155: Presenteeism Correlates in Japanese Workers: Pain, Psychosocial Factors, and Objective Activity

Topic: Clinical Science
Subtopic:

Background and Aims: Presenteeism—reduced productivity while working despite health problems—accounts for a substantial proportion of productivity loss in Japan (1,2). Pain, psychological distress, and impaired daily functioning are well-established correlates (3), yet much of the existing evidence has relied solely on self-report measures. We integrated questionnaire data with actigraphy-derived physical activity (vector magnitude counts per minute (VMCPM) and Step Counts) and sleep duration (actigraphy-derived) to clarify how subjective psychosocial factors and objective behavioral patterns jointly relate to work performance.

Methods: Cross-sectional survey of employed adults recruited from multiple workplaces in Hiroshima, Japan (UMIN000054797). Participants completed HPQ (Health and Work Performance Questionnaire) (absolute and relative scores), SF-MPQ (Short-Form McGill Pain Questionnaire), PCS (Pain Catastrophizing Scale), BDI-II (Beck Depression Inventory-Second Edition), STAI (State–Trait Anxiety Inventory), and WHODAS 2.0 (World Health Organization Disability Assessment Schedule 2.0), and wore a wrist accelerometer for 7 days. We used generalized additive models (GAMs) to examine associations between HPQ scores and other indices. Variables significant in the GAMs were subsequently entered into MIMIC-SEM (multiple indicator multiple cause structural equation model) to examine the interrelationships among these variables.

Results: Final analytic sample: n=214 (68 men, 146 women). In GAMs, greater VMCPM and longer total sleep time were associated with higher absolute and relative HPQ (better work performance). Higher Step Counts were associated with higher relative HPQ. Poorer daily functioning—particularly WHODAS Life activities—was strongly associated with lower HPQ, and pain severity with lower absolute HPQ.
In MIMIC-SEM, activity and sleep showed positive total associations with HPQ, partly direct and partly through daily functioning; daily functioning remained strongly associated with HPQ, whereas pain severity and depressive symptoms were related to lower HPQ mainly through daily functioning.

Conclusions: In workers, daily functioning, objectively measured physical activity, and sleep duration were key correlates of work performance, while pain and depressive symptoms were linked to reduced work performance primarily through daily functional impairment. Objective behavioral indices provided incremental information beyond questionnaires. Longitudinal and interventional studies are warranted to clarify causal relationships and to examine whether improving physical activity, sleep, and daily functioning can mitigate productivity loss.

References: 1) Johns G. Presenteeism in the workplace: A review and research agenda. Journal of Organizational Behavior. 2010;31(4):519-542.
2) Yoshimoto T, Oka H, Fujii T, Nagata T, Matsudaira K. The Economic Burden of Lost Productivity due to Presenteeism Caused by Health Conditions Among Workers in Japan. Journal of Occupational and Environmental Medicine. 2020;62(10):883-888.
3) Yoshino A, Ushio K, Nakamura R, Shiota S, Katagiri T, Nishihara K, Moriwaki K, Anno K, Mikami Y, Tsutsumi Y. Multifaceted analysis of presenteeism: contributions of pain, psychological factors and daily functioning - a cross-sectional study in Japan. BMJ Open. 2025;15(8):e100243.

Presenting Author: Atsuo Yoshino
Submitting Author: Atsuo Yoshino

Senior Author: N/A (First and corresponding author: Atsuo Yoshino)

IASP 2026 Global Year theme of Neuropathic Pain: No

• Ryuji Nakamura: M.D. Ph.D. - Hiroshima Univerisity
• Shigehito Shiota: Ph.D. - Hiroshima University
• Tomoaki Katagiri: M.D. - Hiroshima University
• Kiriko Nishihara: M.A. - Hiroshima University
• Tsuyoshi Ikeda: M.D. Ph.D. - Hiroshima University
• Ikuyo Watanabe: M.D. Ph.D. - Hiroshima University
• Noboru Shimada: Ph.D. - Hiroshima University
• Eri Mishima: B.S. - Hiroshima University
• Katsuyuki Moriwaki: M.D. Ph.D. - Hiroshima University
• Yasuo Tsutsumi: M.D. Ph.D. - Hiroshima University