Excess Insured Health Care Costs from Tobacco-Using Employees in a Large Group Plan

Penner, Maurice; Penner, Susan

doi:10.1097/00043764-199006000-00008

Cited by 21 publications

(5 citation statements)

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“…Some insurers have already increased premiums or denied insurance coverage on the basis of genetic susceptibility test results for breast and ovarian cancer and for Alzheimer's disease (Kite, 2001), despite the low penetrance of relevant genotypes. The adverse impact of smoking on employers' health care costs and worker productivity has been well established, and it has been surmised that employers might currently discriminate against smokers in hiring practices (Penner & Penner, 1990). Employers may be even less willing to hire individuals identified as having an increased risk of addiction or psychiatric illness, based on higher costs associated with substance abuse treatment (Garnick, Hendricks, Comstock, & Horgan, 1997).…”

Section: Privacy and Genetic Discriminationmentioning

confidence: 99%

Translating emerging research on the genetics of smoking into clinical practice: Ethical and social considerations

Shields

Lerman

Sullivan

2004

Nicotine & Tobacco Research

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Despite decades of research aimed at improving the effectiveness of smoking treatment, available treatments are only modestly effective, and smoking remains the leading cause of preventable deaths in the United States. Recent research on genetic factors related to smoking behavior eventually may lead to the design of new tobacco dependence treatments and to the individualization of treatment based on genetic factors. Although this research is in its infancy, and data on the analytic and clinical validity of genetic tests to tailor smoking treatment are not yet available, it is not too soon to begin identifying and addressing key ethical issues associated with genetic testing in the context of tobacco dependence treatment. Key concerns include (a) potential harm (e.g., stigmatization, discrimination) to patients related to inappropriate use of genetic information, (b) implications of pleiotropic associations, (c) differential prevalence of risk-conferring genotypes among racial or ethnic subpopulations, (d) preparedness of primary care physicians to incorporate genetic testing into smoking treatment, (e) informed consent, and (f) ensuring an appropriate balance between individually tailored treatment by genotype and broad-based interventions that focus on social and environmental factors affecting smoking behavior. Additional research on these ethical and social issues must be conducted simultaneously with the scientific work currently under way. Failure to address these concerns will likely undermine efforts to translate knowledge emerging from the United States' substantial investment in genetic research on smoking into clinical practice and improved patient outcomes.

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Section: Privacy and Genetic Discriminationmentioning

confidence: 99%

Translating emerging research on the genetics of smoking into clinical practice: Ethical and social considerations

Shields

Lerman

Sullivan

2004

Nicotine & Tobacco Research

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“…Medical costs (Penner & Penner, 1990) due to lung cancer, heart disease, respiratory problems (Ockene, Kuller, Svendsen, & Meilahn, 1990) Absenteeism (Bush & Wooden, 1995) Musculoskeletal problems Low back pain because of exposure to whole-body vibration in Italian bus operators (Bovenzi, 1996) Increased back and neck pain among urban bus operators in California (Anderson, 1992) Increased risk of musculoskeletal disorders associated with long-term vibration exposure among bus operators in Sweden and the United States (Magnusson, Pope, Wilder, & Areskoug, 1996) A high level of musculoskeletal disorders in operators, appearing to increase with years of driving (Krause et al, 1997b) Workers' compensation (California Department of Industrial Relations, 1990) Sick leave (Grunfeld & Noreik, 1992) Disability (Frymoyer & Cats-Baril, 1991) Costs for recruitment and training because of higher rate of separation from employment…”

Section: Implications For Transit Policymentioning

confidence: 99%

Studies of health outcomes in transit operators: Policy implications of the current scientific database.

Ragland¹,

Krause²,

Greiner³

et al. 1998

Journal of Occupational Health Psychology

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Urban transit operators' medical symptoms and conditions exceed other occupational groups, resulting partly from working conditions. Medical outcomes among operators have an impact on the transit system, including on performance, work attendance, and medical costs. This is exacerbated by external economic and political pressures in which expected service often exceeds the system's capacity in a congested, chaotic urban environment. A vicious cycle of poor working environment, reduced health and well-being among operators, and lowered efficiency and increased costs often results. Operator-health policies focusing solely on individuals are not sufficient to address these problems. A broader approach is needed, acknowledging the relationship between health of the system and health of employees, including redesigning the interface between transit systems and the urban environment and organizational change within companies. This comprehensive approach recognizes the dynamic reciprocity among the transit operators, the transit system, and the larger community.

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“…The costs attributable to smoking are particularly important to employers. Beyond increased medical care costs attributable to smoking,3 employers incur additional indirect costs for smoking employees. These include impacts on workplace absenteeism and productivity 4.…”

mentioning

confidence: 99%

Impact of smoking status on workplace absenteeism and productivity

et al. 2001

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Objectives-To: evaluate the impact of smoking status on objective productivity and absenteeism measures; evaluate the impact of smoking status on subjective measures of productivity; and assess the correlation between subjective and objective productivity measures. Design-Prospective cohort study in a workplace environment. Subjects-Approximately 300 employees (100 each of former, current, and never smokers) at a reservation oYce of a large US airline. Main outcome measures-Objective productivity and absenteeism data were supplied by the employer. Subjective assessments of productivity were collected using a self report instrument, the Health and Work Questionnaire (HWQ). Results-Current smokers had significantly greater absenteeism than did never smokers, with former smokers having intermediate values; among former smokers, absenteeism showed a significant decline with years following cessation. Former smokers showed an increase in seven of 10 objective productivity measures as compared to current smokers, with a mean increase of 4.5%. While objective productivity measures for former smokers decreased compared to measures for current smokers during the first year following cessation, values for former smokers were greater than those for current smokers by 1-4 years following cessation. Subjective assessments of "productivity evaluation by others" and "personal life satisfaction" showed significant trends with highest values for never smokers, lowest for current smokers, and intermediate for former smokers. Conclusions-Workplace productivity is increased and absenteeism is decreased among former smokers as compared to current smokers. Productivity among former smokers increases over time toward values seen among never smokers. Subjective measures of productivity provide indications of novel ways of productivity assessment that are sensitive to smoking status.

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Excess Insured Health Care Costs from Tobacco-Using Employees in a Large Group Plan

Cited by 21 publications

References 0 publications

Translating emerging research on the genetics of smoking into clinical practice: Ethical and social considerations

Translating emerging research on the genetics of smoking into clinical practice: Ethical and social considerations

Studies of health outcomes in transit operators: Policy implications of the current scientific database.

Impact of smoking status on workplace absenteeism and productivity

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