NEW YORK (Reuters Health) - Employees who miss work due to illness or whose performance on the job isn't up to snuff because of chronic or episodic health conditions are costing US employers hundreds of billions of dollars a year, a new study finds.

The top five health conditions alone--including headache, depression and the common cold--cost employers more than $180 billion annually, according to study sponsor AdvancePCS. The annual financial toll for all health conditions is at least $250 billion, or roughly $2,000 per worker per year, the company said.

The problem of lost worker productivity goes well beyond absenteeism, with many individuals reporting to work even when they're not feeling well, the study reveals. The phenomenon, called "presenteeism," is often invisible to employers, yet it accounts for more than two-thirds of health-related lost labor costs, it found.

"There are a lot of things that can have an impact on individual worker productivity," agreed Helen Darling, president of the Washington Business Group on Health. But the impact of those health problems on workers' ability to perform may vary widely, she added.

"If I've got a headache...it's not going to impact my talking to you," Darling said. "But someone who is fatigued and driving a train poses a danger to himself and others."

AdvancePCS, one of the nation's largest pharmacy benefits management companies, studies the connection between health and work performance through its Center for Work and Health. That unit launched the American Productivity Audit, an ongoing daily national survey of US workers, last year. The study released Wednesday is based on 10 months of data and more than 25,000 interviews with US workers.

Dr. Walter F. Stewart, a vice president and director of the Center for Work and Health at AdvancePCS, said the analysis provides a better understanding of the impact of health conditions on work performance. "We now can begin to explore opportunities for achieving a higher return on investment from the healthcare dollar."

According to the survey, more than 80% of women and 70% of men reported at least one episodic or chronic-episodic health condition in the 2-week period prior to being interviewed. While 38% of women and 28% of men reported being at work one or more days during that 2-week period and not feeling well, only 7.2% of women and 5.3% of men actually missed a day of work in the previous 2 weeks for a health reason.

In fact, almost three-quarters of the lost productivity from episodic and chronic conditions occurs on the job, the survey found.

The study also found that the average US worker loses 115 hours of productivity every year due to a health condition. And, for any single condition, 20% to 35% of employees account for 70% to 80% of the lost time.

AdvancePCS said it is using the audit data to help individual employers develop programs to address these costs.

Darling, whose organization represents a number of Fortune 500 companies, said employers can start by making sure the health plans they work with encourage employees to seek appropriate treatment. "If somebody has migraines and gets to the right medication, their lives are transformed."

Many large and mid-sized employers already offer a variety of tools--including access to health Web sites--to help keep people well and thus reduce lost productivity, she noted. And the best employers, she added, sponsor health programs at the work site to ensure that people get the help they need.

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