Metabolic Syndrome in a Workplace: Prevalence, Co-Morbidities, and Economic Impact

Background: Although the prevalence of metabolic syndrome has been studied in nationally representative populations, little is known about its prevalence specifically among working adults. Because corporations are often the primary payers of health-care costs in the United States, they have a vested interest in knowing the impact of metabolic syndrome in employed individuals. Methods: A total of 4188 employees (83.4% male, 92.1% Caucasian, average age 40.8 years) of a midwestern U.S. manufacturing corporation participated in a health risk appraisal and biometric screening in 2006 and also used the company's medical plan. Those with metabolic syndrome were compared to those without metabolic syndrome in terms of their 2006 health risks, health conditions, health-care costs, pharmacy costs, short-term disability costs, and a measure of on-the-job productivity loss known as presenteeism. Results: A total of 30.2% of employees met the criteria for metabolic syndrome and were more likely to also have a variety of additional health risks and health conditions compared to those without metabolic syndrome. For example, 9.4% of those with metabolic syndrome self-reported having diabetes compared to 1.4% of those without metabolic syndrome. Health-care costs, pharmacy costs, and short-term disability costs were significantly higher for those with metabolic syndrome compared to those without metabolic syndrome, and increasing numbers of metabolic syndrome health risks were associated with greater numbers of employees reporting on-the-job productivity losses (presenteeism). Conclusions: Because metabolic syndrome is prevalent among the employees of this manufacturing company and is associated with significant economic costs, employers would be wise to address the health risks of employees through health promotion programs and benefit plan designs that help individuals improve their health and receive appropriate health screenings and medical care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78143/1/met.2009.0008.pd

Asthma Disease Management: A Worksite-Based Asthma Education Program

Asthma accounts for an estimated 3 million workdays lost each year in the United States in addition to reduced worker productivity. Although asthma disease management programs are relatively common in managed care organizations, they have generally not been offered at the workplace. Seventy-six employees participated in a five-session worksite-based asthma education program. A total of 47 of 76 (61.8%) employees completed baseline and 12-month follow-up Asthma Therapy Assessment Questionnaires (ATAQ). The ATAQ includes measurement of poor asthma control, behavior/attitude barriers, knowledge barriers, patient/provider communication barriers, and efficiency. Significant improvement was noted in measures of asthma control (p < 0.05), communication (p < 0.005), knowledge (p < 0.001), and the total ATAQ Index declined from 5.53 to 4.04 (p < 0.001). Employee satisfaction results for the program were exceptionally high. A worksite-based asthma education program should reduce medical care costs, worker absenteeism, and improve worker productivity. The worksite can be a very effective location for disease education programs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63128/1/109350701300038208.pd

Worker Productivity Loss Associated with Arthritis

This study at a major financial services corporation sought to investigate the association of arthritis with on-the-job productivity, also termed "presenteeism." Using a modified version of the Work Limitations Questionnaire (WLQ) incorporated into a Health Risk Appraisal (HRA), 17,685 employees responded to the survey in 2002. Of the 16,651 respondents meeting inclusion criteria, 2,469 (14.8%) reported having arthritis, and 986 (39.9% of those with arthritis) also reported that they were under medical care and/or taking medication for arthritis. Employees with arthritis were older, predominantly female, and reported a higher number of comorbidities. Although all four domains of the WLQ (physical, time, mental, and output) were impacted by arthritis, the greatest productivity effect, as expected, was on physical work tasks. Health risks also play a role in the relationship between arthritis and presenteeism, with high-risk individuals reporting 7%–10% additional loss of productivity compared to lowrisk individuals. In addition, those who reported receiving medication and/or treatment for arthritis had a 2.5% excess productivity loss independently attributed to their arthritis, which equals approximately $1,250 per employee per year, or$5.4 million to the corporation. This arthritis effect was discernible in those with low and moderate levels of health risk, but was not as evident in those with high health risks; in that group, health-associated decrements in productivity were much larger. Arthritis is associated with work productivity loss. Disease management programs should focus on pain management and arthritis-associated health risks and comorbidities in order to significantly decrease arthritis-related losses in on-the-job productivity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63221/1/dis.2006.9.131.pd

Metabolic Syndrome and Workplace Outcomes.

Metabolic syndrome is a cluster of five risk factors which have been shown to be associated with increased odds of developing certain medical conditions such as heart disease and diabetes. However, changing definitions of metabolic syndrome in the past have made it difficult to assess the true prevalence of this condition and previous research has been conducted in patient populations or in nationally representative studies. The purpose of this dissertation is to determine the prevalence and impact of metabolic syndrome risk factors and the syndrome itself in a specific employed population to compare with nationally representative samples and to assess prospectively whether metabolic syndrome is a predictor of disease. Since employers in the U.S. are common payers of heatlh care costs, they have an interest in whether or not metabolic syndrome is prevalent among working individuals. Results found that the prevalence of metabolic syndrome in a manufacturing corporation was similar to that found in nationally representative studies. Furthermore, individuals with metabolic syndrome were found to have higher health care costs, pharmaceutical costs, short-term disability absences, and on-the-job productivity losses compared to employees without metabolic syndrome. Finally, metabolic syndrome was a significant predictor of diabetes and heart disease in employees after two years of follow-up, after controlling for age, gender and ethnicity. Metabolic syndrome is an issue for corporations and organizations concerned with rising health care costs and productivity losses. Employees should be offered opportunities to learn of their risk factors as well as ways in which to maintain their good health or improve their health risks.Ph.D.KinesiologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/62363/1/abelaire_1.pd

The Association Between Achieving Low-Density Lipoprotein Cholesterol (LDL-C) Goal and Statin Treatment in an Employee Population

Abstract Statin medications are recommended for patients who have not achieved low-density lipoprotein cholesterol (LDL-C) goals through lifestyle modifications. The objective of this retrospective observational study was to examine statin medication usage patterns and the relationship with LDL-C goal levels (according to Adult Treatment Panel III guidelines) among a cohort of employees of a major financial services corporation. From 1995 to 2004, a total of 1607 executives participated in a periodic health examination program. An index date was assigned for each study participant (date of their exam) and statin medication usage was determined from the pharmacy claims database for 365 days before the index date. Patients were identified as adherent to statins if the medication possession ratio was ≥80%. In all, 150 (9.3%) executives filled at least 1 statin prescription in the 365 days prior to their exam. A total of 102 statin users (68%) were adherent to statin medication. Among all executives who received statin treatment, 70% (odds ratio [OR]?=?2.30, 95% confidence interval [CI]?=?1.82, 2.90) achieved near-optimal (<130?mg/dL) and 30% (OR?=?1.78, 95% CI?=?1.15, 2.76) achieved optimal (<100?mg/dL) LDL-C goals, which is significantly higher than the rates among statin nonusers (55% and 21%). Adherent statin users were more likely to achieve recommended near-optimal LDL-C goals compared to statin nonusers (overall P?=?0.002; adherent: OR?=?2.75, 95% CI?=?1.662, 4.550), while nonadherent statin users were more likely to achieve the optimal goal compared to statin nonusers (OR?=?2.223; CI?=?1.145, 4.313). Statin usage was associated with improvements in LDL-C goal attainment among executives who participated in a periodic health examination. Appropriate statin medication adherence should be encouraged in working populations in order to achieve LDL-C goals. (Population Health Management 2010;13:1?8)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/85115/1/pop_2009_0020.pd