidence to support the claim that absenteeism, in terms of self-reported absence days, is positively associated with self-reported binge drinking, specifically with beer bingeing. On average, beer bingers reported 49% (p < .05) more absences than people who drink alcohol but do not binge on beer. For wine and spirits variables, the estimates indicated positive but statistically insignificant associations. No group differences were identified across gender and education.Conclusions:A considerable proportion of days absent from work and from school can be associated with beer bingeing. Therefore, it should be acknowledged that beverage-specific alcohol policies that are more lenient toward beer than other types of alcohol can inadvertently increase absenteeism and decrease workplace productivity.

213. Adult spinal deformity surgery is associated with increased productivity and decreased absenteeism from work and school

<h3>BACKGROUND CONTEXT</h3> Adult spinal deformity (ASD) patients experience markedly decreased health-related quality of life along many dimensions. <h3>PURPOSE</h3> We hypothesized that ASD surgery would be associated with improved work- and school-related productivity, as well as decreased rates of absenteeism. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort study. <h3>PATIENT SAMPLE</h3> Only patients eligible for 2-year follow-up were included, and those with a history of previous spinal fusion were excluded. <h3>OUTCOME MEASURES</h3> The primary outcome measures in this study were SRS-22r questions 9 ("What is your current level of work/school activity?") and 17 ("In the last 3 months have you taken any days off of work, including household work, or school because of back pain?"). <h3>METHODS</h3> A repeated measures mixed linear regression was used to analyze responses over time among patients managed operatively (OP) vs nonoperatively (NON-OP). Results were further stratified by baseline employment status, age, SVA, PI-LL, and deformity curve type. <h3>RESULTS</h3> In total, 1,188 patients were analyzed. Of those, 66.6% (n=792) were managed operatively. The vast majority (78.9%, n=934) were female. Patients were relatively evenly distributed across age groups (27.6% 0-49; 21.1% 50-59; 30.1% 60-69; 21.2% ≥70). At baseline, the mean percentage of activity at work/school was 56.4% (SD 35.4%), and the mean days off from work/school over the past 90 days was 1.6 (SD 1.8). Patients undergoing ASD surgery exhibited an 18.1% absolute increase in work/school productivity at 2-year follow-up vs baseline (p<0.0001), while no significant change was observed for the nonoperative cohort (p>0.5). Similarly, the OP cohort experienced 1.1 fewer absent days over the past 90 days at 2 years vs baseline (p<0.0001), while the NON-OP cohort showed no such difference (p>0.3). These differences were largely preserved after stratifying by baseline employment status, age group, SVA, PI-LL, and deformity curve type. <h3>CONCLUSIONS</h3> ASD patients managed operatively exhibited an average increase in work/school productivity of 18.1% and decreased absenteeism of 1.1 per 90 days at 2-year follow-up, while patients managed non-operatively did not exhibit change from baseline. Given the age distribution of patients in this study, these findings should be interpreted as pertaining primarily to obligations at work or within the home. Further study of the direct and indirect economic benefits of ASD surgery to patients is warranted. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Severity of occupational agricultural accidents in Spain, 2013–2018

The objective of this paper is to understand the causes of work accidents in Spain in the agricultural sector, and to propose possible plans and actions to improve the sector’s accident rates in the future. The paper analyses the complete pool of accidents in Spain from 2013 to 2018. Fourteen variables are studied, with the influence of each relating to accident severity, divided into three types (light, serious, and fatal). The analysis is based on a total of 158,166 accidents. Results show that the severity of the accident is related to age, gender, nationality, economic activity, company staff, length of service, location of accident, deviation, injury, days of absence, day of the week, injury, and region of Spain. This sector produces a high rate of serious accidents compared to all other sectors, employs the most foreign workers, and uses heavy machinery at work that also serves as a means of transport. We offer conclusions and future lines of research to improve worker safety and also help regulators. These results provide information that should be of use for both companies and regulators, to increase the safety of agricultural activities. This study analyzes accidents in the agriculture sector in Spain in the period between 2013 and 2018, therefore conclusions may be different when other countries of the European Union or of the rest of the world are considered.

Hamstring Strain Injury (HSI) Prevention in Professional and Semi-Professional Football Teams: A Systematic Review and Meta-Analysis.

Hamstring Strain Injuries (HSIs) are the most common type of lesion in professional footballers and the leading cause of absence days from sports. However, recent studies have shown that high-level football teams apparently do not apply any HSI prevention protocol. The aim of the study was to determine the effect of preventive strategies and protocols in reducing the incidence of hamstring muscle injuries in professional and semi-professional football teams. A literature search of PubMed/MEDLINE, ISI/Web of Science and Scopus databases was conducted with the keywords “hamstring* and (injury* or strain) and prevent* and (soccer or football)”. Quality and bias assessment was completed through the Kennelly modified scale. The Injury Incidence Rate (IIR) and the Incidence Rate Ratio (IRR) were assessed in the statistical analysis. In the meta-analysis, data were extracted, pooled and analysed with “Comprehensive Meta-Analysis Version 3.3.070” software. In total, 8 of the 1017 original search studies met the inclusion criteria of this review. The total exposure of the studies was 170,221.8 h, while the number of HSIs recorded was 165 in the intervention groups and 224 in the control groups. The average score of the quality assessment was 23.6/34. The meta-analysis of six of the eight included studies provided strong evidence that interventions are effective in reducing hamstring injuries. The IRR of the effect size was 0.443, with p-value = 0.001. The studies analysed applied different preventive strategies: the Nordic hamstring exercise, the FIFA 11+ programme and exercises for core stability or balance training. All these interventions proved to have a successful effect on prevention of hamstring injuries.

Gender differences in teachers’ occupational accidents

The authors stated that the main objective of the current research is to analyze the relationship between the gender of injured teachers and independent variables, such as age, place of the accident, absence days, and severity of the injury, to improve women’s occupational health and safety. Teachers’ accidents recorded in Spain (N = 136,702) from 2003 through 2018 were analyzed by calculating their incidence rates, using statistical tools for independent samples. Gender differences were found in some of the variables studied. Women were more likely to suffer an occupational accident. Compensation per lost working day was found to be statistically lower for women, but no differences based on gender were found in the absence days due to occupational accidents suffered by teachers. The salary gap should be addressed to avoid gender economic discrimination among injured teachers. Preventive strategies should be developed to mitigate the negative difference caused by gender variables.

Social Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and Open Cohort Approach

ObjectivesMigraine is a highly prevalent neurological disorder. The most characteristic symptom of migraine is moderate to severe recurrent headache along with other neurological symptoms. In this study, we modeled the potential reduction in migraine days and corresponding avoided productivity losses if erenumab was prescribed to the patient population indicated for prophylactic migraine treatment (≥ 4 monthly migraine days [MMDs]) in Germany from 2020 to the end of 2027. MethodsWe simulated the incremental benefits of erenumab against the standard of care. Response rates, transition probabilities, discontinuation rates, and productivity estimates were derived from the erenumab clinical trial program. Patients had a probability of residing in 1 of 7 states, given the MMDs in addition to the probability of death. Based on accrued MMDs in every cycle, days of absenteeism and presenteeism for paid and unpaid work were derived. Paid work was monetized according to gross value added using the human capital approach, whereas unpaid work was valuated according to the proxy good method. In addition, downstream macroeconomic effects were captured using value-added multipliers. Direct medical costs were concomitantly calculated. ResultsOur results show that prescribing erenumab for the indicated population in Germany could lead to a reduction of 166 million migraine days annually and reduce productivity losses in the range of €27 billion. This includes €13.1 billion from direct productivity and €13.5 billion from economic value chain effects. ConclusionsThis study highlights the macroeconomic effects of a systematic introduction of novel inhibitors of the calcitonin gene-related peptide pathway for migraine in Germany.

Return to work after lumbar disc herniation surgery: an occupational cohort study

Background and purpose — Lumbar disc herniation is a common surgically treated condition in the working-age population. We assessed health-related risk factors for return to work (RTW) after excision of lumbar disc herniation. Previous studies on the subject have had partly contradictory findings. Patients and methods — RTW of 389 (n = 111 male, n = 278 female; mean age 46 years, SD 8.9) employees who underwent excision of lumbar disc herniation was assessed based on the Finnish Public Sector Study (FPS). Baseline information on occupation, preceding health, and health-risk behaviors was derived from linkage to national health registers and FPS surveys before the operation. The likelihood of RTW was analyzed using Cox proportional hazard univariable and multivariable modelling. Results — 95% of the patients had returned to work at 12 months after surgery, after on average 78 days of sickness absence. Faster RTW in the univariable Cox model was associated with a small number of sick leave days (< 30 days) before operation (HR 1.3, 95% CI 1.1–1.6); high occupational position (HR 1.6, CI 1.2–2.1); and age under 40 years (HR 1.5, CI 1.1–1.9). RTW was not associated with sex or the health-related risk factors obesity, physical inactivity, smoking, heavy alcohol consumption, poor self-rated health, psychological distress, comorbid conditions, or purchases of pain or antidepressant medications in either the univariable or multivariable model. Interpretation — Almost all employees returned to work after excision of lumbar disc herniation. Older age, manual job, and prolonged sick leave before the excision of lumbar disc herniation were risk factors for delayed return to work after the surgery.

No significant differences in absenteeism or academic achievements in a Norwegian multiple sclerosis case control study

BackgroundThe duration and features of the multiple sclerosis (MS) prodrome are not well defined. We aimed to ascertain whether people with a future MS diagnosis have more days of absence and perform worse in upper secondary school than age, gender and county-matched controls. MethodsUsing registry data from the southeast of Norway, we identified people with MS born ≥1978. Statistics Norway provided information on grades and days of absence in cases and matched controls. We looked at absence in the three years of upper secondary school and grades in the compulsory subjects Norwegian, English, mathematics and physical education. ResultsWe identified 107 cases with disease onset one year or more after graduation and 626 controls. There were no significant differences in absence or grades achieved in the population as a whole or in those with disease onset within four years of diagnosis, and no association between time to disease onset and days of absence or grades. ConclusionThere was no difference in days of absence or grades achieved in upper secondary school in the four years leading up to disease onset in cases compared to controls. A potential prodrome may not affect cognition enough to impact school achievements.

Educational growth trajectories in adulthood: Findings from an inner-city cohort.

Educational attainment is typically examined as a static status. As adult learners have become the new trend in higher education, the changes in educational attainment in adulthood warrant more attention. Using data from the Chicago Longitudinal study (CLS), an ongoing panel investigation of 1,539 children, predictors of educational growth trajectories in adulthood were investigated. Of the study sample (N = 1,418), 51.8% were women, 93.2% were Black, 6.8% were Hispanic, 83.4% were eligible for free lunch between birth and age 3. The average age of the study sample in June 2015 was 35.1, ranging from 34.4 to 36.6. Hierarchical linear modeling (HLM) was used to analyze the changes in educational attainment between ages 24 and 35. Findings indicate that mothers not completing high school by child's age 3 and days of absence at school were significantly associated with lower educational attainment at age 24. Classroom adjustment, student college expectations, 8th grade reading scores, and on-time high school graduation were significantly associated with higher educational attainment at age 24. Classroom adjustment, 8th grade reading score, and on-time high school graduation were significantly associated with a positive growth of education between ages 24 and 35. Findings suggest that improving academic achievement and socioemotional learning skills in elementary and middle school and promoting on-time high school graduation are likely to increase one's chances to continue pursuing higher education in adulthood for Black low-income children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Survey of laceration injuries experienced by US adolescent and young adult alpine skier racers during the 2018–2019 ski season

Recently during ski racing competitions, a few high-profile accidents resulted in severe life-threatening laceration injuries. Ski-laceration injuries are caused by metal ski edges cutting through skin/muscles/arteries during falls and range in severity. There is a desire by the racing community to better protect skiers. However, current laceration injury research does not provide detailed information about laceration injuries or focus on adolescent and young adult ski racers. Therefore, the Self-Report Slash Injury Survey (Slash Survey) was conducted to (a) measure the frequency, severity, and body location of laceration injuries during skiing and (b) identify the skiing environment and ski maintenance level during laceration injuries. The Slash Survey was an online survey that asked participants ages 10–24, who are enrolled in US ski race programs, to report whether they experienced a laceration injury and what ski maintenance was used during the 2018–2019 ski season. The Slash Survey results suggest that the laceration injury rate during the 2018–2019 ski season was 6.8% and almost half the lacerations reported were considered slight (i.e. &lt;1 day of absence from the sport). For respondents of the survey, no correlation was found between laceration injuries and (a) slope surface conditions, (b) outside temperature, (c) weather, (d) skiing activity, and (e) ski maintenance (tuning). From the survey, the most common ski tuning method was using a file guide by hand (29%), automated ski tune at a ski shop (20%), stone grind (17%), and cup wheel grinder (17%). Furthermore, open-ended responses suggest that a ski community narrative may be amplifying the awareness of laceration injuries. The aim of this survey was to establish detailed information about ski laceration injuries among adolescent and young adult US ski racers for the development of mitigation strategies.

Working with Respiratory Illness: Presenteeism Among Healthcare Personnel at Tertiary-Care Hospitals in Bangladesh, 2008–2016

Background: Healthcare personnel (HCP) in crowded and resource-poor countries (eg Bangladesh), might be at risk of exposure to and transmission of respiratory illnesses to coworkers, patients, and caregivers. The infection control practices in public hospitals are inadequate in Bangladesh. We estimated the incidence of respiratory illness episodes among HCP, and proportion of HCP who worked during respiratory illnesses, including influenza virus infection, at 2 tertiary-care public hospitals in Bangladesh. Methods: From May 2008 to February 2016, HCP (defined as physicians, nurses, interns, patient care assistant, cleaners, and administrative staff working in adult and pediatric medicine wards) were asked to self-report to study physicians when they experienced new onset of cough, rhinorrhea, difficulty breathing, or fever during the April–September influenza epidemic period each year. Study physicians followed HCP throughout their respiratory illness episodes and recorded respiratory symptoms, onset dates, duration of illness, and days of presenteeism and absenteeism during illness. Nasopharyngeal and oropharyngeal swabs were collected after informed written consent and were tested for influenza by rRT-PCR. We used hospital records to enumerate total HCP working in the study wards during influenza season and multiplied by 6-months follow-up per year to calculate person-time contribution for estimating respiratory illness incidence. Results: HCP self-reported 107 episodes of respiratory illness during 656 person years of follow-up, for an estimated incidence of 16.3 per 100 person years (95% CI, 13–20). Of 107 episodes, 33 (31%) included fever and cough. The mean illness length was 3.9 days (SD, ±1.8). HCP worked an average of 3.4 days (SD, ±1.4) while ill. HCP missed work for a median of 1 day (IQR, 1–2) during 29 (27%) of 107 illness episodes. HCP consented to collect swabs during 56 (52%) episodes, and among them 8 (14%) of 56 tested positive for influenza (flu-A, n = 5; flu-B, n = 3). Also, 63% of HCP with influenza reported fever and cough. HCP experiencing either respiratory illness or influenza worked for similar periods of days while ill: mean, 4 (SD, ±2.2) versus mean, 3.3 (SD, ±1.4) (P = .257). HCP worked during 105 (98%) of 107 respiratory illness and 7 (88%) of 8 influenza episodes. Conclusions: Most HCP in Bangladesh, including those with influenza, worked during respiratory illnesses. The potential value of stay-at-home policies, compensation for sick days, and influenza vaccination in reducing HCP-associated respiratory pathogen transmission could be assessed in Bangladesh and similar settings.Funding: NoDisclosures: None

Costs Associated with Productivity Loss Among U.S. Patients Newly Diagnosed with Multiple Myeloma Receiving Oral Versus Injectable Chemotherapy

BackgroundThe use of novel Multiple Myeloma (MM) drug agents has been associated with improved therapeutic outcomes and survival; however, MM continues to pose a significant economic burden on both patients and healthcare systems. Evaluating the economic implications and outcomes of available treatments is important to improve efficiency of care.Patients with MM may experience productivity loss, including lost days from work or inability to work due to MM symptoms or to undergoing treatment. Although direct costs of illness have been well described in the literature, indirect costs associated with MM are understudied. Here, we examine the extent of workplace productivity loss among U.S. adult patients with MM and associated costs. These outcomes were compared among patients who received injectable versus oral MM therapy.MethodsAnalyses were conducted using the Truven Health Analytics MarketScan Commercial Claims and Encounters with Medicare Supplemental Coordination of Benefits and Health and Productivity Management Databases. Subjects at least 18 years of age diagnosed with MM between January 1, 2008 and December 31, 2014 were included in our study and followed until December 31, 2015 (Figure 1). Subjects were analyzed one year prior to, and one year following first MM diagnosis. Patients receiving only oral therapy were compared with those who received injectable therapy.Productivity loss was evaluated using several key variables found within workplace absenteeism (WAB), short-term disability (STD), and long-term disability (LTD) claim files. Workplace productivity loss (WPL), an aggregate of absenteeism days, was calculated using claims for WAB, STD, and LTD benefits. Cost of productivity loss was calculated for each patient by multiplying the number of absenteeism days (as indicated in the aggregate WPL measure) by the average daily wage for all occupations, as reported by the U.S. Bureau of Labor Statistics (Table 1).Absenteeism days and costs were compared among study groups using multi-variable zero-inflated Poisson regression. The following variables were used as covariates in the model: age, index year, gender, Charlson comorbidity index, and plan type. An interrupted time-series analysis was also conducted to evaluate changes in productivity losses in the pre- vs. post-diagnosis periods, and to compare these among the treatment groups.ResultsThe final study cohort included 299 patients with newly diagnosed MM, of whom 73 received oral therapy and 226 received injectable therapy. Baseline characteristics of the study groups are depicted in Table 2. In the zero-inflated Poisson regression, treatment type was a significant predictor of productivity loss (Figure 2). Patients who received injectable therapy missed an average of 110 work days in the one year post-diagnosis, compared with 88 for patients receiving only oral therapy (difference of 22 days, 95% CI: 19 - 25, p<0.001). Treatment type was also a significant predictor of cost of lost productivity in this model (Figure 3). Patients who received injectable therapy experienced productivity loss valued at $18,329, compared with patients who only received oral drug therapy ($14,467). The difference in valuated productivity losses between study cohort groups was also statistically significant ($3,862, 95% CI: $3,518 - $4,205, p<0.001).An interrupted time-series analysis showed a significant increase in missed work days per month following the initial diagnosis of MM for both treatment groups. Patients receiving injectable therapy experienced an immediate increase of 6.9 lost productivity days per month (95% CI: 5.1, 8.7, p<0.001), versus patients receiving oral therapy only (4.4 days per month; 95% CI: 2.7, 6.2, p<0.001). The difference in these values was not statistically significant, although a strong trend was observed (2.5 day per month; 95% CI: -0.1, 5.0, p=0.057).ConclusionsIn conclusion, patients newly diagnosed with MM face significant losses in productivity. Injectable MM therapy users experience significantly more utilization of disability benefits and incur higher productivity costs, compared to oral MM therapy users. Further studies elucidating the nature of the differences between parenteral and non-parenteral chemotherapy users are needed. [Display omitted] DisclosuresMerola:Millennium Pharmaceuticals, Inc.: Consultancy. Yong:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Noga:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Shermock:Millenium Pharmaceuticals: Consultancy.

Telehealth Utilization Is Associated with Lower Risk of Discontinuation of Buprenorphine: a Retrospective Cohort Study of US Veterans.

ObjectiveTreatment for opioid use disorder (OUD) may include a combination of pharmacotherapies (such as buprenorphine) with counseling services if clinically indicated. Medication management or engagement with in-person counseling services may be hindered by logistical and financial barriers. Telehealth may provide an alternative mechanism for continued engagement. This study aimed to evaluate the association between telehealth encounters and time to discontinuation of buprenorphine treatment when compared to traditional in-person visits and to evaluate potential effect modification by rural-urban designation and in-person and telehealth combination treatment.MethodsA retrospective cohort study of Veterans diagnosed with OUD and treated with buprenorphine across all facilities within the Veterans Health Administration (VHA) between 2008 and 2017. Exposures were telehealth and in-person encounters for substance use disorder (SUD) and mental health, treated as time-varying covariates. The primary outcome was treatment discontinuation, evaluated as 14 days of absence of medication from initiation through 1 year.ResultsCompared to in-person encounters, treatment discontinuation was lower for telehealth for SUD (aHR: 0.69; 95%CI: 0.60, 0.78) and mental health (aHR: 0.69; 95%CI: 0.62, 0.76). There was no evidence of effect modification by rural-urban designation. Risk of treatment discontinuation appeared to be lower among those with telehealth only compared to in-person only for both SUD (aHR: 0.48, 95%CI: 0.37, 0.62) and for mental health (aHR: 0.46; 95%CI: 0.33, 0.65).ConclusionsAs telehealth demonstrated improved treatment retention compared to in-person visits, it may be a suitable option for engagement for patients in OUD management. Efforts to expand services may improve treatment retention and health outcomes for VHA and other health care systems.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06969-1.