Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature

Carol Cancelliere, J David Cassidy, Carlo Ammendolia, Pierre Côté, Carol Cancelliere, J David Cassidy, Carlo Ammendolia, Pierre Côté

Abstract

Background: Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem.Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism.

Methods: The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age), and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism.

Results: After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies). These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management.

Limitations: This review is limited to English publications. A large number of reviewed studies (70%) were inadmissible due to issues of bias, thus limiting the amount of primary evidence. The uncertainties surrounding presenteeism measurement is of significant concern as a source of bias.

Conclusions: The presenteeism literature is young and heterogeneous. There is preliminary evidence that some WHP programs can positively affect presenteeism and that certain risk factors are of importance. Future research would benefit from standard presenteeism metrics and studies conducted across a broad range of workplace settings.

Figures

Figure 1
Figure 1
Flow Diagram of Literature Search.

References

    1. Schultz AB, Chen CY, Edington DW. The cost and impact of health conditions on presenteeism to employers: a review of the literature. Pharmacoeconomics. 2009;27(5):365–378. doi: 10.2165/00019053-200927050-00002.
    1. Burton WN, Conti DH, Chen CY. The role of health risk factors and disease on worker productivity. J Occup Environ Health. 1999;41:863–877.
    1. Schultz AB, Edington DW. Employee health and presenteeism: a systematic review. J Occup Rehabil. 2007;17(3):547–579. doi: 10.1007/s10926-007-9096-x.
    1. Loeppke R, Hymel PA, Lofland JH, Pizzi LT, Konicki DL, Anstadt GW, Baase C, Fortuna J, Scharf T. American College of Occupational and Environmental Medicine. Health-related workplace productivity measurement: general and migraine-specific recommendations from the ACOEM Expert Panel. J Occup Environ Med. 2003;45(4):349–359. doi: 10.1097/01.jom.0000063619.37065.e2.
    1. Escorpizo R, Bombardier C, Boonen A, Hazes JMW, Lacaille D, Strand V, Beaton D. Worker productivity outcome measures in arthritis. J Rheum. 2007;34(6):1372–1380.
    1. Naumanen P. Opinions of ageing workers on relative importance of health promotion. Int J Nurs Pract. 2006;12(6):352–358. doi: 10.1111/j.1440-172X.2006.00594.x.
    1. National Business Group on Health/Towers Watson. Staying@Work Report 2009/2010: The health and productivity advantage. TW-NA-2009-14891: Watson Wyatt Worldwide; 2010. Retrieved February 5, 2010.
    1. Chapman LS. Meta-evaluation of worksite health promotion economic return studies: 2005 Update. Am J Health Promot. 2005;19(6):1–11.
    1. Riedel JE, Lynch W, Baase C, Hymel P, Peterson KW. The effect of disease prevention and health promotion on workplace productivity: a literature review. Am J Health Promot. 2001;15(3):167–191.
    1. Kuoppala J, Lamminpaa A, Husman P. Work health promotion, job well-being, and sickness absences - A systematic review and meta-analysis. J Occup Environ Med. 2008;50(11):1216–1227. doi: 10.1097/JOM.0b013e31818dbf92.
    1. Pohjonen T, Ranta R. Effects of worksite physical exercise intervention on physical fitness, perceived health status, and work ability among home care workers: five-year follow-up. Prev Med. 2001;32(6):465–475. doi: 10.1006/pmed.2001.0837.
    1. Chen H, Blanc PD, Hayden ML, Bleecker ER, Chawla A, Lee JH. Assessing productivity loss and activity impairment in severe or difficult-to-treat asthma. Value Health. 2008;11(2):231–239. doi: 10.1111/j.1524-4733.2007.00229.x.
    1. Schultz AB, Edington DW. Metabolic syndrome in a workplace: Prevalence, co-morbidities, and economic impact. Metab Syndr Relat Disord. 2009;7(5):459–468. doi: 10.1089/met.2009.0008.
    1. Tang K, Pitts S, Solway S, Beaton D. Comparison of the psychometric properties of four at-work disability measures in workers with shoulder or elbow disorders. J Occup Rehab. 2009;19:142–154. doi: 10.1007/s10926-009-9171-6.
    1. Goetzel RZ, Long SR, Ozminkowski RJ, Hawkins K, Wang S, Lynch W. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health condition affecting U.S. employers. J Occup Environ Med. 2004;46(4):398–412. doi: 10.1097/.
    1. Escorpizo R, Cieza A, Beaton D, Boonen A. Content comparison of worker productivity questionnaires in arthritis and musculoskeletal conditions using the International Classification of Functioning, Disability, and Health Framework. J Occup Rehab. 2009;19:382–397. doi: 10.1007/s10926-009-9193-0.
    1. Lofland JH, Pizzi L, Frick KD. A review of health-related workplace productivity loss instruments. Pharmacoeconomics. 2004;22(3):165–184. doi: 10.2165/00019053-200422030-00003.
    1. Prasad M, Wahlquist P, Shikiar R, Shih YT. A review of self-report instruments measuring health-related work productivity. Pharmacoeconomics. 2004;22(4):225–244. doi: 10.2165/00019053-200422040-00002.
    1. Beaton D, Bombardier C, Escorpizo R, Zhang W, Lacaille D, Boonen A, Osborne RH, Anis AH, Strand CV, Tugwell PS. Measuring worker productivity: Frameworks and measures. J Rheum. 2009;36(9):2100–2109. doi: 10.3899/jrheum.090366.
    1. Beaton DE, Tang K, Gignac MAM, Lacaille D, Badley EM, Anis AH, Bombardier C. Reliability, validity, and responsiveness of five at-work productivity measures in patients with rheumatoid arthritis or osteoarthritis. Arth Care Research. 2010;62(1):28–37. doi: 10.1002/acr.20011.
    1. Chen H, Blanc PD, Hayden ML, Bleecker ER, Chawla A, Lee JH. Assessing productivity loss and activity impairment in severe or difficult-to-treat asthma. Value Health. 2008;11(2):231–239. doi: 10.1111/j.1524-4733.2007.00229.x.
    1. Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, Stang PE, Ustun TB. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004;46(6 suppl):S23–S37.
    1. Mattke S, Balakrishnan A, Bergamo G, Newberry SJ. A review of methods to measure health-related productivity loss. Amer J Manag Care. 2007;13(4):211–217.
    1. Lerner D, Amick BC, Rogers WH, Malspeis S, Bungay K, Cynn D. The Work Limitations Questionnaire. Med Care. 2001;39:72–85. doi: 10.1097/00005650-200101000-00009.
    1. Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4:353–365. doi: 10.2165/00019053-199304050-00006.
    1. Wahlqvist P, Guyatt GH, Armstrong D, Degl'innocenti A, Heels-Ansdell D, El-Dika S, Wiklund I, Fallone CA, Tanser L, Veldhuyzen van Zanten S, Austin P, Barkun AN, Chiba N, Schunemann HJ. The Work Productivity and Activity Impairment questionnaire for patients with gastroesophageal reflux disease (WPAI-GERD): Responsiveness to change and English language validation. PharmacoEconomics. 2007;25(5):385–396. doi: 10.2165/00019053-200725050-00003.
    1. Koopman C, Pelletier KR, Murray JF, Sharda CE, Berger ML, Turpin RS, Hackleman P, Gibson P, Holmes DM, Bendel T. Stanford Presenteeism Scale: health status and employee productivity. J Occup Environ Med. 2002;44:14–20. doi: 10.1097/00043764-200201000-00004.
    1. Pelletier KR. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: update VI 2000-2004. J Occup Environ Med. 2005;47(10):1051–1058. doi: 10.1097/.
    1. Pelletier KR. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: Update VII 2004-2008. J Occup Environ Med. 2009;51(7):822–837. doi: 10.1097/JOM.0b013e3181a7de5a.
    1. Childress JM, Lindsay GM. National indications of increasing investment in workplace health promotion programs by large- and medium-size companies. N C Med J. 2006;67(6):449–452.
    1. Goetzel RZ, Shechter D, Ozminkowski RJ, Marmet PF, Tabrizi MJ, Roemer EC. Promising practices in employer health and productivity management efforts: findings from a benchmarking study. J Occup Environ Med. 2007;49(2):111–130. doi: 10.1097/JOM.0b013e31802ec6a3.
    1. Hillier D, Fewell F, Cann W, Shephard V. Wellness at work: enhancing the quality of our working lives. Int Rev Psychiatry. 2005;17(5):419–431. doi: 10.1080/09540260500238363.
    1. Kuoppala J, Lamminpaa A, Liira J, Vainio H. Leadership, job well-being, and health effects - A systematic review and a meta-analysis. J Occup Environ Med. 2008;50(8):904–915. doi: 10.1097/JOM.0b013e31817e918d.
    1. Special Committee on Health, Productivity, and Disability Management. Healthy workforce/healthy economy: The role of health, productivity, and disability management in addressing the nation's health care crisis: Why an emphasis on the health of the workforce is vital to the health of the economy. J Occup Environ Med. 2009;51(1):114–119.
    1. Terry PE, Seaverson EL, Grossmeier J, Anderson DR. Association between nine quality components and superior worksite health management program results. J Occup Environ Med. 2008;50(6):633–641. doi: 10.1097/JOM.0b013e31817e7c1c.
    1. Tompa E, Dolinschi R, de Oliveira C, Irvin E. A systematic review of occupational health and safety interventions with economic analyses. J Occup Environ Med. 2009;51(9):1004–1023. doi: 10.1097/JOM.0b013e3181b34f60.
    1. Micucci S, Thomas H. The effectiveness of multi-faceted health promotion interventions in the workplace to reduce chronic disease. 2007. Retrieved November 3, 2009.
    1. Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews Evid-Based Nurs. 2004;Third Quarter:176–184.
    1. Deeks JJ, Dinnes J, D'Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG. International Stroke Trial Collaborative Group, European Carotid Surgery Trial Collaborative Group. Evaluating non-randomized intervention studies. Health Tech Assess. 2003;7(27):1–173.
    1. Slavin RE. Best evidence synthesis: an intelligent alternative to meta-analysis. J Clinical Epidem. 1995;48:9–18. doi: 10.1016/0895-4356(94)00097-A.
    1. Nurminen E, Malmivaara A, Ilmarinen J, Ylöstalo P, Mutanen P, Ahonen G, Aro T. Effectiveness of a worksite exercise program with respect to perceived work ability and sick leaves among women with physical work. Scand J Work Environ Health. 2002;28(2):85–93.
    1. Takao S, Tsutsumi A, Nishiuchi K, Mineyama S, Kawakami N. Effects of the job stress education for supervisors on psychological distress and job performance among their immediate subordinates: a supervisor-based randomized controlled trial. J Occup Health. 2006;48(6):494–503. doi: 10.1539/joh.48.494.
    1. Block G, Sternfeld B, Block CH, Block TJ, Norris J, Hopkins D, Quesenberry CP, Husson G, Clancy HA. Development of Alive! (A Lifestyle Intervention Via Email), and its effect on health-related quality of life, presenteeism, and other behavioral outcomes: randomized controlled trial. J Med Internet Research. 2008;10(4):e43. doi: 10.2196/jmir.1112.
    1. Dababneh AJ, Swanson N, Shell RL. Impact of added rest breaks on the productivity and well being of workers. Ergon. 2001;44(2):164–174.
    1. de Boer AGEM, van Beek JC, Durinck J, Verbeek JHAM, van Dijk FJH. An occupational health intervention programme for workers at risk for early retirement; a randomised controlled trial. Occup Environ Med. 2004;61(11):924–929. doi: 10.1136/oem.2003.009746.
    1. Mills PR, Kessler RC, Cooper J, Sullivan S. Impact of a health promotion program on employee health risks and work productivity. Am J Health Promot. 2007;22(1):45–53.
    1. Rivilis I, Cole DC, Frazer MB, Kerr MS, Wells RP, Ibrahim S. Evaluation of a participatory ergonomic intervention aimed at improving musculoskeletal health. Am J Ind Med. 2006;49(10):801–810. doi: 10.1002/ajim.20382.
    1. Tsutsumi A, Nagami M, Yoshikawa T, Kogi K, Kawakami N. Participatory intervention for workplace improvements on mental health and job performance among blue-collar workers: a cluster randomized controlled trial. J Occup Environ Med. 2009;51(5):554–563. doi: 10.1097/JOM.0b013e3181a24d28.
    1. Viola AU, James LM, Schlangen LJ, Dijk DJ. Blue-enriched white light in the workplace improves self-reported alertness, performance and sleep quality. Scand J Work Environ Health. 2008;34(4):297–306.
    1. Wang PS, Simon GE, Avorn J, Azocar F, Ludman EJ, McCulloch J, Petukhova MZ, Kessler RC. Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. JAMA. 2007;298(12):1401–1411. doi: 10.1001/jama.298.12.1401.
    1. IJzelenberg H, Meerding WJ, Burdorf A. Effectiveness of a back pain prevention program: a cluster randomized controlled trial in an occupational setting. Spine. 2007;32(7):711–719. doi: 10.1097/01.brs.0000259072.14859.d9.
    1. von Thiele Schwarz U, Lindfors P, Lundberg U. Health-related effects of worksite interventions involving physical exercise and reduced workhours. Scand J Work Environ Health. 2008;34(3):179–188.
    1. Blangsted AK, Sogaard K, Hansen EA, Hannerz H, Sjogaard G. One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers. Scand J Work Environ Health. 2008;34(1):55–65.
    1. de Kraker H, de Korte EM, van Mil FLK, Rijs BP, Bongers PM. The effect of a feedback signal in a computer mouse on hovering behaviour, productivity, comfort and usability in a field study. Ergon. 2008;51(2):140–155.
    1. Soler RE, Leeks KD, Razi S, Hopkins DP, Griffith M, Aten A, Chattopadhyay SK, Smith SC, Habarta N, Goetzel RZ, Pronk NP, Richling DE, Bauer DR, Buchanan LR, Florence CS, Koonin L, MacLean D, Grizzell JV, Walker AM. A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback. Am J Prev Med. 2010;38(2S):S237–S262.
    1. Koopmanschap M, Burdorf A, Jacob K, Meerding WJ, Brouwer W, & Severens H. Measuring productivity changes in economic evaluation: Setting the research agenda. Pharmacoecon. 2005;23:47–54. doi: 10.2165/00019053-200523010-00004.
    1. Kristensen TS. Intervention studies in occupational epidemiology. Occup Environ Med. 2005;62(3):205–210. doi: 10.1136/oem.2004.016097.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analysis: the PRISMA statement. Ann Int Med. 2009;151(4):264–269.
    1. Allen HM Jr, Borden S, Pikelny DB, Paralkary S, Slavin T, Bunn WB III. An intervention to promote appropriate management of allergies in a heavy manufacturing workforce: evaluating health and productivity outcomes. J Occup Environ Med. 2003;45(9):956–972. doi: 10.1097/01.jom.0000090742.76380.8c.
    1. Burton WN, McCalister KT, Chen C, Edington DW. The association of health status, worksite fitness center participation, and two measures of productivity. J Occup Environ Med. 2005;47(4):343–351. doi: 10.1097/01.jom.0000158719.57957.c6.
    1. Galinsky TL, Swanson NG, Sauter SL, Hurrell JJ, Schleifer LM. A field study of supplementary rest breaks for data-entry operators. Ergonomics. 2000;43(5):622–638. doi: 10.1080/001401300184297.
    1. Galinsky T, Swanson N, Sauter S, Dunkin R, Hurrell J, Schleifer L. Supplementary breaks and stretching exercises for data entry operators: a follow-up field study. Am J Ind Med. 2007;50(7):519–527. doi: 10.1002/ajim.20472.
    1. Harlow KC. The effectiveness of a problem resolution and brief counseling EAP intervention. Journal of Workplace Behavioral Health. 2007;22(1):1–12. doi: 10.1300/J490v22n01_01.
    1. Henning RA, Jacques P, Kissel GV, Sullivan AB, Alteras-Webb SM. Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics. 1997;40(1):78–91. doi: 10.1080/001401397188396.
    1. Karazman R, Kloimuller I, Geissler H, Karazman-Morawetz I. "Effect typology" and Work Ability Index: Evaluating the success of health promotion in elder workforce. Experimental Aging Research. 1999;25(4):313–321. doi: 10.1080/036107399243760.
    1. Karazman R, Kloimuller I, Geissler H, Karazman-Morawetz I. Effects of ergonomic and health training on work interest, work ability and health in elderly public urban transport drivers. Int J Ind Ergon. 2000;25(5):503–511. doi: 10.1016/S0169-8141(99)00037-2.
    1. Larsson A, Karlqvist L, Gard G. Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: a 9-month prospective study. BMC Musculoskelet Disord. 2008;9:105. doi: 10.1186/1471-2474-9-105.
    1. Loeppke R, Nicholson S, Taitel M, Sweeney M, Haufle V, Kessler RC. The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity. Popul Health Manag. 2008;11(6):287–296. doi: 10.1089/pop.2008.0006.
    1. Low D, Gramlich M, Engram BW. Self-paced exercise program for office workers: impact on productivity and health outcomes. AAOHN journal: official journal of the American Association of Occupational Health Nurses. 2007;55(3):99–105.
    1. Meenan R, Vogt T, Williams A, Stevens V, Albright C, Nigg C. Economic Evaluation of a Worksite Obesity Prevention and Intervention Trial Among Hotel Workers in Hawaii. J Occup Environ Med. 2010;52(1 Supplement):S8–S13.
    1. Meijer EM, Frings-Dresen MHW, Sluiter JK. Effects of office innovation on office workers' health and performance. Ergonomics. 2009;52(9):1027–1038. doi: 10.1080/00140130902842752.
    1. Morales A, Martinez MM, Tasset-Tisseau A, Rey E, Baron-Papillon F, Follet A. Costs and benefits of influenza vaccination and work productivity in a Columbian company from the employer's perspective. Value in Health. 2004;7(433):441.
    1. Mushet GR, Miller D, Clements B, Pait G, Gutterman DL. Impact of sumatriptan on workplace productivity, nonwork activities, and health-related quality of life among hospital employees with migraine. Headache. 1996;36(3):137–143. doi: 10.1046/j.1526-4610.1996.3603137.x.
    1. Pelletier B, Boles M, Lynch W. Change in health risks and work productivity over time. J Occup Environ Med. 2004;46(7):746–754. doi: 10.1097/01.jom.0000131920.74668.e1.
    1. Pohjonen T, Ranta R. Effects of worksite physical exercise intervention on physical fitness, perceived health status, and work ability among home care workers: five-year follow-up. Preventive medicine. 2001;32(6):465–475. doi: 10.1006/pmed.2001.0837.
    1. Puig-Ribera A, McKenna J, Gilson N, Brown WJ. Change in work day step counts, wellbeing and job performance in Catalan university employees: a randomised controlled trial. Promot Educ. 2008;15(4):11–16. doi: 10.1177/1025382308097693.
    1. Samad AH, Usul MHBHJ, Zakaria D, Ismail R, Tasset-Tisseau A, Baron-Papillon F, Follet A. Workplace vaccination against influenza in Malaysia: Does the employer benefit? J Occup Health. 2006;48(1):1–10. doi: 10.1539/joh.48.1.
    1. Slot T, Charpentier K, Dumas G, Delisle A, Leger A, Plamondon A. Evaluation of forearm support provided by the Workplace Board on perceived tension, comfort and productivity in pregnant and non-pregnant computer users. Work. 2009;34(1):67–77.
    1. Umanodan R, Kobayashi Y, Nakamura M, Kitaoka-Higashiguchi K, Kawakami N, Shimazu A. Effects of a worksite stress management training program with six short-hour sessions: a controlled trial among Japanese employees. J Occup Health. 2009;51(4):294–302. doi: 10.1539/joh.L8055.
    1. Vicente-Herrero T, Burke TA, Lainez MJ. The impact of a worksite migraine intervention program on work productivity, productivity costs, and non-workplace impairment among Spanish postal service employees from an employer perspective. Curr Med Res Opin. 2004;20(11):1805–1814. doi: 10.1185/030079904X10151.
    1. Watson DT, Long WJ, Yen D, Pichora DR. Health promotion program: a resident well-being study. Iowa Orthop J. 2009;29:83–87.
    1. Laestadius JG, Ye J, Cai X, Ross S, Dimberg L, Klekner M. The proactive approach - is it worthwhile? A prospective controlled ergonomic intervention study in office workers. J Occup Environ Med. 2009;51(10):1116–1124. doi: 10.1097/JOM.0b013e3181bae19d.
    1. Anderzen I, Arnetz BB. The impact of a prospective survey-based workplace intervention program on employee health, biologic stress markers, and organizational productivity. J Occup Environ Med. 2005;47(7):671–682. doi: 10.1097/01.jom.0000167259.03247.1e.
    1. Earle-Richardson G, Jenkins PL, Strogatz D, Bell EM, Sorensen JA, May JJ. Orchard evaluation of ergonomically modified apple bucket. J Agromed. 2006;11(3-4):95–105.
    1. Faucett J, Meyers J, Miles J, Janowitz I, Fathallah F. Rest break interventions in stoop labor tasks. Appl Ergon. 2007;38(2):219–226. doi: 10.1016/j.apergo.2006.02.003.
    1. Greene BL, Miller JD, Brown TM, Harshman RS, Richerson GT, Doyle JJ. Economic impact of the BP DownShift Program on blood pressure control among commercial driver license employees. Journal of Occupational and Environmental Medicine. 2009;51(5):542–553. doi: 10.1097/JOM.0b013e3181a2fec7.
    1. Guppy A, Marsden J. Assisting employees with drinking problems: changes in mental health, job perceptions and work performance. Work Stress. 1997;11(4):341–350. doi: 10.1080/02678379708252997.
    1. Page MJ, Paramore LC, Doshi D, Rupnow MF. Evaluation of resource utilization and cost burden before and after an employer-based migraine education program. Journal of Occupational and Environmental Medicine. 2009;51(2):213–220. doi: 10.1097/JOM.0b013e318192bcd1.
    1. Pedersen MT, Blangsted AK, Andersen LL, Jørgensen MB, Hansen EA, Sjøgaard G. The effect of worksite physical activity intervention on physical capacity, health, and productivity: a 1-year randomized controlled trial. J Occup Environ Med. 2009;51(7):759–770. doi: 10.1097/JOM.0b013e3181a8663a.
    1. Yeow PHP, Nath Sen R. Quality, productivity, occupational health and safety and cost effectiveness of ergonomic improvements in the test workstations of an electronic factory. International Journal of Industrial Ergonomics. 2003;32:147–163. doi: 10.1016/S0169-8141(03)00051-9.
    1. van den Heuvel SG, de Looze MP, Hildebrandt VH, Thé KH. Effects of software programs stimulating regular breaks and exercises on work-related neck and upper-limb disorders. Scand J Work Environ Health. 2003;29(2):106–116.
    1. Loeppke R, Taitel M, Richling D, Parry T, Kessler RC, Hymel P, Konicki D. Health and productivity as a business strategy. J Occup Environ Med. 2007;49(7):712–721. doi: 10.1097/JOM.0b013e318133a4be.
    1. Chapman LS. Presenteeism and its role in worksite health promotion. Am J Health Promot. 2005;19(4 suppl):1–8.

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