Influenza Leads to Increased Missed Work Time

Compared to Non-Influenza Illness, Flu Causes More Productivity Loss

Employees with laboratory-confirmed influenza have more lost work time — including absences and reduced productivity while at work—compared to those with other types of acute respiratory illness (ARI), reports a study in the December 2017 Journal of Occupational and Environmental Medicine.

"Compared to non-influenza ARI, [workers] with influenza lose an additional half-day of work due to absenteeism/presenteeism over the week following symptom onset," write Jeffrey J. Van Wormer, PhD, and colleagues of Marshfield Clinic Research Institute, Marshfield, Wisc.

The study included data on 1,278 employed adults who had ARI over four influenza seasons, from 2012-13 to 2015-16. As part of a vaccine effectiveness study, all underwent laboratory tests to confirm the presence or absence of influenza virus infection.

Testing confirmed influenza in 470 employees. Productivity loss over seven to 17 days after initial symptoms was compared for workers with influenza versus non-influenza ARI. Productivity loss included not only absenteeism but also presenteeism: days the employee was at work but less productive due to illness.

Employees with confirmed influenza lost an average 69 percent of expected work hours, compared to 58 percent for those with non-influenza ARI. "A typical full-time employee could expect to lose about 3½ of their 5 work days in a given week…due to absenteeism and presenteeism from an influenza infection," the researchers write. Productivity loss was similar for workers infected with different influenza virus strains.

While previous studies have suggested high productivity losses due to influenza, few studies have included laboratory testing to confirm influenza. Dr. Van Wormer and colleagues conclude: "Future research should explore specific financial returns on employer investments in initiatives and policies designed to help their employees prevent seasonal influenza transmission and infection, and minimize the economic impact of ARI."
About the Author — Dr. VanWormer may be contacted for interviews at

About ACOEM — The American College of Occupational and Environmental Medicine (, an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About JOEM — The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Van Wormer JJ, King JP, Gajewski A, et al. Influenza and workplace productivity loss in working adults. J Occup Environ Med. 2017;59(12):1135-9.