An Investigation of Self-reported Health-related Productivity Loss in Office Workers and Associations With Individual and Work-related Factors Using an Employer's Perspective

Association between work from home and health-related productivity loss among Korean employees

Background

After the coronavirus disease 2019 pandemic, the widespread adoption of working from home, or teleworking, has prompted extensive research regarding its effects on work productivity and the physical and mental health of employees. In this context, our study aimed to investigate the association between working from home and health-related productivity loss (HRPL).

Methods

An online survey was conducted with a sample of 1,078 workers. HRPL was estimated by the Work Productivity and Activity Impairment Questionnaire: General Health version. Workers that have been working from home in the last 6 months were categorized into the "work from home" group. Generalized linear models were used to compare the mean difference of HRPL between "work from home" and "commuters" group. Stratified analyses were conducted based on various factors including gender, age, income level, occupation, education level, previous diagnosis of chronic disease, presence of preschool children, living in studio apartment, living alone, commuting time, working hours and regular exercise.

Results

The overall HRPL was higher in the "work from home" group than in the "commuters" group with a mean difference of 4.05 (95% confidence interval [CI]: 0.09-8.01). In the stratified analyses, significant differences were observed in workers with chronic diseases (mean difference: 8.23, 95% CI: 0.38-16.09), who do not live alone (mean difference: 4.84, 95% CI: 0.35-9.33), and workers that do not exercise regularly (mean difference: 4.96, 95% CI: 0.12-9.80).

Conclusions

Working from home is associated with an increased HRPL in the Korean working population, especially among those with chronic diseases, those who do not live alone, and those who do not exercise regularly.

Job satisfaction and job security as moderators in the relationships among job demands, musculoskeletal symptoms, and work performance

PURPOSE

This study examined whether job satisfaction and job security moderate the path from physical demands and job strain to impaired work performance via musculoskeletal symptoms in the upper extremities (MSUE). Moderation effects on five paths were examined: (1) from job strain to MSUE; (2) from job strain to work performance; (3) from physical demands to MSUE; (4) from physical demands to work performance; (5) from MSUE to work performance.

METHODS

This was a cross-sectional study of 669 full-time workers from 9 manufacturing and 3 healthcare facilities. Data were collected via health interviews, on-site physical exposure assessments, and computation of the Strain Index by ergonomists, and self-administered questionnaires on psychosocial factors. Structural equation modeling and zero-inflated negative binomial regression analysis were performed to examine the moderation effect on each path.

RESULTS

Job satisfaction moderated the relationship between MSUE and impaired work performance (B = - 0.09, 95% CI: - 0.15, - 0.04) and job security moderated the relationship between physical demands and MSUE (B = - 0.64, 95% CI: - 1.17, - 0.11). Interaction between job satisfaction and MSUE was significant on both the occurrence (OR: 0.92, 95% CI: 0.87, 0.97) and the degrees of impaired work performance (mean ratio: 0.99, 95% CI: 0.97, 0.99), while the interaction between job security and physical demands was significant only on the degrees of MSUE (mean ratio: 0.94, 95% CI: 0.89, 0.99).

CONCLUSION

Job satisfaction and job security can, respectively, mitigate the adverse impacts of working with MSUE and physical demands on work performance. Workplace interventions to improve workers' job satisfaction and job security can contribute to their musculoskeletal health and work performance.

Greater muscle volume and muscle fat infiltrate in the deep cervical spine extensor muscles (multifidus with semispinalis cervicis) in individuals with chronic idiopathic neck pain compared to age and sex-matched asymptomatic controls: a cross-sectional study

Muscle size and composition (muscle volume and muscle fat infiltrate [MFI]) may provide insight into possible mechanisms underpinning chronic idiopathic neck pain, a common condition with no definitive underlying pathology. In individuals with chronic idiopathic neck pain > 3 months and age- and sex-matched asymptomatic controls, muscle volumes of levator scapulae, multifidus including semispinalis cervicis (MFSS), semispinalis capitis, splenius capitis including splenius cervicis (SCSC), sternocleidomastoid and longus colli from C3 through T1 were quantified from magnetic resonance imaging. Between-group differences were determined using linear mixed models, accounting for side (left or right), muscle, spinal level, sex, age, and body mass index (BMI). Individuals with pain had greater muscle volume (mean difference 76.8mm³; 95% CI 26.6-127.0; p = .003) and MFI (2.3%; 0.2-4.5; p = .034) of the MFSS compared to matched controls with no differences in relative volume, accounting for factors associated with the outcomes: muscle, spinal level, side (left had smaller volume, relative volume and MFI than right), sex (females had less volume and relative volume than males), age (older age associated with less relative volume and greater MFI), and BMI (higher BMI associated with greater muscle volume and MFI). Greater MFI in individuals with chronic idiopathic neck pain suggests a possible underlying mechanism contributing to neck pain. Perspective: These findings suggest MFI in the MFSS may be radiologic sign, potentially identifying patients with a less favourable prognosis. Future studies are needed to confirm this finding and determine if MFI is a contributor to the development or persistence of neck pain, or consequence of neck pain.

Effectiveness of an 8-week hatha yoga intervention to improve lower back pain in university office workers: A mixed-methods pilot exploratory study

BACKGROUND: Hatha yoga programs have been shown to be effective at improving low back pain among a variety of populations; however, methods to decrease low back pain of university office employees have not been studied. OBJECTIVE: To examine the impact of an 8-week hatha yoga intervention on measures of health among university office employees. METHOD: Seven participants completed the 8-week yoga intervention. All measures, including anthropometric measures and online questionnaires, were completed at baseline and post-intervention. RESULTS: Baseline pain intensity (6.6±3.1) and pain interference (15.6±4.7) reflected a moderate level of back pain and moderate to severe interference. Pain intensity showed a non-significant improvement with medium-to-large effect size [p = 0.07, (d = 0.7)]. There was a significant improvement with a large effect size [p = 0.002, (d = 2.4)] in pain interference. Baseline anxiety (7.4±3.6) reflected a borderline abnormal symptom level, but anxiety significantly reduced to normal levels at post-intervention with a medium effect size [p = 0.002 (d = 0.5)]. Focus group themes were improvements in health and development of a sense of community. CONCLUSIONS: Hatha yoga may be an effective mode of low-impact physical activity to decrease pain and improve mental health while facilitating a sense of community for office workers employed by a university. This study demonstrates promising results with large effect sizes; however, more research with larger sample size and randomized treatment and control groups are needed for future study efforts.

Differences in upper body posture between individuals with and without chronic idiopathic neck pain during computerised device use: A 3D motion analysis study

BACKGROUND

Computer use is associated with poor postures and increased risk of developing neck pain. Evaluating differences in working posture of individuals with and without chronic neck pain may assist the development of strategies to lessen or prevent pain.

OBJECTIVE

To identify if upper body kinematics differs between individuals with and without chronic idiopathic neck pain during four conditions (tablet, laptop, and desktop computer sitting and standing).

METHODS

Three-dimensional (3D) motion capture measured upper body kinematics in 44 individuals with chronic idiopathic neck pain > 90 days (Cases n = 22) and without pain (Control n = 22), during a typing task under four conditions: tablet, laptop, desktop computer (sitting and standing). Differences between groups were evaluated using generalised linear mixed models.

RESULTS

Across all conditions and compared to controls, cases had significantly less flexion between their head-neck and upper trunk segments (between group mean difference 7.15°, 2.1, 12.2, p = .006), greater upper trunk flexion relative to the laboratory (-6.15°, -10.9, -1.3, p = .012), greater shoulder flexion bilaterally (left 12.35°, 6.7, 17.9, p < .001; right 13.49°, 7.9, 19.1, p < .001) and less right elbow flexion (-6.87°, -12.1, -1.7, p = .010). Approaching significance, the case group had less left elbow flexion (between group mean difference -5.36°, -10.9, 0.1, p = .056) and a smaller mean craniocervical angle for the seated desktop condition (group x condition interaction -6.37°; 95% CI -12.7, -0.1, p = .052).

SIGNIFICANCE

Individuals with neck pain consistently used different upper body postures compared to individuals without pain when working on computerised devices under varying workstation conditions. This finding suggests that people with neck pain work in potentially aggravating postures that may be associated with their pain.

Occupant health in buildings: Impact of the COVID-19 pandemic on the opinions of building professionals and implications on research

The objectives of this study are to investigate building professionals' experience, awareness, and interest in occupant health in buildings, and to assess the impact of the COVID-19 pandemic on their opinions, as well as to compare the research on occupant health in buildings to professionals' opinions. To address these objectives, a mixed research methodology, including a thorough review of the literature (NL = 190) and an online survey (NS = 274), was utilized. In general, there is an increasing research interest in occupant health and a heightened interest in health-related projects, among professionals, following the COVID-19 pandemic. Specifically, among the nine different building attributes examined, indoor air quality was the most researched building attribute with a focus on occupant health and was also presumed to be the most important by the professionals. Professionals considered fatigue and musculoskeletal pain to be the most important physical well-being issues, and stress, anxiety, and depression to be the most important mental well-being issues that need to be the focus of design, construction, and operation of buildings to support and promote occupant health, while eye-related symptoms and loss of concentration were the most researched physical and mental well-being symptoms in the literature, respectively. Finally, professionals indicated that COVID-19 pandemic had significant effect on their perspectives regarding buildings' impact on occupant health and they believed future building design, construction and operation will focus more on occupant health because of the pandemic experience.

Evidence for the Effectiveness of Feedback from Wearable Inertial Sensors during Work-Related Activities: A Scoping Review

Background: Wearable inertial sensor technology (WIST) systems provide feedback, aiming to modify aberrant postures and movements. The literature on the effects of feedback from WIST during work or work-related activities has not been previously summarised. This review examines the effectiveness of feedback on upper body kinematics during work or work-related activities, along with the wearability and a quantification of the kinematics of the related device. Methods: The Cinahl, Cochrane, Embase, Medline, Scopus, Sportdiscus and Google Scholar databases were searched, including reports from January 2005 to July 2021. The included studies were summarised descriptively and the evidence was assessed. Results: Fourteen included studies demonstrated a 'limited' level of evidence supporting posture and/or movement behaviour improvements using WIST feedback, with no improvements in pain. One study assessed wearability and another two investigated comfort. Studies used tri-axial accelerometers or IMU integration (n = 5 studies). Visual and/or vibrotactile feedback was mostly used. Most studies had a risk of bias, lacked detail for methodological reproducibility and displayed inconsistent reporting of sensor technology, with validation provided only in one study. Thus, we have proposed a minimum 'Technology and Design Checklist' for reporting. Conclusions: Our findings suggest that WIST may improve posture, though not pain; however, the quality of the studies limits the strength of this conclusion. Wearability evaluations are needed for the translation of WIST outcomes. Minimum reporting standards for WIST should be followed to ensure methodological reproducibility.

Work-Related Factors Affecting the Occurrence of Presenteeism － Recent Research Trends and Future Directions

Productivity loss due to presenteeism accounts for a large proportion of economic losses caused by workers' health problems. To reduce presenteeism, it is necessary to identify its causes, but, in contrast to the large amount of research on the effects of diseases and lifestyles, there is not enough research on the effects of work-related factors on presenteeism. In this study, those factors include the work environment and the work-related psychological status of workers. The purpose of this review was to identify research trends in presenteeism, defined as work-related productivity loss, and to examine future directions for presenteeism research. We conducted a search with only the keyword "presenteeism" using MEDLINE/PubMed for the last 5 years and extracted 30 relevant articles, most of which were cross-sectional studies. The articles were categorized into the following themes: 1) studies on the associations of various stress models and factors with presenteeism; 2) studies on the mediators and the pathways of association between stress factors and presenteeism; 3) studies on the relationships between organizational factors and presenteeism; and 4) studies on the link between workers' positive and negative psychological status and presenteeism. Our findings showed that, over the last 5 years, the relationship between psychological stress and presenteeism has been extended to include a variety of stress models and stressors. In addition, by putting many models and factors into a single statistical model and adjusting for their interrelationships, important factors have been examined by ensuring that a significant relationship with presenteeism remains. As there is still a lack of longitudinal studies necessary to discuss causality, more research of higher quality is needed.

Testing the Construct Validity and Responsiveness of the Single-Item Presenteeism Question

OBJECTIVE

We tested the construct validity and responsiveness of a single-item instrument for measuring absolute presenteeism-the single-item presenteeism question (SPQ).

METHODS

Two self-report questionnaire surveys were conducted among employees of 24 small- or medium-sized companies (N = 1021) concerning the recognized predictors of presenteeism-absenteeism, subjective health risks, work engagement, and workplace social capital. Responsiveness was measured by determining whether changes in the presence of predictors between the surveys were accompanied by commensurate changes in SPQ presenteeism.

RESULTS

SPQ presenteeism exhibited significant associations with the predictors, denoting adequate construct validity. Regarding responsiveness, unfavorable changes in most predictors were associated with increased SPQ presenteeism, as expected.

CONCLUSIONS

We confirmed the construct validity and responsiveness of the SPQ-an instrument that can be employed to promote workplace health and productivity management.

Worker Perspectives on Incorporating Artificial Intelligence into Office Workspaces: Implications for the Future of Office Work

Workplace environments have a significant impact on worker performance, health, and well-being. With machine learning capabilities, artificial intelligence (AI) can be developed to automate individualized adjustments to work environments (e.g., lighting, temperature) and to facilitate healthier worker behaviors (e.g., posture). Worker perspectives on incorporating AI into office workspaces are largely unexplored. Thus, the purpose of this study was to explore office workers' views on including AI in their office workspace. Six focus group interviews with a total of 45 participants were conducted. Interview questions were designed to generate discussion on benefits, challenges, and pragmatic considerations for incorporating AI into office settings. Sessions were audio-recorded, transcribed, and analyzed using an iterative approach. Two primary constructs emerged. First, participants shared perspectives related to preferences and concerns regarding communication and interactions with the technology. Second, numerous conversations highlighted the dualistic nature of a system that collects large amounts of data; that is, the potential benefits for behavior change to improve health and the pitfalls of trust and privacy. Across both constructs, there was an overarching discussion related to the intersections of AI with the complexity of work performance. Numerous thoughts were shared relative to future AI solutions that could enhance the office workplace. This study's findings indicate that the acceptability of AI in the workplace is complex and dependent upon the benefits outweighing the potential detriments. Office worker needs are complex and diverse, and AI systems should aim to accommodate individual needs.

Association between comprehensive workstation and neck and upper-limb pain among office worker

OBJECTIVES

Our study aimed to investigate the association between comprehensive workstations and neck and upper-limb pain (NUP) among office workers.

METHODS

This cross-sectional study included 307 office workers (median age, 39 years; 88% men). Workstations (presence of armrest, armrest position, number of monitors used, mouse position, mouse usage, keyboard usage, and keyboard position) were investigated in terms of 17 items and judged as "adequate" or "inadequate." NUP was assessed using a numerical rating scale. NUP locations included the neck, shoulder, elbow, and wrist. In the statistical analysis, outcome variables were the presence of pain in each part, while explanatory variables were the number of inadequate workstations. Logistic regression analyses were conducted with adjustment for age, gender, working duration, and exercise habit.

RESULTS

The prevalence of neck pain was 47% (n = 143), shoulder pain was 50% (n = 153), elbow pain was 7.2% (n = 22), and wrist pain was 13% (n = 40). In the adjusted model, the number of inadequate workstations had significant positive associations with elbow pain (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06.1.81) and wrist pain (OR, 1.80; 95% CI, 1.17.2.26). However, the number of inadequate workstations was not significantly associated with neck pain or shoulder pain.

CONCLUSIONS

Workstation-related factors (presence of armrest, armrest position, mouse usage, and keyboard usage) were significantly associated with elbow and wrist pain. Our findings suggest that workstations can contribute to elbow and wrist pain in office workers.

On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial

Background

Non-specific neck pain and headache are major economic and individual burden in office-workers. The aim of this study is to investigate the effect of a multi-component intervention combining workstation ergonomics, health promotion information group workshops, neck exercises, and an app to enhance intervention adherence to assess possible reductions in the economic and individual burden of prevalent and incident neck pain and headache in office workers.

Methods/design

This study is a stepped wedge cluster-randomized controlled trial. Eligible participants will be any office-worker aged 18–65 years from two Swiss organisations in the Cantons of Zurich and Aargau, working more than 25 h a week in predominantly sedentary office work and without serious health conditions of the neck. One hundred twenty voluntary participants will be assigned to 15 clusters which, at randomly selected time steps, switch from the control to the intervention group. The intervention will last 12 weeks and comprises workstation ergonomics, health promotion information group workshops, neck exercises and an adherence app. The primary outcome will be health-related productivity losses (presenteeism, absenteeism) using the Work Productivity and Activity Impairment Questionnaire. Secondary outcomes are neck disability and pain (measured by the Neck Disability Index, and muscle strength and endurance measures), headache (measured by the short-form headache impact test), psychosocial outcomes (e.g. job-stress index, Fear-Avoidance Beliefs Questionnaire), workplace outcomes (e.g. workstation ergonomics), adherence to intervention, and additional measures (e.g. care-seeking). Measurements will take place at baseline, 4 months, 8 months, and 12 months after commencement. Data will be analysed on an intention to treat basis and per protocol. Primary and secondary outcomes will be examined using linear mixed-effects models.

Discussion

To the authors’ knowledge, this study is the first that investigates the impact of a multi-component intervention combining current evidence of effective interventions with an adherence app to assess the potential benefits on productivity, prevalent and incident neck pain, and headache. The outcomes will impact the individual, their workplace, as well as private and public policy by offering evidence for treatment and prevention of neck pain and headache in office-workers.

Trial registration

ClinicalTrials.gov, NCT04169646. Registered 15 November 2019 - Retrospectively registered.

Workplace-Based Exercise Intervention Improves Work Ability in Office Workers: A Cluster Randomised Controlled Trial

Neck pain is a burden to employers and employees amenable to improvement with neck/shoulder strengthening exercises. However, the benefits of such interventions on office workers' work ability remains unknown. This study evaluated the effects of a 12-week combined ergonomics and neck/shoulder strengthening exercise intervention (EET, n = 177, mean age 41.7 years, 26% female), versus a 12-week combined ergonomics and health promotion intervention (EHP, n = 173, mean age 43 years, 29% female) on work ability among office workers. Work ability was measured by a single question. Differences in the work ability score were analyzed using the intention-to-treat (ITT) and per-protocol (i.e., adherence ≥70%) analyses for between- and within-group differences at baseline, 12 weeks, and 12 months. A sub-group analysis was performed for neck cases, defined as reporting neck pain as ≥3 (out of 10). No significant between-group differences for work ability were observed in the general population, and subgroup of neck cases. A significant group-by-time interaction effect at 12 weeks and the trend for significance at 12 months favored the EET group in the per-protocol analysis of the neck cases. EET was effective in increasing work ability post-intervention and potentially, in the long-term, in symptomatic participants with ≥70% adherence to the intervention. However, EET was not superior to EHP.

Quantifying cervical and axioscapular muscle stiffness using shear wave elastography

This study aimed to assess intra-rater (intra-session and inter-day) reliability and influence of side dominance and the scapular resting position on the shear modulus (an index of stiffness) of resting cervical and axioscapular muscles. Sixteen healthy participants were recruited. On day one, ultrasound shear wave elastography was used to measure the shear modulus of superficial and deep cervical extensor and axioscapular muscles bilaterally. Clinical assessments of scapular resting position were performed bilaterally. On day two, testing was repeated on the dominant side. Both intra-session and inter-day reliability were good to excellent for shear modulus of superficial muscles, and poor to excellent for deep muscles. Side differences of shear modulus for posterior upper trapezius were statistically significant but clinically irrelevant. The shear modulus of posterior upper trapezius and middle trapezius were significantly correlated with scapular depression. Ultrasound shear wave elastography is a reliable tool for quantitatively assessing stiffness of superficial cervical and axioscapular muscles. The influence of scapular position should be considered in future comparative studies of healthy controls and patients with neck/shoulder pain. This study provides the necessary first step for future studies on assessing and interpreting the stiffness of cervical and axioscapular muscles for neck and shoulder musculoskeletal disorders.

The impact of musculoskeletal injuries sustained in road traffic crashes on work-related outcomes: a protocol for a systematic review

BACKGROUND

Musculoskeletal injuries (strains/sprains, contusions, dislocations, and fractures) are the most common injury sustained in a road traffic crash. They can have a long-term impact upon the ability to engage in work. Persisting symptoms as well as poor physical and psychological recovery may reduce the ability to return to or remain at work necessitating the use of sick leave or alternate duties to enable a gradual return to full duties. There is also a need to investigate rates of return to work, along with other work-related outcomes in this population so that interventions designed to facilitate return to work can be targeted to this clinical population. In addition, there is a need to explore factors associated with work-related outcomes in people with musculoskeletal injuries subsequent to a road traffic crash.

METHODS

A systematic review will be conducted to determine the impact of sustaining a musculoskeletal injury during a road traffic crash on an individual's ability to work. Observational studies will be identified by searching six electronic databases for reports of adults having sustained musculoskeletal injuries during a road traffic crash. Studies featuring paediatric cohorts or those with neurological injuries will be excluded. To be eligible for inclusion, studies must report at least one of the following work-related outcomes: return to work status/rate, sick leave, work ability, work capacity, and health-related work productivity loss. The methodological quality of included studies will be assessed with the National Institutes of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools for observational cohort and cross-sectional studies, and case-control studies.

DISCUSSION

The results of this systematic review may increase our knowledge of work-related outcomes and understanding of the associated factors for people with musculoskeletal injuries following road traffic crashes. Future studies could use the results to plan interventions and influence policy and legislation, and raise awareness of the needs of this clinical population.

SYSTEMATIC REVIEW REGISTRATION

Registered on PROSPERO, reference number CRD42018099252 , dated 14 August 2018.