August 2016: How Discomfort Drives Healthcare Overutilization


  • DiscomfortAmidst the overwhelming and irrefutable data regarding the deleterious effects from prolonged sitting, a brief article in EHS Today reported on a large survey which polled 1,000 full-time office employees and self-employed workers. The findings included: “A new survey reveals that 74 percent of office workers experience pain a few times a week or more while sitting at their desks.

The report documents strikingly similar numbers to another study conducted by The University of California Los Angeles (UCLA) published several years ago (see below) measuring 2,000+ people using computers at work.

The EHS Today report continued: “Additionally, more than 70 percent of respondents endure back pain and more than half felt eyestrain or headaches in the last 3 years. Nearly 10 percent of workers, meanwhile, experience pain all day long while sitting at their desks.

Ten percent?  How many employees using computers do you have?  What sized pool do you have of evolving new injuries to report?  Who are they?  What above-average healthcare resources do they consume?  Who is on a trajectory to join that pool in the next twelve months?

It’s well known that pre-injury employees experiencing discomfort consume a considerable amount of healthcare resources beyond obvious productivity loss. Further compounding the financial hemorrhaging is the fact that high ergonomic risk factors are by no means confined to traditionally perceived high-risk groups anymore due to a number of independently contributing reasons (Statins usage, technology usage out of work, older employees, increased BMI, increasing sedentary lifestyles, etc…).

A number of major studies have been published, over the past decade, which have examined this topic with many thousands of employees at multiple employers. An example recent research project “Work Loss, Healthcare Utilization, and Costs among US Employees with Chronic Pain” (Disease Management & Health Outcomes, Volume 13, Number 3, pp. 201-208(8)), studied thousands of full-time employees and the annual total costs experienced for medical, pharmacy and productivity.

This study was consistent with other recent studies and the authors confirmed: “The findings demonstrate that employees with chronic pain experience frequent sickness absences and short-term disability days and consume a considerable amount of healthcare resources.” The authors concluded: “Given the economic impact of chronic pain, employers and managed care organizations should evaluate the potential benefits in productivity resulting from workplace initiatives such as ergonomic modifications, rest breaks, or pain management programs.

What Is Discomfort?

Discomfort is well-understood and defined as:

  • an absence of comfort or ease; uneasiness, hardship, or mild pain.

  • anything that is disturbing to or interferes with comfort.

Many studies over the past 20 years have framed the clear impact on organizations:

  • While experiencing discomfort, an employee is thinking about something other than work.

  • Discomfort impairs performance in any human activity.

  • A lagging indicator of Musculoskeletal Disorder Risk is discomfort.

  • Discomfort is a leading indicator of MSD Injuries.

  • Discomfort is a conscious awareness of irritation, inflammation or injury.
  • DiscomfortOf particular interest, the survey found: “All that sitting can lead to painful conditions that workers clearly are trying to avoid: nearly 70 percent adjust or rearrange their workspace at least once a day to get more comfortable, while 18 percent spend 30-60 minutes daily trying to make improvements.
What Is Known?

We know that discomfort is an integral stage within the pathology of a Musculoskeletal Disorder:

   MSD Pathology

Of course, when you identify and address an issue at its earliest stage you significantly reduce the costs associated with the issue including treatment of the issue (intervention) and increase the likelihood of intervention success.

Another study conducted by The University of California Los Angeles (UCLA) was published around the same time (see UCLA Study) and showed that well more than half of the 2,310 respondents reported musculoskeletal discomfort.

According to the study: “Musculoskeletal disorders (MSDs) persist among clerical workers despite ergonomic advances.” This study showed specifically:

“The prevalence of MSD cases was:

  • 37% neck/shoulders

  • 21% upper extremities

  • 18% lower extremities

  • 34% back region”
Framing The Issue

  • World of Regulation
    Numerous similar studies have been conducted in North American, Europe and Asia over the past ten years (call us for a full list) and the range of respondent reporting of discomfort typically is bracketed at between 50% and 75%.”

Although there are more associative clues in the data (such as how different employee characteristics often correlate to risk factors such as age, non-work activities, prescription usage and body mass index) assessing your employee population for these indicators is at best impractical and at worst perhaps rubs against privacy guidelines.

The Effective Strategy

So what is the EH&S Professional or Risk Manager to do in order to identify and mitigate risk as early-on as possible while facing the complexities of causation? This only has to be as complicated as you allow it to be.

Our most successful clients clearly see that there are three required strategies that need to be combined:

  • Break The Blood Cycle – Stop doing more of the same which has not eliminated injuries.

  • Improve Employee Behaviors – Make good ergonomic behaviors automatic.

  • Get and Stay Ahead of Risk – Identify and neutralize tomorrow’s threats today.

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