Accounting for employee health: The productivity cost of leading health risks

Mobile Heart Rate Variability Biofeedback for Work-Related Stress in Employees and the Influence of Instruction Format (Digital or Live) on Training Outcome: A Non-Randomized Controlled Trial

Work-related stress is a major health issue in most industrialized countries. Heart rate variability biofeedback (HRV-BfB) can promote resilience and stress coping capacity. Mobile HRV-BfB could contribute to stress prevention in the workplace. Little is known about whether the type of training, with digital or live instruction, has an impact on the training outcome. This study analyzes the psychophysiological effects of four-week workplace resilience training with mobile HRV-BfB and the influence of instruction format (digital or live) on training success. This was a prospective, three-arm, non-randomized controlled trial with parallel group design. 73 employees of a bearing and seal manufacturer (58.9% male, 86.3% full-time employment, 67.1% office workers) attended resilience training with HRV-BfB, live (n = 24) or digital (n = 19) format, or served as waitlist controls (n = 30). HRV-BfB training spanned four weeks. Participants applied resilience techniques to increase HRV using visual biofeedback. Data were collected at baseline (T0), post-intervention (T1), and another four weeks later (T2). Primary outcome measure was the Burnout scale of the Copenhagen Psychosocial Questionnaire (COPSOQ) at T1. Secondary outcome measures included further COPSOQ scales, self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), and HRV parameters. Burnout parameters decreased significantly in HRV-BfB and waitlist. The decrease (T0-T1 and T0-T2) showed higher effect sizes in HRV-BfB (Cohen's d: 0.63; 0.69) than in waitlist (d: 0.27; 0.36). Sleep quality improved in HRV-BfB with small effect sizes (no change for waitlist). SDNN (standard deviation of beat-to-beat intervals) increased in HRV-BfB between T0 and T1 (d: 0.23;). In subgroup analysis, digital reached higher effect sizes for improvement in burnout (d: 0.87; 0.92) and sleep quality (d: 0.59; 0.64) than live learning (burnout: d: 0.43; 0.51; sleep quality: d: 0.28; 0.22). HRV-analysis revealed no differences between subgroups. Four-week mobile HRV-BfB resilience training reduced stress and burnout symptoms in employees. No significant differences were found between HRV-BfB digital or live. Hence, companies should choose the approach that fits their company profile or, if possible, offer both formats to accommodate the different needs of employees. However, findings were nonhomogeneous and should be verified by further studies.Trial Registration: ClinicalTrials.gov , NCT04897165, 05/18/2021, retrospectively registered.

Employee Dietary Initiative Improved Chronic Symptoms

With the awareness that the Standard American Diet is a critical contributor to chronic diseases, this initiative aimed to assess the effects of a 28-day dietary challenge health care improvement project on health system employee energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains, including the impact of adherence level, during a period of restricted intake of gluten, dairy, and sugar offered annually from 2021 to 2023. A total of 754 employees completed the pre-challenge survey; analyses included 354 employees who completed both pre-challenge and post-challenge surveys in at least 1 year of this project. Wilcoxon signed rank tests compared presurvey and postsurvey responses to self-reported energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains. Analysis of variance with Tukey's honestly significant difference tests compared self-reported adherence level with change scores, with η2 representing effect size. In each challenge year, the mean rank levels of energy, sleep quality, gastrointestinal function, concentration, and aches/pains improved significantly between pre-surveys and post-surveys (all P<.001). Although an association between significant positive change and diet adherence level was found for all items in at least 1 challenge year, those who mostly or completely adhered to the challenge diet restrictions reported significantly greater positive change in energy levels and gastrointestinal symptoms than those who did not or minimally adhered in all challenge years, with small to medium effect sizes. In conclusion, Essentia Health's employee challenge appeared to improve self-reported outcomes in 5 symptom domains, with energy levels and gastrointestinal symptoms correlating most favorably to adherence to the challenge. These findings have health and cost implications, which could be confirmed by formal research in employee and other populations.

Prioritizing decision-making of health and well-being response tactics: Incorporating organizational and individual shared demands

As a major energy source in China, the occupational health and well-being (OHW) of miners is a priority. Various statistical techniques have been used to identify factors or assess OHW to provide valuable information for the implementation of health promotion activities. The main bottleneck is the limited focus on solutions that address the demands of both organizations and individuals, and scientific and effective decision-making is pending. Therefore, this study describes the OHW mechanism covering both antecedents and consequences through the driving force-pressure-state-impact-response model. A probabilistic model of management tradeoff analysis was established by using a Bayesian decision network. Causal relationships and dependencies between multiple factors are captured visually. The model was verified and applied with samples of miners (N = 816). The results showed that the comprehensive strategy (R5) was the best tactic, and the management effect of stress (R2) and vulnerability (R3) was prominent. This study provides a valuable tool for managers to identify priority management factors. Prioritizing tactics formulated from dual demands of organizational and individual can ensure project feasibility, operability, and effectiveness. This study is a novel attempt to combine theory with practice, which is timely and necessary for management.

Cost of Health-Related Work Productivity Loss among Fly-In Fly-Out Mining Workers in Australia

Sufficient knowledge on the work productivity impact of the health of fly-in fly-out (FIFO) workers in the mining sector in Australia is lacking. This study examined the impact of health and lifestyle behaviours on the work productivity of FIFO workers in the mining industry in Australia. FIFO workers completed an online questionnaire on health and work productivity loss measures. Linear regressions were used to model annual work productivity losses through absenteeism, presenteeism and total productivity loss. Workers with a high risk for health conditions were, on average, associated with 3.87% more productivity loss (absenteeism: 1.27% and presenteeism: 2.88%) than those with low risk. Workers who had multiple health risks classified as medium (3-4 health conditions) and high (5 or more health conditions) reported 1.75% and 7.46% more total productivity loss, respectively, than those with fewer multiple health risks (0-2 health conditions). Health conditions were estimated to account for an annual additional productivity cost due to absenteeism of AUD 8.82 million, presenteeism of AUD 14.08 million and a total productivity loss of AUD 20.96 million per 1000 workers. FIFO workers with high health risks experience more absenteeism, presenteeism and overall productivity loss. These measures provide strong economic justifications that could support the need for targeted workplace health interventions.

Hotel building design, occupants' health and performance in response to COVID 19

In the COVID-19 pandemic, the employee realized the importance of a healthy workplace. A healthy workplace provides natural protection against respiratory disease and reduces exposure to viruses. Therefore, the current COVID-19 pandemic should be a wake-up call to understand the importance of building design and a dress rehearsal for future challenges because building-based prevention and control measures have become one of the most significant ways of fighting against the epidemic. This study investigates the role of hotel building design in employee health and performance during the COVID-19 pandemic. The study covered the LEED-certified hotel building in India. The formulated Hypothesis was tested empirically by the structural equation modeling (SEM) for determining the potential of the hotel building design. It was obtained from the study that during the COVID-19 pandemic, the hotel building design of the hospitality industry had a more significant influence on employee performance, followed by employee health.

Lacticaseibacillus paracasei Lpc-37® improves psychological and physiological markers of stress and anxiety in healthy adults: a randomized, double-blind, placebo-controlled and parallel clinical trial (the Sisu study)

Chronic stress is a risk-factor for the development of mood and stress-related disorders. Clinical evidence indicates that probiotics can influence the stress response and mood. The Sisu study investigated whether Lacticaseibacillus paracasei Lpc-37® (Lpc-37®) could modulate stress, mood and well-being. Prior to a two-week run-in period, 120 healthy adults (18-45 y) were stratified for sex and chronic stress and randomized to either 1.75 × 1010 colony forming units (CFU) of Lpc-37 or placebo (1:1) per day for 5 weeks. The primary objective was the effect of Lpc-37 on heart rate (HR) in response to the Trier Social Stress Test (TSST). Secondary objectives were assessed by biomarkers and self-report scales over the study. The primary hypothesis was not met in either the Intention-to-Treat (ITT) or Per Protocol (PP) population, but Lpc-37 reduced the increase in HR in participants with low chronic stress (LCS) and increased HR in participants with high chronic stress (HCS) during the TSST. Supporting significant efficacy in the PP population (n = 113), Lpc-37 reduced perceived stress following intervention. More significant effects were identified within the subgroups where Lpc-37 reduced exhaustion during the TSST and normalized cortisol levels at 8pm in participants with LCS, reduced perceived stress also in females, and increased perceived health and sleep-related recovery in participants with HCS. Adverse events (AEs) were similar between groups, there were no severe AEs, and vital signs remained unchanged. Overall, Lpc-37 reduced perceived stress compared to placebo. Other beneficial effects within biomarkers related to stress indicate that the effects of Lpc-37 may be differentially dependent on sex and chronic stress. (ClinicalTrials.gov: NCT03494725).

Employee Stress, Reduced Productivity, and Interest in a Workplace Health Program: A Case Study from the Australian Mining Industry

The Australian mining sector has an elevated industry prevalence of stress and high stress related productivity impairment costs. This study surveyed 897 employees from an Australian mining company to identify characteristics associated with: (a) high stress related productivity impairment costs; and (b) likelihood of stressed employees wanting stress management assistance at work. Groups associated with average annual productivity impairment costs in excess of $50,000 per employee included: permanent day shift employees; employees who reported being stressed at work most of the time; employees who reported being stress at work all of the time; and employees who were contemplating better managing their stress in the next 6 months. Overall, 52% of employees who identified as being in the contemplation stage of change for stress management and 52% of employees who experienced stress most of the time reported wanting stress assistance with stress. However, only 33% of stressed permanent day shift employees and 36% of employees who experienced stress all the time reported wanting stress assistance. To achieve a high return on investment when implementing workplace stress management programs in the mining industry, practitioners need to strategically target health promotion to engage stressed employees with high productivity impairment costs and low desire for stress management assistance.