bims-cieche 2025-10-12 papers

Issue of 2025–10–12
four papers selected by
Jonas Stefaan Steel, IDEWE

Eur J Public Health. 2025 Oct 08. pii: ckaf063. [Epub ahead of print]

Multimorbidity and the indirect cost of productivity loss from health-related work absenteeism in Belgium.

Phuong Bich Tran, Finaba Berete, Bart De Clercq, Johan Van der Heyden, Josefien van Olmen, Lander Willem.

This cross-sectional observational study aims to estimate the number of days absent from work due to health-related problems among employed individuals with multimorbidity and to quantify the lost productivity value from these absences. Data were obtained from the Belgian Health Interview Survey 2018, comprising employed individuals aged 15-64 (N = 4096). We examined 12 chronic conditions and 57 dyads. The Human Capital Approach was used by multiplying the reported number of days absent by the average wage per person per day, utilizing stratified gross wages from the Belgian Statistical Office. Approximately one-third of the study population reported multimorbidity. For individuals with zero to four+ chronic conditions, mean days of absence were 5.5 (95% CI: 2.3-8.8), 6.8 (95% CI: 2.9-10.7), 14.8 (95% CI: 10-19.6), 24 (95% CI: 17.8-30.2), and 36.2 (95% CI: 30.4-42), respectively. Depression (€3089; 95% CI: 2129-4049), diabetes (€2315; 95% CI: 962-3668), arthropathies (€1972; 95% CI: 1101-2844), and cancer (€1848; 95% CI: 598-3099), as standalone conditions, were associated with the greatest productivity losses. The effects were amplified up to seven times with the co-occurrence of multiple chronic conditions. We estimated 34.2 million days absent or €7.5 billion in lost productivity due to health-related work absenteeism among working-age employed individuals with multimorbidity in 2018. At the population level, the coexistence of two musculoskeletal disorders was linked to the highest aggregated productivity loss. At the individual level, the coexistence of a mental health condition and a somatic condition was associated with the highest average productivity loss per capita. The indirect cost due to health-related absence from work for individuals with multimorbidity in Belgium is high, and in many cases, exceeds the direct cost of treatment.

DOI: https://doi.org/10.1093/eurpub/ckaf063

J Public Health (Oxf). 2025 Oct 10. pii: fdaf132. [Epub ahead of print]

Workplace productivity losses due to multimorbidity: findings from an Australian longitudinal population survey, 2009-21.

Mohammad Afshar Ali, Syed Afroz Keramat, Christine Y Lu.

BACKGROUND: While productivity loss has been studied in various populations, the impact of multimorbidity on workplace productivity at a population level remains understudied. This study estimates the productivity losses attributable to multimorbidity.
METHOD: Using data from four waves of the Household, Income and Labour Dynamics in Australia (HILDA) survey, we investigated the relationship between multimorbidity and productivity loss. Negative binomial and logistic regression models were employed to analyze absenteeism, presenteeism, and working hour tension as measures of productivity loss.
RESULTS: We found a significant association between multimorbidity and increased absenteeism, presenteeism and working hour tension. After controlling for socio-economic, demographic, health, and workplace-related factors, individuals with multimorbidity had a 1.07-fold higher rate of absenteeism (incidence rate ratios: 1.07; 95% CI: 1.02-1.13) compared to those without serious illness. Their odds of experiencing presenteeism were three times higher, and the incidence of working hour tension was 32% higher. On average, the annual cost of absenteeism was AU$265.20 higher for individuals with multimorbidity than for those without serious illness.
CONCLUSION: Our results underscore the need for evidence-based workplace policies to support the productivity and well-being of employees living with multimorbidity.

Keywords: health services; morbidity and mortality; public health

DOI: https://doi.org/10.1093/pubmed/fdaf132

Clinicoecon Outcomes Res. 2025 ;17 661-671

Economic Evaluation of Molecular Testing for Pulmonary Tuberculosis Diagnosis: A Systematic Review.

Natthakan Chitpim, Panida Yoopetch, Jiraphun Jittikoon, Wanvisa Udomsinprasert, Kornkanok Bunwong, Surakameth Mahasirimongkol, Usa Chaikledkaew.

Purpose: Rapid molecular assays such as Xpert MTB/RIF and TB-LAMP accelerate pulmonary tuberculosis (TB) diagnosis but are more expensive than smear microscopy. This study provided an updated economic synthesis for presumptive adult pulmonary TB in high-burden settings, broadening the evidence from Xpert MTB/RIF to other WHO endorsed tests compared to conventional strategies.
Methods: Medline, Embase and Scopus were searched through March 2025. The strategy combined search terms related to molecular diagnostic tests, pulmonary tuberculosis, and economic evaluation study designs. Full economic evaluations comparing molecular tests with smear microscopy, culture or passive case-finding were eligible. Two reviewers independently screened articles, extracted data, and adjusted costs to 2025 US dollars (USD) using average exchange rates. Reporting quality was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist. Due to heterogeneity in evaluation criteria, model structures, time horizons, and outcome measures, meta-analysis were not feasible. Therefore, results were synthesized narratively, and incremental cost-effectiveness ratios (ICERs) were contextualized against country-specific cost-effectiveness thresholds to enable meaningful cross-study interpretation.
Results: Eight studies conducted in low- and middle-income countries with high TB burdens were included. All evaluated Xpert MTB/RIF and the Thai studies also examined TB-LAMP. Five studies reported cost per disability-adjusted life years (DALYs) averted or quality-adjusted life years (QALYs) gained, while three used TB cases detected or years of life saved (YLS). CHEERS reporting quality was high (median is 23/28 items). Reported ICERs for molecular testing were either cost-saving or highly cost-effective compared with country-specific thresholds. Probabilistic sensitivity analyses (five studies) indicated ≥90% probability of cost-effectiveness in four studies and 6% in one.
Conclusion: Recent evidence supports the cost-effectiveness and cost-saving of Xpert MTB/RIF and TB-LAMP for diagnosing adult pulmonary TB. Policymakers should prioritize reducing cartridge costs and implementing models that capture patient-level benefits to maximize economic benefits.

Keywords: Xpert MTB/RIF; cost-effectiveness; molecular testing; systematic review

DOI: https://doi.org/10.2147/CEOR.S541923

Am J Ind Med. 2025 Oct 08.

Counting the Costs of Silicosis in Victoria, Australia, 2019-2024, With Projections to 2031.

Dunya Tomic, Ryan F Hoy, Janneke Berecki-Gisolf, Win Wah, Stella May Gwini, Malcolm R Sim, Karen Walker-Bone.

BACKGROUND: Silicosis has re-emerged in middle- and high-income countries globally due to high silica exposures from manufacturing and fabrication of artificial stone countertops. No studies have reported the costs of workers' compensation claims for silicosis; we therefore examined cost trends in Victoria, Australia, and projected claim costs to 2031.
METHODS: Data from the WorkSafe Victoria Compensation Research Database were used to identify all silicosis compensation claims among males from 2019 to 2024, and claim rates were estimated per year and age group. Using Poisson regression model estimates, claim cost projections were calculated for 2025-2031, separately for statutory (no-fault) and common law (fault-based) payments.
RESULTS: From 2019 to 2024, there were 663 silicosis compensation claims made by 356 males aged 15-74 years in Victoria. Cumulative costs totaled AU $111.78 million. Annual cost projections suggest an increase over time, with a total of AU $29.88 million per year by 2031. Most claims remained active for over a year, particularly those by workers aged 25-54 years. Within 4-year follow-up, common law (fault-based) payments accounted for approximately 30% of total costs but dominated younger workers' claims. Projected 2031 costs were highest for claims by workers aged 35-44 years.
CONCLUSIONS: This study presents the first comprehensive estimate of projected workers' compensation costs for silicosis, highlighting a sustained financial burden driven by ongoing claims among younger workers. As artificial stone continues to be used internationally, these findings underscore the need for regulatory action to prevent a foreseeable health and economic burden.

Keywords: cost of illness; healthcare costs; occupational lung disease; silica exposure; silicosis; workers' compensation

DOI: https://doi.org/10.1002/ajim.70030