J Occup Environ Med. 2012 Jan 20. 10.1097/JOM.0b013e318240df1e
Plotnikoff GA 1, Finch MD 2, Dusek JA 3.
1 3 Center for Health Care Innovation and Penny George Institute for Health and Healing
2 Allina Hospitals and Clinics; and University of Minnesota Carlson School of Management, Minneapolis, Minn.
OBJECTIVE: To define the relationship between vitamin D status and employee presenteeism in a large sample of health care employees.
METHODS: Prospective observation study of 10,646 employees of a Midwestern-integrated health care system who completed an on-line health risk appraisal questionnaire and were measured for 25-hydroxyvitamin D.
RESULTS: Measured differences in productivity due to presenteeism were 0.66, 0.91, and 0.75 when comparing employees above and below vitamin D levels of 20 ng/mL, 30 ng/mL, and 40 ng/mL, respectively. These productivity differences translate into potential productivity savings of 0.191%, 0.553%, and 0.625%, respectively, of total payroll costs.
CONCLUSIONS: Low vitamin D status is associated with reduced employee work productivity. Employee vitamin D assessment and replenishment may represent a low-cost, high-return program to mitigate risk factors and health conditions that drive total employer health care costs.
Employees: 10,500, mainly white female nurses
Employees were asked to rate, on a scale of 0-10, how much health problems during the past week had effected their productivity.
Results of vitamin D blood test: average 29 ng, with 29% < 20ng, 6% < 10 ng
The results varied, not unexpectedly, inversely with their vitamin D levels, that is, the more that health affected their work, the lower their vitamin D levels
< 20 ng = 5.6; < 40 ng = 4.5 (on a scale of 0-10)
- 5% for this study of health care employees – who had paid sick leave!
- 2% for healthy populations
- 29% for those with allergies
- 40% for individuals with pain
This study does not apply to those who no paid sick leave (30%),
or who have used up all of their sick leave
Unlikely that chronic pain was considered by the survey
- Less Sick leave - both due to decreased sickness by employee and family
It the spouse or children get sick an employee may take "personal leave"
Sick leave incurs cost to hire a temp replacement who is typically less productive
Employee will get back to work more quickly after a sickness, hospital procedure
- Less sickness while on the job
this presenteeism study shows productivity lowered even more if present if they have low vitamin D
if the employee sickness is contagious it can spread to co-workers (colds, flu)
- Less health care costs for the individual
which should result in decreased health care premiums for the smaller employers
- Essential employees (managers, and others for whom a temp is not possible)
- Employees with dark skins
- Employees who are over-weight
- Employees who have already had vitamin D-related medical problems
- Employees who especially get colds and the flu in the winter
- Employees who are > 55 years old
Seniors get about 1/4 as much vitamin D from the sun as juniors
Vitamin D will reduce sickness AND restore their cognitive abilities
- Employees who work 3rd shift
- Employees who work far from the equator and get less sun (for very large companies)
- Employees who work in areas with extremely hot sun (Phoenix, Middle East)
Employees avoid the hot sun so much that they often have very low levels of vitamin D - in the summer!
- Employees who are pregnant
Less sick leave, less complications from pregnancy, less trouble with the new-born
- Hiring/ Recruiting – turnover (25% to 200% of annual salary)
employee stays with employer who is concerned his health
employee does not have to leave to to his own illness or illness in immediate family
lost productivity as replacement comes up to speed, training, moving,
- Retirement pension -healthier person has fare fewer major health expenses
- Health insurance (single vs family) - small employers can get lower cost on healthy group insurance
- Sick leave - less sick leave taken for employee or family illness
- Vacation pay
- Medicare 2.9% (employee + employer)
- Holiday pay
- Unemployment insurance
- social security
- workman's compensation (0.3% to 7.5%)
- Companies and individuals will benefit from more vitamin D
which includes the following costs of obesity:
Medical Costs, Productivity, Absenteeism, Presenteeism, Disability, Premature mortality, Additional cost of health insurance,
- HMOs will save millions of dollars with vitamin D
- Cost Savings with Vitamin D category listing has
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