Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce
Summary written by Kevin Fontaine, Ph.D.
Pain is often thought on as the bane of human existence. It spares no group and often adversely affects function and quality of life. Both chronic episodic pain (e.g., migraine headache), and chronic persistent pain (e.g., arthritis), among the working-age populations, is likely to have a profound affect on work performance and productivity. Up to now, most research designed to estimate the effect of pain on productivity and cost has been limited to discrete conditions or has focused on the association of pain to absenteeism and not lost productivity per se. Moreover, no study has estimated the impact of pain on productivity and translated those estimates into economic terms. Stewart and colleagues (Journal of the American Medical Association, 290:2443-2454, 2003.) address these issues by estimating lost productive time and economic cost due to painful conditions using data from a large cross-sectional survey of the American workforce.
Methods: Data from the American Productivity Audit, a computer assisted telephone survey of health and work, of 28,902 working adults between August, 2001, and July 2002, was used to estimate lost productive time due to headache, arthritis, back pain, and other musculoskeletal conditions expressed in hours per worker per week and calculated in US dollars.
Results: Over half (52.7%) of the workforce surveyed reported having headache, back pain, arthritis, or other musculoskeletal pain in the past two weeks, and 12.7% of the workforce lost productive time in a two-week period due to pain. Headache (5.4%) was the most common pain condition prompting lost productive time; followed by back pain (3.2%), arthritis pain (2%) and other musculoskeletal pain (2%). Overall, workers lost an average of 4.6 hours per week of productive time due to a pain condition. Other musculoskeletal pain (5.5 hours/week) and arthritis or back pain (5.2 hours/week) produced the largest amounts of lost productive time. Headache produced, on average, 3.5 hours of lost productive time per week. Age did not seem to attenuate the findings. Lost productive time from common painful conditions was estimated to be $61.2 billion per year, while 76.6% of lost productive time was explained by reduced work performance, not absenteeism.
Conclusions: Pain is a common and disabling condition in the US workforce. Annually it is estimated that over 50 billion dollars are lost due to pain-related conditions that that reduce productivity by compromising performance.
Editorial Comments: These results confirm that pain is costly both at the individual and societal level. Of course, this study is not without limitations. Among are the exclusion of lost productive time due to other common painful conditions such as dental pain, cancer pain, and menstrual pain; the exclusion of pain-induced disability that prompted a work absence of one week or more; and the failure to consider and incorporate secondary costs associated with lost productive time (e.g., hiring and training of replacement workers). Nonetheless, this study provides the best estimate we have of the impact of pain on the productivity of the US workforce. As our ability to treat painful conditions improves, it will be interesting to observe whether this translates into improved productivity of our workforce.
