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‘Presenteeism,’ Productivity and Integrating Wellness Into Your OHS Program

One of the best ways to demonstrate the value of your OHS program to management is to link it to the productivity of the workers it protects. Of course, it’s one thing to assert that safety measures increase worker productivity and another to prove it. What makes this especially challenging is that traditional views of productivity are being challenged by a concept known as “presenteeism.” We’ll explain presenteeism and tell you how to build a business case for integrating wellness initiatives into your OHS program on the basis of minimizing presenteeism.

How Safety Contributes to Productivity

In its simplest form, productivity is about getting the most out of your workers. When workers get injured or sick, they miss work and thus productivity suffers. So by helping workers avoid illness and injury, safety programs contribute to productivity.

At least that’s the traditional way of linking safety to productivity. But although this logic is still fundamentally sound, modern research about what productivity is really all about has cast doubt on this connection. It turns out that eliminating hazards that cause safety incidents may not the most effective way to avoid productivity losses after all.

A study from the American Productivity Audit (APA) that appeared in the Journal of Occupational and Environmental Medicine in December 2003 challenges the traditional view. Based on over 28,000 employee interviews, the study’s authors made some important findings about the impact of two health-related factors on productivity losses:

Absenteeism. The fundamental assumption is that absenteeism is at the root of productivity losses. Simply stated, workers who miss work because of injury or illness are less productive than those who show up. However, the APA study found that workers who were absent accounted for only 29% of health-related productivity losses—and only 23% of these absences were due to injury or illness. The other 6% were due primarily to the health of the worker’s family member.

Wellness. The overwhelming majority of health-related productivity losses—71%—occurred on the job. They were the result of reduced performance by the workers who actually showed up for work. These losses have gone largely unnoticed, the study notes, because the ailment detracting from a worker’s performance isn’t serious enough to keep him from missing work.

The APA study cites five conditions that most frequently impair the performance of workers who show up for work:

  • Headache/pain;
  • Cold/flu;
  • Fatigue/depression;
  • Digestive problems; and
  • Arthritis.

Productivity losses from these conditions cost businesses more than $180 billion per year, the study claims.

[box]The Impact of Wellness on Productivity

One of the key findings of the APA study is that most health-related productivity losses occur on-the-job. They’re the result of ailments not serious enough to keep workers home but serious enough to hamper their performance while they’re working. Here’s some data illustrating the impact of the wellness factor on productivity:

  • More than half (53%) of the workers experienced an episodic or chronic-episodic health condition, such as headache or fatigue, in any two-week period;
  • Thirteen percent said that musculoskeletal pain or headaches impaired their productivity (This figure would have been much higher but the study didn’t ask about other common pains that impair productivity, such as dental or menstrual pain.); and
  • On average, a US worker loses 115 productive work hours per year due to nagging health conditions.


Presenteeism & the Importance of Wellness Programs

Health-related productivity losses attributable to the diminished capacity of workers suffering from minor ailments who still manage to drag themselves to work is known as “presenteeism.” The implications of presenteeism as documented by the APA study are enormous. The best thing a company can do to enhance productivity, the study suggests, is concentrate on the less serious and somewhat vaguer ailments, such as fatigue and pain, that detract from the performance of workers who do come to work. This approach is a departure from the traditional focus of safety programs on the physical hazards that cause absenteeism.

OHS programs are best suited to tackling absenteeism. To combat presenteeism, companies need to implement programs that maximize worker wellness and minimize the minor ailments that diminish the productivity of workers on the job. Bottom line: All things being equal, investing in wellness initiatives offers a company greater potential return than only investing in safety initiatives, at least to the extent that the primary goal is to maximize productivity.

Insider Says: For more information on the ties between workplace safety and wellness, see “Why Your OHS and Wellness Programs Should Work Together.”

Implementation: The Manitoba Model

Integrating elements of a wellness strategy into a safety program isn’t the kind of thing you can do overnight. It takes time. And, as with any other safety initiative, it requires the support and commitment of management and workers. But if you’re serious about integrating wellness into your OHS program, a good starting point to consider is the model set out by the Canadian Mental Health Association, Manitoba Division (Manitoba Model).

Unlike most wellness plans which count on workers to take responsibility and supply initiative for their own health and wellbeing, the Manitoba Model is controlled from above by management through a steering committee that includes both the safety and HR coordinators. The Manitoba Model is essentially a feedback loop involving three basic stages:

  • Evaluation;
  • Intervention; and
  • Re-evaluation.

The basic idea is to keep track of how workers are feeling, measure their productivity and make appropriate changes on the fly.

The Manitoba Model is based on case studies and best practices involving companies across Canada. These case studies suggest that the Model works best when it’s phased in gradually within a particular business unit rather than imposed across the company in one fell swoop. The Model suggests a four-step process:

1. Obtain Worker Feedback

The first step is to have workers fill out a questionnaire to determine their perceptions about their health, well-being and what causes them to feel stress at work. Respondents should remain anonymous so they provide candid responses.

Download this Model Wellness Questionnaire and adapt it for your workplace.

2. Evaluate Feedback

Next, the safety coordinator and other members of the steering committee should evaluate the results of the questionnaires to identify problems that need to be addressed. For example, questionnaires might reveal that a certain process is unusually stressful or fatiguing to the workers who perform it.

3. Intervene

This step involves prioritizing the problems and deciding when and how to address them. Management should let workers know when they take steps to resolve identified problems to reassure them that their concerns are being taken seriously.

4. Re-Issue Questionnaires

The results from the first round of questionnaires serve as a baseline. Once the results have been processed and interventions taken, the cycle begins again. That is, you should re-issue the questionnaires, evaluate the new results and implement any appropriate new interventions. How long should the cycle last’ Between one and three years, according to the Model’s authors.


Building Healthy Organizations: A Practical Approach for Managers and Workers,” Bruning (2006)