Reduced Work Performance Research Articles

The Prognostic Value of the Work Ability Index for Sickness Absence among Office Workers.

BackgroundThe work ability index (WAI) is a frequently used tool in occupational health to identify workers at risk for a reduced work performance and for work-related disability. However, information about the prognostic value of the WAI to identify workers at risk for sickness absence is scarce.ObjectivesTo investigate the prognostic value of the WAI for sickness absence, and whether the discriminative ability differs across demographic subgroups.MethodsAt baseline, the WAI (score 7-49) was assessed among 1,331 office workers from a Dutch financial service company. Sickness absence was registered during 12-months follow-up and categorised as 0 days, 0<days<5, 5≤days<15, and ≥15 days in one year. Associations between WAI and sickness absence were estimated by multinomial regression analyses. Discriminative ability of the WAI was assessed by the Area Under the Curve (AUC) and Ordinal c-index (ORC). Test characteristics were determined for dichotomised outcomes. Additional analyses were performed for separate WAI dimensions, and subgroup analyses for demographic groups.ResultsA lower WAI was associated with sickness absence (≥15 days vs. 0 days: per point lower WAI score OR=1.27; 95%CI 1.21-1.33). The WAI showed reasonable ability to discriminate between categories of sickness absence (ORC=0.65; 95%CI 0.63-0.68). Highest discrimination was found for comparing workers with ≥15 sick days with 0 sick days (AUC=0.77) or with 1-5 sick days (AUC=0.69). At the cut-off for poor work ability (WAI≤27) the sensitivity to identify workers at risk for ≥15 sick days was 7.5%, the specificity 99.6%, and the positive predictive value 82%. The performance was similar across demographic subgroups.ConclusionsThe WAI could be used to identify workers at high risk for prolonged sickness absence. However, due to low sensitivity many workers will be missed. Hence, additional factors are required to better identify workers at highest risk.

Heat stress causes substantial labour productivity loss in Australia

Climate change is expected to exacerbate absenteeism as a result of heat stress, with ramifications for labour productivity. Reduced work performance in 2013–2014 in Australia was found to represent an economic burden of around US$6.2 billion.

Effects of Structure Characteristics of Fly Ash on Performance of Ready-Mixed Concrete

Effects of structural characteristics of two different types of fly ash on performance of ready-mixed concrete were studied.Results indicated that, comparing with fly ash containing round spherical micro-Pearl 80% around , fly ash containing round spherical micro-Pearl below 20% will reduced work performance of pre-mix concrete clearly, water requirement increases 16% around, slump loss 0.5h for 100mm around, 1h for 140mm around, and because needed using excessive of pumping agent and makes setting time of concrete extended. Major accident hazards exist in actual pumping concrete. Respectively 40% two types of fly ash cement hydration morphology comparative studies showed that, mixed with fly ash containing round spherical micro-Pearl below 20% ,hardened cement paste with high porosity, density is low, such ash failed to improve performance of cement matrix.

Burnout : concepts and implications affecting public health

Burnout was originally described as a mental condition characterized by reduced work performance, impotence, frustration and lack of capability to reach objectives or goals while performing a job. For some authors, burnout is a poorly defined mixture of symptoms and signs, while other professionals think of it as a disease and a potential threat to public health. Worldwide, it has been observed that the most afflicted professionals and technicians are those who work providing services or assistance to other people, especially those dedicated to health care. This paper focuses on the idea that burnout should be considered a disease more than a syndrome. On the other hand, definitions of health and disease have changed with time, as well as theoretical and methodological references about burnout. In addition, burnout remains a condition that is being discussed in various scientific areas, with radically opposing positions; these approaches are discussed in this article. After presenting different conceptions regarding burnout, the essay concludes with an exploration of its implications and the identification of possible treatments, especially for health workers, among whom it is more common depending on their predisposing conditions and environments.

PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines.

Traumatic events after a road traffic accident (RTA) can be physical and/or psychological. Posttraumatic stress disorder (PTSD) is one of the major psychological conditions which affect accident victims. Psychological issues may not be addressed in the emergency department(ED) immediately. There have been reports about a mismatch between the timely referrals from ED to occupational or primary care services for these issues. If left untreated, there may be adverse effects on quality of life (QOL) and work productivity. Hospital expenses, loss of income, and loss of work could create a never ending cycle for financial difficulties and burden in trauma victims. The aim of our review is to address the magnitude of PTSD in post-RTA hospitalized patients in Indian subcontinent population. We also attempted to emphasis on few management guidelines. A comprehensive search was conducted on major databases with Medical Subject Headings (MeSH) term ‘PTSD or post-traumatic stress’ and Emergency department and vehicle or road or highway or automobile or car or truck or trauma and India. Out of 120 studies, a total of six studies met our inclusion criteria and were included in the review. Our interpretation of the problem is that; hospital expenditure due to trauma, time away from work during hospitalization, and reduction in work performance, are three major hits that can lead RTA victims to financial crisis. Proposed management guidelines are; establish a coordinated triage, implementing a screening tool in the ED, and provide psychological counseling.

Bullied Back in the Closet

F ull-time employed adults spend nearly 25% of their time working for their employers every year. For the estimated 8.8 million lesbian, gay, bisexual, or transgendered (LGBT) adults living in the United States (Ramos, Badgett, & Sears, 2008), the concept of spending 25% of a year at work believing they lack the safety to self-identify as LGBT because of a fear of losing employment can cause psychological stress, diminished physical health, and reduced work performance (Chun, 2011). The LGBT equal rights movement works so that fairness and ethical treatment of LGBT individuals continue; one area of continued attention is the existing and persistent social strain for LGBT individuals within workplace environments in which they often experience exclusion and bias (Field, 2009; Gay and Lesbian Alliance Against Defamation [GLAAD] et al., 2011; Human Rights Campaign, 2011a, 2011b, 2011c). Researchers largely have focused on the bullying epidemic at schools, including primary, secondary, and collegiate levels (GLAAD et al., 2011); however, bullying is also pervasive and epidemic in adult workplace settings (Field, 2009; Namie, 2011; Salin, 2008). LGBT individuals encounter workplace bias, discrimination, and bullying; the negative treatment may occur at each level within organizations (Elmslie & Tebaldi, 2007). Such bullying treatment, which is rooted in organizational culture and power, occurs disproportionately for the LGBT community. Although school bullying in the K–12 sector is illegal in 46 states (and disproportionately affects children associated with an alternative lifestyle; Stuart-Cassel, Bell, & Springer, 2011), workplace bullying is still legal in all 50 states. Ferfolja (2007) suggested bullying of LGBT individuals is disproportionate in Western societies because heterosexuality is considered natural (an antecedent to heterosexism and homophobia), and many consider homosexuality immoral, deviant, and contradictory to biological determinism of what is normal.

Influence of indoor air temperature variation on office work performance

Abstract Indoor air quality as well as thermal comfort has a significant effect on productivity of the employees in office buildings. It may reduce work performance and cause financial losses in a long term perspective. Sudden temperature swings may have an impact on the work performance as well. The aim of this study was to assess the change of office work performance of the same individuals affected by unsteady air temperature. Office work was simulated in the test chamber with two workplaces and two persons at the time. 78 individuals of age 19 to 31 were divided into three groups and took participation in performing productivity tests. Two cases were analysed: one with the temperature rise from +22 to +26 °C and another with the temperature drop from +22 to +18 °C. The same tests were performed with the placebo group under a constant air temperature of +22 °C. Results of the study showed that subjects in the placebo group performed better while executing tasks for the second time and the overall produ...

AB 94. Burden of COPD and SDB

Most of the information available on COPD prevalence, morbidity and mortality come from high-income countries. Even in those countries, accurate epidemiologic data on COPD are difficult and expensive to collect. It is known that almost 90% of COPD deaths occur in low and middle-income countries. WHO recognizes that chronic obstructive pulmonary disease (COPD) is of major public health importance. Unfortunately, there is no accurate epidemiological data for Serbia, but from everyday situation, we note the dominance of these patients in ambulatory and hospital work. By far the largest number of hospital admissions during the pulmonologist duty is exacerbations of COPD. We are preparing COPD register, which would improve our work. Untreated obstructive sleep apnea (OSA) and other similar sleep breathing disorders (SDB) increases healthcare utilization and are associated with reduced work performance and occupational injuries. The economic burden related to untreated OSA is substantial, accounting for billions of euros per year. Furthermore, therapy of OSA is an extremely cost-efficient use of healthcare resources, comparing highly favorably with other commonly funded medical therapies. Governments need to be better informed concerning the economic impact of untreated OSA and the benefits of therapy. In Serbia, health insurance covers the cost of polysomnography, but devices for non-invasive ventilation, which treat respiratory disorders during sleep, are not covered. The coexistence of SDB and COPD is associated with a definite increase in morbidity and a probable reduction in survival. Successful treatment of SDB through the application of positive pressure to the upper airway via nasal mask has led to the application of nocturnal positive-pressure ventilation as therapy for chronic respiratory failure due to multiple causes, including COPD. Clearly, more studies are required before valid conclusions can be made about the efficacy of noninvasive ventilation in patients with advanced COPD. In theory, noninvasive ventilation could have a role in the treatment of patients with the overlap syndrome by eliminating both upper-airway obstruction and nocturnal hypoventilation. We hope that some kind of regional cooperation will be implemented in the future, especially at projects linked with respiratory disorders during sleep.

Does modest weight loss translate into improvements in workplace productivity?

Introduction: Overweight and obesity are increasingly linked to reduced productivity (i.e. increased absenteeism and reduced work performance) in the workplace. What is yet to be determined is whether a reduction in weight, of any magnitude, translates into an improvement in these productivity variables. The aim of this study was to investigate whether employees who lost weight in a workplace weight loss maintenance intervention also showed improvements in their productivity levels.

Is occupational stress associated with work engagement ?

The occupational stress is associated with dissatisfaction, excessive demand at work and personal factors. Those factors can reduce work performance and can predispose workers to various diseases. Workers' health may be protected if there is encouragement to face challenges, which may lessen the impact on psychological and somatic stress and thus have greater personal and professional satisfaction. The aim of this study was to evaluate the association between occupational stress and work engagement. Participated in this study 457 male and female workers of a metallurgical industry. Subjects answered personal data, and the Job Stress Scale and Utrecht Work Engagement Scale were applied. Results showed an association between occupational stress and work engagement (P=0,001). The way the individual deals with his frustrations, or rather the work engagement, is associated with the occupational stress.

Blood donation, blood supply, iron deficiency and anemia - It is time to shift attention back to donor health

Since the 1980s blood collectors worldwide have focused on two central themes: blood product safety and an adequate blood supply. From the standpoint of safety, specifically the reduction of transfusion-transmitted diseases, the achievements over the past quarter century are remarkable. With respect to the adequacy of the blood supply, the past decade has witnessed major gains in some countries of Europe, Canada and the US and less than had been expected in others, including Brazil, where the challenge of having a more stable blood supply, in which supply and demand are in better balance remains an important issue(1). On the other hand, the aforementioned achievement has come at a price: iron depletion of the repeat blood donor. Blood centers have long recognized that it is more effective and less expensive to collect blood from existing donors than to recruit new donors. While first-time donors, particularly the young and minorities, have been more successfully recruited, 70% of US and 40-70% (depending on the region) of Brazilian donors are repeat donors(1,2). The only known significant disadvantage of blood donation is the potential risk of iron deficiency (ID). Iron is a vitally important element in the human metabolism. It plays a central role in erythropoiesis and is also involved in many other intracellular processes in all the tissues of the body. The potentiality of the individual donor to give blood without developing ID and iron deficiency anemia (IDA) varies widely, probably due to differences in nutritional iron intake, the differences in prevalences of ID in each study population, menstrual iron loss in females, the frequency of blood donation and the use of supplemental iron(2). The frequency of ID is high in blood donors (1.8% to 8.4% in males and 4.5% to 34.8% in females), and more dependent on the frequency of donations than on the cumulated number of donations(2,4). In addition to this, ID is a significant problem and its prevalence is increasing in many countries around the world. The prevalence has been reported to be 9-40% in women, depending on age and menstrual status and 2-5% in men(1,2). Because menstruating females begin their blood donation careers from a lower starting point, subsequent donations pose a risk for greater clinical harm. Females have much higher rates of both ID and IDA.The clinical implications of ID and IDA are not insignificant, including fatigue, reduced work performance and intellectual capacity, reduced endurance, restless leg syndrome, pica, and cognitive and immune function changes. The degree of symptomatology is proportionate to the severity of the anemia(1,2). Moreover, low hemoglobin (Hb) accounts for 4-10% of total deferrals, with the vast majority occurring in women. Therefore it seems reasonable to secure adequate iron reserves in the donor population in order to maintain an appropriate donation potentiality and to avoid possible hematological and non-hematological complications related to ID(1,2). The question that arises is whether this practice is in the best interest of donor health. In this issue of Revista Brasileira de Hematologia e Hemoterapia, Silva et al., representing the Hemocentro Regional de Uberaba, Minas Gerais, Brazil, have brought this issue to light(5). Given the findings in this and other studies, what measures can blood collectors pursue to address iron depletion? There is no single answer, but several approaches should be considered: 1) modifying the donor Hb requirements and measurement of Hb, 2) changing the interdonation interval, 3) testing for serum ferritin, and 4) iron supplementation.

Factors associated with absenteeism, presenteeism and activity impairment in patients in the first years of RA

To understand the impact of the early years of RA on all aspects of work productivity, and determine how this is related to clinical markers. Previous research on work productivity has examined predominantly early retirement and absenteeism. The impact of reduced work performance (presenteeism) and activity impairment is less well understood in early RA populations. Working patients enrolled in an RA inception cohort were recruited into a nested study. A questionnaire incorporating the Work Productivity and Activity Impairment (WPAI) instrument was administered with a number of clinical outcomes, including the Multidimensional Health Assessment Questionnaire (MD-HAQ) and scales for pain, fatigue and patient assessment of disease patient global assessment (PtGA). Analysis included 150 RA patients, with the mean age at onset being 48 years (s.d. 10 years) and disease duration from symptom onset being 49 months. Patients had relatively mild disease: MD-HAQ (0.6), pain (3.6), PtGA (3.6) and fatigue (4.6). Of the 92% patients working for pay, 19% reported missing work (absenteeism) in the past week due to their health, accounting for 46% of their working time. Even while at work, ∼25% of actual hours was lost due to poor health, while outside work 33% of patients' regular daily activities were prevented. In multivariate analyses, disease severity was associated with the presence of absenteeism, presenteeism and activity impairment. Patients able to self-schedule their work had lower presenteeism and activity impairment. Productivity loss is common in patients in the first years of RA who are in paid work and was associated with work characteristics and adverse clinical outcomes.

Relationships between psychological, physical, and behavioural health and work performance: A review and meta-analysis

The relationships between health and job performance problems have received increased attention in business and scientific communities. This paper attempts to synthesize theoretical and empirical work in this arena. First, the theoretical links between health and work performance are presented. This is followed by a meta-analysis of the relations between psychological, physical, and behavioural health variables and work performance criteria. Meta-analytic results from 111 independent samples obtained from a search of the literature indicate that psychological health, in the form of psychological well-being, depression, general anxiety, and life satisfaction, is a moderate-to-strong correlate of work performance. Associations between physical health, particularly somatic complaints and hypertension, and performance were weak-to-moderate. Regarding health behaviour, alcohol consumption, and smoking were weakly and sleep problems moderately associated with performance problems. Effect sizes sometimes differed across performance dimensions and data sources. The results are consistent with the notion that ill-health is associated with substantial reductions in work performance. This implies that interventions to improve health may have an impact on performance. However, as most of the research in this area has been cross-sectional, more longitudinal research is needed to test theoretical and alternative causal explanations for the relations summarized in this review.

Necessidades humanas básicas dos profissionais de enfermagem: situações de (in)satisfação no trabalho

O cuidado está associado às ações da enfermagem considerando, sobretudo um conjunto de necessidades da equipe de enfermagem. Os objetivos desta pesquisa foram: caracterizar situações de (in)satisfações da equipe de enfermagem no trabalho e analisar as implicações destas (in)satisfações da equipe de enfermagem no trabalho. Adotou-se a teoria das necessidades humanas básicas de Maslow para compreender fatores motivacionais e utilizou-se uma metodologia qualitativa com aplicação de técnicas quantitativas. O método compôs-se de observação participante com registros em diário de campo associada à aplicação de um questionário para 18 participantes da equipe de enfermagem em um Hospital Público do Rio de Janeiro. O estudo indica que as necessidades básicas da equipe de enfermagem encontram-se comprometidas, principalmente as necessidades de segurança e fisiológicas, as mais primárias. O comprometimento das necessidades primárias do sujeito que cuida implica em prejuízo para a saúde e redução do desempenho no trabalho em cenários hospitalares.

Sleep and Arousal as Risk Factors for Adverse Health and Work Performance in Public Health Workers Involved in the 2004 Florida Hurricane Season

We examined the relation of sleep disturbance and arousal to work performance, mental and physical health, and day-to-day functioning in Florida Department of Health (FDOH) employees 9 months after the 2004 Florida hurricane season. FDOH employees were contacted via e-mail 9 months after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires including measures of sleep disturbance, arousal, work performance, physical health, mental health, day-to-day function, hurricane injury, and work demand. More than 18% of FDOH employees reported ≥ 25% reduced work performance and 11% to 15.3% reported ≥ 7 "bad" mental or physical health days in the past month. Sleep disturbance and elevated arousal were strongly associated with impaired work performance (odds ratios [ORs] 3.33 and 3.34, respectively), "bad" mental health (ORs 3.01 and 3.64), "bad" physical health (ORs 3.21 and 2.01), and limited day-to-day function (ORs 4.71 and 2.32), even after adjusting for sex, race, age, education, and marital status. Among public health workers exposed to the 2004 hurricanes, sleep disturbance and arousal were associated with personal and work impairment. Future research should continue to examine the effect of repeated exposure to disasters in first responders.

Cost of low back pain in Switzerland in 2005

Low back pain (LBP) is the most prevalent health problem in Switzerland and a leading cause of reduced work performance and disability. This study estimated the total cost of LBP in Switzerland in 2005 from a societal perspective using a bottom-up prevalence-based cost-of-illness approach. The study considers more cost categories than are typically investigated and includes the costs associated with a multitude of LBP sufferers who are not under medical care. The findings are based on a questionnaire completed by a sample of 2,507 German-speaking respondents, of whom 1,253 suffered from LBP in the last 4 weeks; 346 of them were receiving medical treatment for their LBP. Direct costs of LBP were estimated at €2.6 billion and direct medical costs at 6.1% of the total healthcare expenditure in Switzerland. Productivity losses were estimated at €4.1 billion with the human capital approach and €2.2 billion with the friction cost approach. Presenteeism was the single most prominent cost category. The total economic burden of LBP to Swiss society was between 1.6 and 2.3% of GDP.

High-intensity exercise training in mice with cardiomyocyte-specific disruption of Serca2

Several lines of evidence indicate that the sarco(endo)plasmic reticulum ATPase type 2 (SERCA2) is essential for maintaining myocardial calcium handling and cardiac pump function. Hence, a reduction in SERCA2 abundance is expected to reduce work performance and maximal oxygen uptake (VO2max) and to limit the response to exercise training. To test this hypothesis, we compared VO2max and exercise capacity in mice with cardiac disruption of Serca2 (SERCA2 KO) with control mice (SERCA2 FF). We also determined whether the effects on VO2max and exercise capacity could be modified by high-intensity aerobic exercise training. Treadmill running at 85-90% of VO2max started 2 wk after Serca2 gene disruption and continued for 4 wk. VO2max and maximal running speed were measured weekly in a metabolic chamber. Cardiac function was assessed by echocardiography during light anesthesia. In sedentary SERCA2 KO mice, the aerobic capacity was reduced by 50% and running speed by 28%, whereas trained SERCA2 KO mice were able to maintain maximal running speed despite a 36% decrease in VO2max. In SERCA2 FF mice, both VO2max and maximal running speed increased by training, while no changes occurred in the sedentary group. Left ventricle dimensions remained unchanged by training in both genotypes. In contrast, training induced right ventricle hypertrophy in SERCA2 KO mice. In conclusion, the SERCA2 protein is essential for sustaining cardiac pump function and exercise capacity. Nevertheless, SERCA2 KO mice were able to maintain maximal running speed in response to exercise training despite a large decrease in VO2max.

Work Impairment and Disability in Posttraumatic Stress Disorder: A Review and Recommendations for Psychological Injury Research and Practice

Work impairment and disability are common consequences of posttraumatic stress disorder (PTSD), as reflected by significant rates of sickness absence, failure to return to work, and reduced work performance. Within the psychological injury field, the issue of work impairment and disability in PTSD often arises in workers’ compensation and disability insurance claims and in personal injury litigation. In this context, clinical and forensic practitioners are faced with challenges in rendering expert opinions on diagnosis, causality, prognosis, and recommendations for treatment and rehabilitation. To promote understanding of this important, yet understudied area, there are three aims of this paper: first, to review the current literature on work impairment and disability associated with PTSD; second, to draw on this literature to present a biopsychosocial framework of work impairment and disability in PTSD; and third, to offer suggestions for improving the assessment and management of PTSD-related work impairment and disability.

Employer burden of mild, moderate, and severe major depressive disorder: mental health services utilization and costs, and work performance

Treatment utilization/costs and work performance for persons with major depressive disorder (MDD) by severity of illness is not well documented. Using National Comorbidity Survey-Replication (2001-2002) data, US workforce respondents (n=4,465) were classified by clinical severity (not clinically depressed, mild, moderate, severe) using a standard self-rating scale [Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR)]. Outcomes included 12-month prevalence of medical services/medications use/costs and workplace performance. Treatment costs (employer's perspective) were estimated by weighing utilization measures by unit costs obtained for similar services used by MDD patients in claims data. Descriptive analysis across three severity groups generated chi(2) results. Using a sample of 539 US workforce respondents with MDD, 13.8% were classified mild, 38.5% moderate, and 47.7% severe cases. Mental health services usage, including antidepressants, increased significantly with severity, with average treatment costs substantially higher for severe than for mild cases both regarding mental health services ($697 vs. $388, chi(2)=4.4, P=.019) and antidepressants ($256 vs. $88, chi(2)=9.0, P=.001). Prevalence rates of unemployment/disability increased significantly (chi(2)=11.7, P=.003) with MDD severity (15.7, 23.3, and 31.3% for mild, moderate, and severe cases). Severely and moderately depressed workers missed more work than nondepressed workers; the monthly salary-equivalent lost performance of $199 (severely depressed) and $188 (moderately depressed) was significantly higher than for nondepressed workers (chi(2)=10.3, P<.001). Projected to the US workforce, monthly depression-related worker productivity losses had human capital costs of nearly $2 billion. MDD severity is significantly associated with increased treatment usage/costs, treatment adequacy, unemployment, and disability and with reduced work performance.

Shiftwork impacts and adaptation among health care workers

Shiftwork among health care workers impacts upon the safety and health of both employees and patients. To characterize shiftwork-related attitudes, behaviours, symptoms and coping strategies among health care workers, two validated questionnaires (the Standard Shiftwork Index and the Pressure Management Indicator) were used to identify factors predicting shiftwork adaptation. Participants (n = 376, response rate 25%) were grouped according to their work schedule (days, permanent evenings, rotating days plus evenings, permanent nights or relief and combined shifts). Indicators of lifestyle, work organization, sleep disruption, health and pressure management among workers on irregular shifts were compared with participants on day shifts, after adjustment for gender, age and marital status. Principal components analysis and ordinal logistic regression were used among irregular shiftworkers to identify factors predicting schedule adaptation. Night and relief/combined shiftworkers reported a greater ability to accommodate irregular schedules and disrupted sleep, but were also more likely to report work-related impacts than day workers. Permanent night workers generally reported poorer health, more absenteeism and less job satisfaction than day workers. Factors associated with optimal work performance or schedule contentment among shiftworkers included adequate sleep, evening circadian preference, increased age and organizational satisfaction. Reduced work performance or schedule discontent was associated with sleep/wake difficulties and poor health. This study confirmed previous research and identified factors that can be targeted for the development of more effective shiftwork adaptation programmes in a health care setting (sleep timing and duration, exercise and optimal health and organizational satisfaction).