title: Association Between Costs Related to Productivity Loss and Modified Risk Factors Among Users of the Brazilian National Health System.
abstract: The aim of this study was to investigate the associations between costs related to productivity losses and its risk factors among users of the Brazilian National Health System.
  
  
  
  The public cost associated with productivity losses of 342 adults has been estimated, taking into account a period of 18 months. Costs related to productivity loss were estimate using data provided by the Brazilian National Health System (disability retirements) and absenteeism. Modifiable risk factors and unhealthy behaviors were assessed through interviews (physical inactivity, alcohol consumption, and smoking) and clinical assessments (obesity).
  
  
  
  Smoking and physical inactivity affected significantly the amount of money lost with productivity losses related to absenteeism. The presence of obesity generated higher expenditures with disability retirement, while low back pain and sleep disorder were the most relevant confounders in multivariate models for disability retirement and absenteeism.
  
  
  
  Among users of the Brazilian National Health System, obesity, smoking, and physical inactivity seem to have a significant effect on productivity losses associated with health problems. Moreover, low back pain and sleep quality seem variables few explored but with potential to affect health care costs.
authors.affiliation: São Paulo State University-UNESP, Presidente Prudente (Mrs Araujo, Dr Fernandes, Dr Monteiro, Dr Turi, Dr Codogno); University of São Paulo-USP, São Paulo (Dr Sarti), Brazil; Brunel University, London, England (Dr Anokye).
authors.forename: Monique Yndawe Castanho
authors.initials: MY
authors.lastname: Araujo
authors.forename: Flávia Mori
authors.initials: FM
authors.lastname: Sarti
authors.forename: Rômulo Araújo
authors.initials: RA
authors.lastname: Fernandes
authors.forename: Henrique Luiz
authors.initials: HL
authors.lastname: Monteiro
authors.forename: Bruna Camilo
authors.initials: BC
authors.lastname: Turi
authors.forename: Nana
authors.initials: N
authors.lastname: Anokye
authors.forename: Jamile Sanches
authors.initials: JS
authors.lastname: Codogno
mesh_terms: D000041:Absenteeism; D000368:Aged; D000428:Alcohol Drinking / Q000191:economics; D001938:Brazil; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004526:Efficiency; D005260:Female; D015438:Health Behavior; D006801:Humans; D017116:Low Back Pain / Q000191:economics; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics; D012179:Retirement / Q000191:economics* / Q000706:statistics & numerical data; D012307:Risk Factors; D057185:Sedentary Behavior; D012893:Sleep Wake Disorders / Q000191:economics; D012907:Smoking / Q000191:economics; D011795:Surveys and Questionnaires