This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (228)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Occupational and Environmental Medicine  • Pain  • Alert me on articles by topic  Social Bookmarking   What's this?

Walter F. Stewart, PhD, MPH; Judith A. Ricci, ScD, MS; Elsbeth Chee, ScD; David Morganstein, MS; Richard Lipton, MD

JAMA. 2003;290:2443-2454.

Context  Common pain conditions appear to have an adverse effect on work, but no comprehensive estimates exist on the amount of productive time lost in the US workforce due to pain.

Objective  To measure lost productive time (absence and reduced performance due to common pain conditions) during a 2-week period.

Design and Setting  Cross-sectional study using survey data from the American Productivity Audit (a telephone survey that uses the Work and Health Interview) of working adults between August 1, 2001, and July 30, 2002.

Participants  Random sample of 28 902 working adults in the United States.

Main Outcome Measures  Lost productive time due to common pain conditions (arthritis, back, headache, and other musculoskeletal) expressed in hours per worker per week and calculated in US dollars.

Results  Thirteen percent of the total workforce experienced a loss in productive time during a 2-week period due to a common pain condition. Headache was the most common (5.4%) pain condition resulting in lost productive time. It was followed by back pain (3.2%), arthritis pain (2.0%), and other musculoskeletal pain (2.0%). Workers who experienced lost productive time from a pain condition lost a mean (SE) of 4.6 (0.09) h/wk. Workers who had a headache had a mean (SE) loss in productive time of 3.5 (0.1) h/wk. Workers who reported arthritis or back pain had mean (SE) lost productive times of 5.2 (0.25) h/wk. Other common pain conditions resulted in a mean (SE) loss in productive time of 5.5 (0.22) h/wk. Lost productive time from common pain conditions among active workers costs an estimated $61.2 billion per year. The majority (76.6%) of the lost productive time was explained by reduced performance while at work and not work absence.

Conclusions  Pain is an inordinately common and disabling condition in the US workforce. Most of the pain-related lost productive time occurs while employees are at work and is in the form of reduced performance.

Author Affiliations: AdvancePCS Center for Work and Health, Hunt Valley, Md (Drs Stewart, Ricci, and Chee); Geisinger Health Systems, Danville, Pa (Dr Stewart); Statistical Group, Westat, Rockville, Md (Mr Morganstein); and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (Dr Lipton).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Loss of Productive Time Due to Pain
Sanjoy Roy
JAMA. 2004;291(6):694.
EXTRACT | FULL TEXT  

Loss of Productive Time Due to Pain—Reply
Walter F. Stewart and Judith A. Ricci
JAMA. 2004;291(6):694.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Worksite Wellness Programs for Cardiovascular Disease Prevention: A Policy Statement From the American Heart Association
Carnethon et al.
Circulation 2009;120:1725-1741.
FULL TEXT  

Management of Chronic Pain
JWatch Women's Health 2009;2009:1-1.
FULL TEXT  

In Search of Analgesia: Emerging Poles of GPCRs in Pain
Stone and Molliver
Mol. Interv. 2009;9:234-251.
ABSTRACT | FULL TEXT  

Measuring Worker Productivity: Frameworks and Measures
BEATON et al.
The Journal of Rheumatology 2009;36:2100-2109.
ABSTRACT | FULL TEXT  

Hyaluronic Acid Viscosupplementation and Osteoarthritis: Current Uses and Future Directions
Strauss et al.
Am J Sports Med 2009;37:1636-1644.
ABSTRACT | FULL TEXT  

A Comparison of Long- and Short-Acting Opioids for the Treatment of Chronic Noncancer Pain: Tailoring Therapy to Meet Patient Needs
Argoff and Silvershein
Mayo Clin Proc. 2009;84:602-612.
ABSTRACT | FULL TEXT  

Optimized Antidepressant Therapy and Pain Self-management in Primary Care Patients With Depression and Musculoskeletal Pain: A Randomized Controlled Trial
Kroenke et al.
JAMA 2009;301:2099-2110.
ABSTRACT | FULL TEXT  

A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain
Cherkin et al.
Arch Intern Med 2009;169:858-866.
ABSTRACT | FULL TEXT  

Assessing and Managing All Aspects of Migraine: Migraine Attacks, Migraine-Related Functional Impairment, Common Comorbidities, and Quality of Life
Buse et al.
Mayo Clin Proc. 2009;84:422-435.
ABSTRACT | FULL TEXT  

Trigeminal Neuralgia Treated With Pregabalin in Family Medicine Settings: Its Effect on Pain Alleviation and Cost Reduction
Perez et al.
J Clin Pharmacol 2009;49:582-590.
ABSTRACT | FULL TEXT  

The Rising Prevalence of Chronic Low Back Pain
Freburger et al.
Arch Intern Med 2009;169:251-258.
ABSTRACT | FULL TEXT  

Evidence-based Assessment of Pediatric Pain
Cohen et al.
J Pediatr Psychol 2008;33:939-955.
ABSTRACT | FULL TEXT  

Physical and Mental Comorbidity of Headache in a Nationally Representative Sample of US Adults
Kalaydjian and Merikangas
Psychosom. Med. 2008;70:773-780.
ABSTRACT | FULL TEXT  

Calcitonin gene-related peptide (CGRP) antagonists and migraine: Is this a new era?
Goadsby
Neurology 2008;70:1300-1301.
FULL TEXT  

Impact of comorbidity on headache-related disability
Saunders et al.
Neurology 2008;70:538-547.
ABSTRACT | FULL TEXT  

Improving State Pain Policies: Recent Progress and Continuing Opportunities
Gilson et al.
CA Cancer J Clin 2007;57:341-353.
ABSTRACT | FULL TEXT  

The Impact of Comorbidity of Mental and Physical Conditions on Role Disability in the US Adult Household Population
Merikangas et al.
Arch Gen Psychiatry 2007;64:1180-1188.
ABSTRACT | FULL TEXT  

Using Opioids for Patients With Moderate to Severe Pain
Rasor and Harris
JAOA: Journal of the American Osteopathic Association 2007;107:ES4-ES10.
ABSTRACT | FULL TEXT  

Pain Management: A Fundamental Human Right
Brennan et al.
Anesth. Analg. 2007;105:205-221.
ABSTRACT | FULL TEXT  

The Pain Protective Haplotype: Introducing the Modern Genetic Test
Klein
Clin. Chem. 2007;53:1007-1009.
FULL TEXT  

Pain Management in Hospitalized Cancer Patients: A Systematic Review
Goldberg and Morrison
JCO 2007;25:1792-1801.
ABSTRACT | FULL TEXT  

Arthrokinematics in a Subgroup of Patients Likely to Benefit From a Lumbar Stabilization Exercise Program
Teyhen et al.
ptjournal 2007;87:313-325.
ABSTRACT | FULL TEXT  

Overcoming the Influence of Chronic Pain on Older Patients' Difficulty With Recommended Self-Management Activities
Krein et al.
Gerontologist 2007;47:61-68.
ABSTRACT | FULL TEXT  

Psychiatry in Chronic Pain: A Review and Update
Sharp and Keefe
Focus 2006;4:573.
FULL TEXT  

The Economic Burden of Angina in Women With Suspected Ischemic Heart Disease: Results From the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation
Shaw et al.
Circulation 2006;114:894-904.
ABSTRACT | FULL TEXT  

A Controlled Trial of Methods for Managing Pain in Primary Care Patients With or Without Co-Occurring Psychosocial Problems
Ahles et al.
Ann Fam Med 2006;4:341-350.
ABSTRACT | FULL TEXT  

Monetary value of lost productivity over a five year follow up in early rheumatoid arthritis estimated on the basis of official register data on patients' sickness absence and gross income: experience from the FIN-RACo trial
Puolakka et al.
Ann Rheum Dis 2006;65:899-904.
ABSTRACT | FULL TEXT  

Systematic review of studies of productivity loss due to rheumatoid arthritis
Burton et al.
Occup Med (Lond) 2006;56:18-27.
ABSTRACT | FULL TEXT  

Health-Related Quality of Life, Health Risk Behaviors, and Disability Among Adults With Pain-Related Activity Difficulty
Strine et al.
AJPH 2005;95:2042-2048.
ABSTRACT | FULL TEXT  

Management of Work-Related Low Back Pain: A Population-Based Survey of Physical Therapists
Poitras et al.
ptjournal 2005;85:1168-1181.
ABSTRACT | FULL TEXT  

Combining Registry, Primary, and Secondary Data Sources to Identify the Impact of Cancer on Labor Market Outcomes
Bradley et al.
Med Decis Making 2005;25:534-547.
ABSTRACT  

American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management: American Pain Society Quality of Care Task Force
Gordon et al.
Arch Intern Med 2005;165:1574-1580.
ABSTRACT | FULL TEXT  

Opioid Use for Moderate to Severe Pain
Rasor and Harris
JAOA: Journal of the American Osteopathic Association 2005;105:S2-S7.
ABSTRACT | FULL TEXT  

The Effect of Web-Based, Personalized, Osteoarthritis Quality Improvement Feedback on Patient Satisfaction With Osteoarthritis Care
Sciamanna et al.
American Journal of Medical Quality 2005;20:127-137.
ABSTRACT  

The Effect of Chronic Pain on Diabetes Patients' Self-Management
Krein et al.
Diabetes Care 2005;28:65-70.
ABSTRACT | FULL TEXT  

A Clinical Prediction Rule To Identify Patients with Low Back Pain Most Likely To Benefit from Spinal Manipulation: A Validation Study
Childs et al.
ANN INTERN MED 2004;141:920-928.
ABSTRACT | FULL TEXT  

Prevalence and impact of migraine and probable migraine in a health plan
Patel et al.
Neurology 2004;63:1432-1438.
ABSTRACT | FULL TEXT  

Update in General Internal Medicine
Kroenke and Logio
ANN INTERN MED 2004;141:213-220.
FULL TEXT  

Loss of Productive Time Due to Pain
Roy
JAMA 2004;291:694-694.
FULL TEXT  

The prevalence of migraine in neurologists
Sacks et al.
Neurology 2004;62:342-342.
FULL TEXT  

Absent from Work: Nature versus Nurture
Weinstein
ANN INTERN MED 2004;140:142-143.
FULL TEXT  

Pain Management
DeAngelis
JAMA 2003;290:2480-2481.
FULL TEXT