| Objectives To analyze the impact of work environment and work characteristic risk factors on health related productivity, in order to provide evidence to facilitate the conduction of workplace health promotion in the future.Materials and methods Typical cases study was conducted through cross-sectional epidemiological survey.6 enterprises that are similar in type, size and industry were selected as the cases. All participants were included after signing an informed consent form designed according to Helsinki Declaration. A carefully developed questionnaire was then completed by the participants independently. The questionnaire covers information on demographics, job characteristics, health situation, work environment and health related productivity. Health related productivity was evaluated with absenteeism and presenteeism. Chi-square test, Mann-Whiney test, negative binominal regression, zero-inflated negative binominal regression and path analysis were conducted for quantitative data using stata, Mplus. Content analysis was conducted for qualitative data using Atlas.TI.Results A total of 2743 participants were included. Participation ratio reached 91.5%. The proportion of work time missed due to health was 0.27%±3.18%. Percentage of impairment while working due to health reached 12.02%±21.25%. Percentage of overall work impairment due to health reached 12.22±21.38%. The rate of absenteeism was 1.9%(male 1.8%, female 2.1%), while the rate of presenteeism was 38.7%(male 37.1%, female 42.9%). The rate of total work impairment time was 39.3%(male 37.8%, female 43.2%). The total work impairment time of 2743 employees during the past week was 15393.00 hours, among which absenteeism time accounted for 466.00 hours (made up 3.03% in total work impairment time) and presenteeism time accounted for 14927.00 hours (made up 96.97% in total work impairment time). The overall economic loss was RMB 494250.07 yuan, among which the economic loss due to absenteeism was 15707.67 yuan and the economic loss due to presenteeism was 478542.39 yuan. The economic loss of health-related productivity for each employee per hour arrived at 4.11 yuan (male 3.99 yuan, female 4.42 yuan). In the path analysis for absenteeism, manufacturing workers (path coefficientβ=0.02,P=0.02), shift-work employees (β=0.04,P<0.01), chemical hazards (β=0.03,β＜0.001), physical hazards (β=0.02, P=0.01), ergonomic hazards (β=0.04, P<0.001), active psychosocial work environment (β=0.04, P=0.001), passive psychosocial work environment (β=0.03, P=0.01),high strain psychosocial work environment (β=0.07, P<0.001), failing to take part in workplace health promotion programs (β=0.03, P=0.001) increase the risk of absenteeism, while high social support (β=-0.01, P<0.001) reduces the risk of absenteeism through health mediating factors. In the path analysis for presenteeism, manufacturing workers (β=0.05, P=0.001), shift-work employees (β=0.06, P<0.001), chemical hazards (β=0.04, P=0.002), physical hazards (β=0.04, P=0.003), ergonomic hazards (β=0.06, P<0.001), active psychosocial work environment (β=0.07, P=0.001), passive psychosocial work environment (β=0.04, P=0.01),high strain psychosocial work environment (β=0.11, P＜0.001), failing to take part in workplace health promotion programs (β=0.05, P<0.001) show an accessive risk of presenteeism, while monthly incomes ranging 4000～8000 yuan (β=-0.03, P=0.047), other employment types (β=-0.03,P=0.04) and high social support (β=-0.16, P<0.001) show a reducing risk of presenteeism through health mediating factors. Statistically significant results of job position were detected in neither absenteeism nor presenteeism. In addition, network of organization, management style, health promotion professionals, funds and government's policy also produce impacts on the workplace health promotion according to the qualitative analysis.Conclusion Occupational hazards, psychosocial work environment, workplace health promotion programs, occupations, monthly incomes, work shifting, employment type impact health-related productivity through diseases, burnout and subjective well-being. In addition, network of organization, management style, health promotion professionals, funds and health promotion-related system and government's policy also produce impacts on the workplace health promotion according to the qualitative analysis. Improving work environment, paying attention to population at risk of impairment of health-related productivity, optimizing network of organization, raising the leader's attention, providing health promotion professionals, increasing funds and optimizing the system are expected to reduce the impairment of health-related productivity. |
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