Workplace-Related Socioeconomic Issues Associated with Job Performance and Productivity among Employees with Various Impairments: A Systematic Literature Review

Abstract

The main purpose of this article is to present a systematic literature review of socioeconomic issues such as employee productivity, workplace absenteeism, workplace presenteeism, productivity loss, and indirect costs among employees with different impairments/disabilities. The related articles were obtained from the Scopus and Web of Science (WOS) databases. In general, 568 studies were found. A total of 141 articles were identified as open-access and non-duplicate articles in English in which disability-related issues among employees were raised. Ultimately, only 22 studies were selected for analysis since they were concerning socioeconomic issues associated with productivity and job performance among employees with various impairments. Based on the studies, workplace performance among employees with and without disabilities was almost equal. Workplace absenteeism and short-term disability costs were higher among employees with acromegaly, migraine, gout, depression, cardiovascular events and related clinical procedures, chronic diseases, and metastatic breast cancer. Mood disorders, heart diseases, and bowel disorders were the principal causes of absenteeism among employees with chronic conditions. Productivity loss was higher among employees with depression, psoriatic arthritis, multiple sclerosis, chronic migraine disease, and employees who received injectable multiple myeloma therapy. Worsening physical health, more functional disabilities, poorer relations with a supervisor, recurrent sick leave, back problems, mood disorders, migraine, and fatigue were the primary reasons for lost productivity.

1. Introduction

In social science, employee productivity is known as workforce productivity, individual productivity, the individual level of productivity (individual-level productivity), individual employee productivity, personal productivity, micro-level productivity, micro-level individual productivity, and workplace productivity (productivity in the workplace). A high level of employee productivity has a positive impact on the productivity of an enterprise, in other words, on enterprise performance, team productivity, group productivity, overall productivity, macro-level productivity, and organisational productivity.

Furthermore, employee productivity, in other words, workplace-specific outcomes are usually measured in three ways: by an employee’s workplace absenteeism, workplace presenteeism and job performance (Shi et al. 2013). Other researchers discussed this issue broadly. According to Sears et al. (2013), productivity outcomes can be measured by absenteeism, presenteeism, job performance, and short-term disability (STD). For instance, workplace absenteeism is the working hours or days that are missed due to health issues, whereas presenteeism means being at the workplace but not functioning at full capability (Ciconelli et al. 2006; Domingues et al. 2020; Gennep et al. 2021; Gussenhoven et al. 2012; Haw et al. 2020; Howard et al. 2009; Lerner et al. 2004; Lötters et al. 2005; Meijster et al. 2011; Nakata et al. 2018; Rodriguez Llorian et al. 2022; Rotaru et al. 2021; Selekler et al. 2013; Shimizu et al. 2021; Smith et al. 2021; Sruamsiri et al. 2018; Stewart et al. 2003b; Walsh et al. 2014; Wan et al. 2013; Wong et al. 2020; Zhang et al. 2016) (Appendix A shows the definitions of absenteeism and presenteeism based on the above-cited studies). Meanwhile, today’s workplace presenteeism can be the result of tomorrow’s absenteeism. So, both absenteeism and presenteeism are the primary causes of productivity loss in the workplace (Behrens et al. 2020; Ciconelli et al. 2006; Domingues et al. 2020; Gennep et al. 2021; Nakata et al. 2018; Smith et al. 2021; Zhang et al. 2016). However, Merola et al. (2018) discussed this issue differently. They argued that productivity loss includes absenteeism, short-term disability (STD), and long-term disability (LTD) days. It is important to note here that Bonafede et al. (2021) suggested that the above-mentioned components, absenteeism and short- and-long-term disability days, are the types of absence, not the reasons for productivity loss.

Besides workplace absenteeism and presenteeism, job performance is another way of measuring employee productivity (Sears et al. 2013; Shi et al. 2013). Therefore, the level of employee productivity depends on the employee’s job performance. If an employee’s job performance is evaluated at a high level, it means that the level of his/her productivity is also high. Smith et al. (2004) found that workplace climate, speed (rate) of work, and quality (accuracy) of work are basic components to measure workplace performance. However, Hernandez and McDonald (2010) did not include workplace climate and rate (speed) of work as the ways to measure job performance; only accuracy and quality of work were included. Ramakrishnan and Arokiasamy (2019) discussed this issue widely. He stressed that the quantity of the outcome, the quality of the output, the amount of time spent on completing the performance, the efficiency of the completed job, the effectiveness of the completed job, and the participation in the job are the basic components of performance. Pressure, workload, a non-family-friendly environment in a workplace, horizontal and vertical conflicts in a labour collective, dissatisfaction with the job, and stressful conditions tend to decrease job performance among employees. In other words, as Young et al. (2016) pointed out, presenteeism is what an employee cannot do at the workplace while job performance or productivity is what an employee can do.

Productivity and job performance among employees with impairments/disabilities are research questions that have not been answered yet in psychology, human development, sociology, social work, and so on. Other disability-related issues such as policies, rights, quality of life, job satisfaction, the unemployment rate of people with disabilities (PWDs) and caregivers, and employers’ attitudes toward their willingness to hire PWDs were discussed in many studies (Alkaabi 2022; Anderson et al. 2021; Bastas and Altinay 2019; Butterworth et al. 2020; Chajduga and Ingaldi 2021; Choi et al. 2018; King and Waghorn 2018; Ochrach et al. 2022; Pihlajamäki et al. 2020; Rotaru et al. 2021; Werner and Hochman 2019).

According to the studies, there are different attitudes and points of view toward disabled employees. Some employers and able-bodied employees find that their employees and colleagues with impairments are less productive and have a low level of job performance. Moreover, the turnover rate is higher among them in comparison to able-bodied employees (Chi and Qu 2004; Kim 2015). On the other hand, based on other studies, employees with disabilities are motivated, loyal, and responsible; their productivity level is almost equal to their non-disabled colleagues (Chajduga and Ingaldi 2021; Chao et al. 2018; Jammaers et al. 2016). A study by Katz et al. (2015) concluded that employees with high-functioning autism spectrum disorders (HFASD) are honest people and are highly responsible since none of them were required to quit their jobs due to behavioural and professional matters during the 9-month study in Israel. In addition, the study mentioned that people with HFASD are very good at maths and computer skills, and possess abilities such as vision and memory, which are essential for coping with their work.

Hence, it can be seen that employees with disabilities are disabled individuals for some employers; for others, they are human resources and the labour force. As Birau et al. (2019) suggested that disabled people can be “objects” of charity, medical treatment, and social protection, they also can be “subjects”, who are capable of claiming rights, making decisions, and having active personal and professional lives.

Unfortunately, research reviews that summarise the socioeconomic issues, including employee productivity, workplace absenteeism, workplace presenteeism, lost productivity (time), and indirect costs, among disabled employees with various impairments are rarely discussed to prepare them for high job performance or productivity.

Therefore, the objective of this paper is to present a systematic review of socioeconomic issues, namely, employee productivity, workplace absenteeism, workplace presenteeism, lost productivity (time), and indirect costs, among employees with various impairments. Additionally, regarding job performance and productivity, systematic data collection from different original papers about workplace experiences of employees with headache problems, metastatic breast cancer, diabetes, mood disorders, heart diseases, bowel disorders, depression, psoriatic arthritis, multiple myeloma, acromegaly diagnosis, gout, musculoskeletal disorders, asthma, sclerosis, migraine, intellectual and developmental disabilities, sensory, and physical impairments has never been performed before in one review article. Hence, this review paper can clearly show socioeconomic issues among employees with various disabilities/impairments.

2. Methodology

2.1. Search Strategy

The e-library website (https://www.ukm.my/ptsl/ (accessed on 2 May 2022)) of Universiti Kebangsaan Malaysia (UKM) was used to search for workplace disability-related articles. Scopus (https://www.scopus.com.eresourcesptsl.ukm.remotexs.co/search/form.uri?display=basic#basic (accessed on 7 May 2022)) and Web of Science (WOS) (https://www.webofscience.com.eresourcesptsl.ukm.remotexs.co/wos/woscc/basic-search (accessed on 22 September 2022)) were selected as the major databases for the mining of articles. Since Scopus and Web of Science databases are the most popular among students, researchers, and professionals as well as both cover a broad range of academic journals and research literature in the social science fields, these databases were selected to review publications systematically. In fact, both databases are used as a measurement of quality research journals for high-ranking universities, including the QS University Ranking and Times Higher Education; hence, they are the right databases to provide a quality systematic literature review to achieve this article’s research objective.

Based on the search, which was conducted between May to September 2022, 434 and 134 articles were found in Scopus and WOS, respectively. Advanced keywords such as “employee productivity”, “productivity and disabled employees”, and “productivity and impairment” were used to search for the related articles.

2.2. Eligibility Criteria

The selection of the articles for this study was based on the following eligibility criteria:

Procedure-1:

Inclusion criteria (IC): (1) journal articles related to people with disabilities (based on their title, abstract, and keywords); (2) full papers; (3) English-language publications. Articles included are published between the years of 2003 and 2022.

Exclusion criteria (EC): (1) restricted-access articles; (2) duplicate publications.

Procedure-2:

Exclusion criteria (EC): (1) not original (research) articles.

Procedure-3:

Inclusion criteria (IC): (1) studies in which workplace-related problems among employees with disabilities (EWDs) are raised.

Exclusion criteria (EC): (1) studies that were published before 2003; (2) studies in which subjects are students with impairments and caregivers.

Procedure-4:

Inclusion criteria (IC): (1) studies in which socioeconomic issues (employee productivity, workplace absenteeism, workplace presenteeism, lost productivity, and indirect costs) in the workplace are discussed.

3. Results

3.1. Study Selection

Based on the inclusion and exclusion criteria for Procedure-1, 141 articles out of 568 were identified. All the 141 studies were journal articles, open-access, full papers, and English-language and non-duplicate publications related to PWDs. Out of these 141 articles, 74.4% (n = 105) of the articles were original (research) studies, whereas 25.5% (n = 36) of them were literature reviews (LR), systematic literature reviews (SLR), narrative reviews, reviews based on national surveys and claim databases, theoretical research articles, study protocols, scoping reviews, reviews with recommendations for future research (future articles), reports, opinion papers, and auto-ethnographic essays. In addition, in Procedure-2, a total of 105 original (research) papers were selected, while In Procedure-3, with some of the stated exclusions and only studies in which workplace-related problems among EWDs were raised, only a total of 61 articles were identified out of 105. From these numbers, 44 studies were excluded due to some reason, namely: (1) workplace-related obstacles and barriers among employees with impairments were not raised (n = 35); (2) the articles were published before 2003 (n = 3), and (3) the subjects were students with impairments and caregivers (n = 6). Additionally, in Procedure-4, 22 studies out of 61 met the inclusion criteria, whereas the rest of the 39 studies were excluded insofar as social, socio-psychological, juridical, and other issues in the workplace were concerned (Figure 1—PRISMA Flow Chart).

3.2. General Description of the Identified Studies

A total of 45.4% of the selected research articles (n = 10) were related to productivity loss and/or reduced productivity at the workplace (Bonafede et al. 2021; Lerner et al. 2004; Lötters et al. 2005; Merola et al. 2018; Rodriguez Llorian et al. 2022; Selekler et al. 2013; Shimizu et al. 2021; Song et al. 2015; Stewart et al. 2003b; Walsh et al. 2014). The rest of the studies, i.e., 54.6% (n = 12), were on workplace-related issues such as employee productivity (Haw et al. 2020; Jammaers et al. 2016; Lysaght et al. 2017; Wong et al. 2020), costs (Hernandez and McDonald 2010; Meijster et al. 2011; Wan et al. 2013; Yuen et al. 2021), as well as workplace absenteeism and presenteeism (Howard et al. 2009; Keramat et al. 2020; Kleinman et al. 2007; Zhang et al. 2016).

In terms of the location of the studies, half of the studies (50%; n = 11) were conducted in the U.S. (Bonafede et al. 2021; Hernandez and McDonald 2010; Howard et al. 2009; Kleinman et al. 2007; Lerner et al. 2004; Merola et al. 2018; Song et al. 2015; Stewart et al. 2003b; Wan et al. 2013; Yuen et al. 2021). A total of 13.6% (n = 3) and 9% (n = 2) of the studies were carried out in Canada (Lysaght et al. 2017; Rodriguez Llorian et al. 2022; Zhang et al. 2016) and the Netherlands (Lötters et al. 2005; Meijster et al. 2011), respectively. The remaining 27% of the studies (n = 6) were conducted in Turkey (Selekler et al. 2013), Belgium (Jammaers et al. 2016), Malaysia (Wong et al. 2020), Australia (Keramat et al. 2020), Philippines (Haw et al. 2020), and Japan (Shimizu et al. 2021).

Based on the research design of the 22 original papers, 59% (n = 13) of them were cross-sectional (Haw et al. 2020; Hernandez and McDonald 2010; Jammaers et al. 2016; Kleinman et al. 2007; Lysaght et al. 2017; Meijster et al. 2011; Rodriguez Llorian et al. 2022; Selekler et al. 2013; Shimizu et al. 2021; Stewart et al. 2003b; Walsh et al. 2014; Wong et al. 2020; Zhang et al. 2016), while the remaining 41% (n = 9) were longitudinal studies (Bonafede et al. 2021; Howard et al. 2009; Keramat et al. 2020; Lerner et al. 2004; Lötters et al. 2005; Merola et al. 2018; Song et al. 2015; Wan et al. 2013; Yuen et al. 2021).

A quantitative approach was used in 91% (n = 20) of the studies (Bonafede et al. 2021; Haw et al. 2020; Hernandez and McDonald 2010; Howard et al. 2009; Keramat et al. 2020; Kleinman et al. 2007; Lerner et al. 2004; Lötters et al. 2005; Meijster et al. 2011; Merola et al. 2018; Rodriguez Llorian et al. 2022; Selekler et al. 2013; Shimizu et al. 2021; Song et al. 2015; Stewart et al. 2003b; Walsh et al. 2014; Wan et al. 2013; Yuen et al. 2021; Zhang et al. 2016). A total of 9% of them (n = 2) were qualitative-based research studies that were conducted in Belgium (Jammaers et al. 2016) and Canada (Lysaght et al. 2017). There were no mixed-method-based studies.

A total of 22.7% (n = 5), 22.7% (n = 5), 13.6% (n = 3), 4.5% (n = 1), and 4.5% (n = 1) of the data in the identified 22 studies were statistically analysed in Stata (Haw et al. 2020; Keramat et al. 2020; Lerner et al. 2004; Merola et al. 2018; Shimizu et al. 2021), SAS (Kleinman et al. 2007; Stewart et al. 2003b; Wan et al. 2013; Yuen et al. 2021; Zhang et al. 2016), SPSS (Hernandez and McDonald 2010; Selekler et al. 2013; Wong et al. 2020), R (Bonafede et al. 2021), and Excel (Meijster et al. 2011), respectively. The qualitative-based Canadian study was analysed in NVIVO (Lysaght et al. 2017). In 27.2% (n = 6) of the studies (Howard et al. 2009; Jammaers et al. 2016; Lötters et al. 2005; Rodriguez Llorian et al. 2022; Song et al. 2015; Walsh et al. 2014), the software that was used to analyse the data was not mentioned (5 out of these 6 studies were quantitative; only one of them was a qualitative study in Belgium).

3.3. Participants

Employees with/without headache problems and migraine (Haw et al. 2020; Selekler et al. 2013; Shimizu et al. 2021; Wong et al. 2020; Zhang et al. 2016), depression (Jammaers et al. 2016; Lerner et al. 2004; Stewart et al. 2003b; Zhang et al. 2016), gout (Kleinman et al. 2007), musculoskeletal disorder (Howard et al. 2009; Lötters et al. 2005), occupational asthma and rhinitis (Meijster et al. 2011; Zhang et al. 2016), breast cancer (Wan et al. 2013; Zhang et al. 2016), heart diseases (Song et al. 2015; Zhang et al. 2016), multiple sclerosis (MS) (Bonafede et al. 2021; Rodriguez Llorian et al. 2022), multiple myeloma (MM) (Merola et al. 2018), acromegaly diagnosis (Zhang et al. 2016), and intellectual and developmental disabilities (IDD) (Lysaght et al. 2017) were subjects in the identified 22 studies.

In addition to the above-mentioned participants, employees with hearing, vision, and mobility impairments (wheelchair users) were also involved in the research studies (Hernandez and McDonald 2010; Jammaers et al. 2016). Employers and Human Resource (HR) representatives (Hernandez and McDonald 2010) as well as family members (Wan et al. 2013) were respondents in the quantitative research studies in the U.S. Disability/diversity experts (Jammaers et al. 2016) and caregivers (parents, siblings, support workers, and a spouse) of employees with IDD (Lysaght et al. 2017) participated in the qualitative-based research studies.

3.4. Instruments and Measurements

Several research instruments were used in the 22 identified studies to measure issues related to headache problems, migraine, depression, arthritis, musculoskeletal disorder, and multiple sclerosis at the workplace.

3.4.1. Instruments Used to Measure Headache and Migraine-Related Issues

To assess the level of migraine among employees with/without headache problems and migraine, the ID-Migraine Questionnaire was used (Haw et al. 2020; Wong et al. 2020). The severity and impact of migraine on work productivity and activities were measured by the Migraine Disability Assessment Score Questionnaire (MIDAS) (Haw et al. 2020; Shimizu et al. 2021), and the Work Productivity and Activity Impairment (WPAI) Questionnaire (Shimizu et al. 2021; Wong et al. 2020). The quality of life (QoL) and health-related quality of life (HRQoL) were rated by the 36-item Short Form Survey (SF-36) (Haw et al. 2020) and the 12x2 Short Form Survey (SF-12x2) (Shimizu et al. 2021), respectively.

3.4.2. Instruments Used to Measure Depression-Related Issues

Mood, physical symptoms, and the diagnosis of a specific depressive disorder among employees with/without depression were estimated by the Primary Care Evaluation of Mental Disorders—Mood Model (PRIME-MD), the 26-item Somatic Symptom Inventory (SSI), and the DSM-III-R, respectively. In addition, (a) pain, weakness, and fatigue, (b) gastrointestinal complaints, (c) panic or anxiety, (d) faintness or dizziness, (e) autonomic instability with anxiety, (f) ringing in the ears, or head or nose fullness, and (g) sensory or nerve impairment was assessed by a 7-factor solution (Stewart et al. 2003b). To rate the general health status, level of alcoholism, depressive symptom severity, as well as dysthymia and major depressive disorder, the 12-item Short Form Survey (SF-12), CAGE questionnaire, Patient Health Questionnaire (PHQ-9) (Depression Scale), and Patient-Administered Depression Screening instrument (PC-SAD) were employed, respectively. Meanwhile, workplace absenteeism and presenteeism among employees with/without depression were measured using the Work Limitations Questionnaire (WLQ) (Lerner et al. 2004).

3.4.3. Instruments Used to Measure Arthritis-Related Issues

To assess workplace productivity loss (WPL) and presenteeism among employees with/without arthritis, the 8-item Work Limitations Questionnaire (WLQ) was used. Fatigue was measured using question 1 from the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI#1) and question 1 from the Psoriatic Arthritis Quality of Life Questionnaire (PsAQOL#1). Depressed mood in employees, as well as psoriasis pain and itch were assessed using question 4 from the Psoriatic Arthritis Quality of Life Questionnaire (PsAQOL#4) and question 4 from the Dermatology Life Quality Index (DLQI#4) (Walsh et al. 2014).

3.4.4. Instruments Used to Measure Musculoskeletal-Disorder-Related Issues

General health, functioning, role—physical, bodily pain, vitality, role—emotional, social functioning, and mental health among employees with musculoskeletal disorders were rated by the 12-item Short Form Survey (SF-12). Mobility, self-care, daily activity, pain, and anxiety or depression were estimated by the Euro Quality of Life-5-dimension Questionnaire (EuroQol-5d). Psychological factors at work (work demands, skill discretion and discussion authority) and functional disability were measured using the Job Content Questionnaire, while the Ronald Morris Disability Questionnaire was used to measure back complaints (Lötters et al. 2005).

3.4.5. Instruments Used to Measure Multiple-Sclerosis-Related Issues

Productivity loss components, the severity of disease, fatigue, depression, anxiety, and the health-related quality of life (QoL) utility were evaluated by using the Valuation of Lost Productivity (VOLP) Questionnaire, Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), 9-item Patient Health Questionnaire (PHQ-9) (Depression Scale), 7-item Generalised Anxiety Disorder (GAD-7), and EQ-5D-5L (Rodriguez Llorian et al. 2022), respectively.

4. Discussion and Key Findings

This paper systematically reviewed the literature on employee productivity, workplace absenteeism and presenteeism, productivity loss (time), and indirect costs among employees with different impairments/disabilities such as headache problems, migraine, multiple sclerosis, acromegaly, gout, breast cancer, multiple myeloma, and psoriatic arthritis, as well as developmental, mobility, and sensory impairments.

4.1. Employee Productivity

The research, which was conducted in the healthcare, trial, and hospitality sectors in the U.S., showed that workplace performance was almost equal among employees with and without disabilities (Hernandez and McDonald 2010). In terms of quality of life (QoL), the rating was at least 10 points lower among Filipino employees with high migraine disability (MIDAS: III-IV) in comparison to employees with low migraine disability (MIDAS: I-II) (Meijster et al. 2011). The study in the U.S. proved that short- and long-term disability leave was not beneficial for employers and for ill or injured employees. It was better to stay at work (SAW) post-injury, since it influenced an increase in employee productivity (Howard et al. 2009).

4.2. Workplace Absenteeism and Presenteeism

The level of absenteeism was considerably higher among employees with acromegaly (Yuen et al. 2021), migraine (Shimizu et al. 2021), gout (Kleinman et al. 2007), depression (Lerner et al. 2004), cardiovascular events and related clinical procedures (CVERP) (Song et al. 2015), and chronic diseases (Zhang et al. 2016) compared to their counterparts without the above-mentioned diseases. Apart from absenteeism, presenteeism was also higher among U.S. employees with depression than among their colleagues without depression (Lerner et al. 2004). Presenteeism-related days were remarkably higher among Japanese employees with chronic migraines rather than with episodic migraines (Shimizu et al. 2021). It is significant to note that the level of presenteeism was greater among U.S. employees with none, mild, or moderate depression, whereas the rate of absenteeism was higher among employees with severe and extreme depressive symptoms (Howard et al. 2009). According to an Australian study, disabled employees had 2.83 times more absenteeism in the workplace in comparison to their non-disabled colleagues. In terms of gender, the number of days of absenteeism among female employees with impairments was 2.63 times higher than for female employees without disabilities. Therefore, the workplace absenteeism rate was greater among disabled male employees compared with females (Keramat et al. 2020). A Malaysian study found that absenteeism was almost 20 times lower than presenteeism among employees with migraine in the banking sector (Wong et al. 2020).

The median of absent workdays among Canadian employees with chronic conditions was 1.35 days in 3 months. The cardinal causes of missed working days were mood disorders, heart disease, and bowel disorders (Zhang et al. 2016).

4.3. Productivity Loss (PL)/Productivity Time Loss (PTL)

Productivity loss and/or productivity time loss (PTL) was higher among employees with depression (Stewart et al. 2003b), psoriatic arthritis (PsA) (Walsh et al. 2014), multiple sclerosis (MS) (Rodriguez Llorian et al. 2022), chronic migraine disease (Shimizu et al. 2021), and employees who received injectable multiple myeloma (MM) therapy (Merola et al. 2018) in comparison to their colleagues without the above-mentioned diseases, employees with episodic migraine, and who received oral multiple myeloma (MM) therapy. It is notable to mention that productivity time loss (PTL) and lost productivity were 4 times and 6.7% greater among Japanese employees with chronic migraine disease and U.S. employees with psoriatic arthritis (PsA) compared to employees with fewer migraine attacks and without psoriatic arthritis (PsA) (Shimizu et al. 2021; Walsh et al. 2014), respectively. A total of 55% of Canadian employees with multiple sclerosis (MS) experienced productivity loss due to their health condition (Rodriguez Llorian et al. 2022). In the longitudinal study, reduced productivity and lost productivity were 60% and 75% after return to work (RTW) (at the baseline period) among employees in the Netherlands with musculoskeletal disorders, respectively. During the 12-month follow-up period, their percentage decreased slightly to 40% and 60%, respectively. At both the baseline and 12-month follow-up periods, the median loss of productivity was 16 hours on an 8-hour workday (Lötters et al. 2005).

Productivity loss in presenteeism was greater in comparison to workplace absenteeism among Japanese employees with migraines (Smith et al. 2021). The main reasons for productivity loss were worsening physical health, more functional disability, and poorer relations with a supervisor during the baseline period, whereas during the 12-month follow-up period, recurrent sick leave (SL) was the principal cause of lost productivity among the employees with musculoskeletal disorders in the Netherlands (Lötters et al. 2005). However, Canadian research conducted among employees with chronic diseases revealed that back problems, mood disorders, and migraine were the major reasons for productivity loss (Zhang et al. 2016). Therefore, fatigue was the primary cause of lost productivity among Canadian employees with multiple sclerosis (MS) (Rodriguez Llorian et al. 2022) and U.S. employees with psychiatric arthritis (PsA) (Walsh et al. 2014).

4.4. Costs

Based on many of the studies, presenteeism-related workplace productivity losses were more costly compared to absenteeism-related productivity losses (Howard et al. 2009). Research conducted among Malaysian employees with migraine in the banking sector proved that absenteeism-related costs were 3.5 times lower compared with presenteeism-related ones (Wong et al. 2020). The total number of sick days among U.S. employees with and without acromegaly were equal (Yuen et al. 2021), whereas the number of days for sick leave (SL) was 2.78 times more among U.S. employees with gout compared to gout-free employees (Kleinman et al. 2007). There was no difference in the number of days for sick leave (SL) among U.S. employees with metastatic breast cancer (MBC) and early-stage breast cancer (EBC), whereas sick leave (SL) costs were higher among employees with metastatic breast cancer (MBC) than employees without breast cancer (control) (Wan et al. 2013). The utilisation of short- and long-term sick leave (SL) was greater among U.S. employees with multiple sclerosis (MS) compared with MS-free employees (Bonafede et al. 2021). Short-term disability (STD) hours/days/costs were higher among U.S. employees with acromegaly, gout, cardiovascular events, and related clinical procedures (CVERP), and metastatic breast cancer (MBC) than employees without acromegaly (Yuen et al. 2021), gout (Kleinman et al. 2007), CVERP (Song et al. 2015), and breast cancer, and those with early-stage breast cancer (EBC) (Wan et al. 2013). This was 3.03 days more among employees with gout (Kleinman et al. 2007), and 47% higher among employees with metastatic breast cancer (MBC) (Wan et al. 2013).

Table 1. Main characteristics of the selected studies.

Author/Year of Publication/Country	Purpose of the Study	Design/Approach/Software	Sample Size/Participants/Sampling Method	Instruments/Measurements	Mean Age/Percentage in Terms of Gender	Key Findings
(Stewart et al. 2003b) The U.S.	To estimate the impact of depression on labour costs (work absenteeism and reduced performance while at work) among US workers.	Cross-sectional. Quantitative. Wesvar, version 4 and SAS, version 8.2.	219 employees with depression and 908 employees without depression. Random sampling.	PRIME-MD (mood). The 26-item SSI (26 physical symptoms). The DSM-III-R (the diagnosis of a specific depressive disorder). A 7-factor solution (1-pain, weakness and fatigue (7 items), 2-gastrointestinal complaints (3 items), 3-panic or anxiety (3 items), 4-faintness or dizziness (4 items), 5-autonomic instability with anxiety (2 items), 6-ringing in the ears, or head or nose fullness (2 items) and 7-sensory or nerve impairment (2 items).	66%—between 35 and 65 years. 65.6%—female.	A majority of the LPT costs that employers face from employee depression are invisible and explained by reduced performance while at work.
(Lerner et al. 2004) The U.S.	To comprehensively assess work outcomes among employees with depression.	Longitudinal. Quantitative. Stata, version 7.0.	229 employees with depression, 87 employees with rheumatoid arthritis, and 173 healthy employees in the control group. N. A.	CAGE questionnaire (alcoholism). PC-SAD (dysthymia and major depressive disorder). PHQ-9 scale (depressive symptom severity). WLQ (presenteeism). Two items from the WLQ (absenteeism). The Medical Outcomes Study SF-12 (health status).	41.1 years—dysthymia, 38.7 years—major depression, 39.8 years—both dysthymia and major depression, 47.7 years—rheumatoid arthritis, 41.4 years—control group. 81%—female.	In addition to helping employees with depression obtain high-quality depression treatment, new interventions may be needed to help them to overcome the substantial job upheaval.
(Lötters et al. 2005) The Netherlands	To quantify the reduced productivity of workers on full duty after sickness absence from a musculoskeletal disorder and determine the effect of health parameters such as perceived pain, functional disability, and general health on reduced productivity.	Longitudinal. Quantitative. N.A.	253 occupational physicians with musculoskeletal disorders. N.A.	The Job Content Questionnaire (psychological factors at work: work demands (11 items), skill discretion (6 items), and discussion authority (11 items); The Ronald Morris Disability Questionnaire for back complaints (functional disability). The physical dimension of the Sickness Impact Profile (low back pain). SF-12 (general health, functioning, role—physical, bodily pain, vitality, role—emotional, social functioning, and mental health). EuroQol-5d (mobility, self-care, daily activity, pain, and anxiety or depression). EuroQol visual analogue scale (thermometer).	43 years. 73%—male.	Reduced productivity was prevalent for 60% of the workers after they returned to work and for 40% still at the 12-month follow-up. Worsening physical health, more functional disability, and poorer relations with the supervisor were associated with productivity loss shortly after RTW, whereas recurrent sick leave was the greatest predictor of productivity loss at the follow-up.
(Kleinman et al. 2007) The U.S.	To evaluate the impact of gout, a painful inflammatory arthritis condition, on an employed population’s health-related work absence and to objectively measure productivity output.	Cross-sectional. Quantitative. SAS, version 9.1.	86 employees with gout and 27,632 employees without gout. N.A.	N.A.	45.91 years—employees with gout, 40.41 years—employees without gout. 85.0%—male employees with gout, 54.3%—male employees without gout.	Gout has a substantial impact on work absence and may negatively affect productivity.
(Howard et al. 2009) The U.S.	To take a new approach to understand how presenteeism relates to chronic pain or disability patient outcomes.	Longitudinal. Quantitative. N.A.	2191 CDOMD patients (presentees—n = 704 and absentees—n = 1487). N.A.	The Pain Intensity Analog. The Million Visual Analog Scale. A measurement for assessing perceived disability. The Beck Depression Inventory. The Minnesota Multiphasic Personality Inventory. The Structured Clinical Interview for DSM-IV Axis I and Axis II diagnoses.	46.4 years—presentees, 45.4 years—absentees. 46.7%—male presentees, 55.9%—male absentees.	Presentees are significantly more likely to complete the prescribed functional restoration treatment program, return to work, retain work 1-year post-treatment, and not to have a decrease in job demand from preinjury to post-treatment. Both employers and employees will benefit if the ill or injured employee SAW post-injury instead of taking short- or long-term disability leave.
(Hernandez and McDonald 2010) U.S.	To examine the costs and benefits of workers with and without disabilities within three sectors: healthcare, retail, and hospitality.	Cross-sectional. Quantitative. SPSS.	314 employees with hearing loss, cognitive impairments, physical disabilities, and chronic illnesses (95 with and 219 without disabilities). N.A.	The Business Survey (the company’s duration of operation, size and makeup of the workforce): from employers. The Employee Survey (disability status, job title, and department): from employees. The Cost–Benefit Survey (cost–benefit information on workers with disabilities).	N.A. N.A.	Job performance and supervision were similar for both groups of employees. However, findings were mixed when tenure, absenteeism, and worker’s compensation claims were considered. Lastly, the costs of accommodation were minimal. EWDs across the three sectors were nearly equivalent to those without disabilities in overall job performance.
(Meijster et al. 2011) The Netherlands	To evaluate cost–benefit ratios for different stakeholders (employers, employees, and society (taxpayers)).	Cross-sectional. Quantitative (the human capital method). Excel.	Bakery workers with occupational asthma and rhinitis. N.A.	N.A.	N.A.	The use of the model-based approach enables investigation of those parameters most likely to impact the effectiveness and costs of interventions for work-related diseases.
(Wan et al. 2013) The U.S.	To compare the indirect costs of productivity loss between MBC and EBC patients, as well as their respective family members.	Longitudinal. Quantitative. SAS, version 9.2	139 MBC, 432 EBC, and 820 controls (for sick leave). 432 MBC, 1552 EBS, and 4682 controls (for STD). N.A.	CCI.	49 years—MBC patients, 51 years—EBC patients, 50 years—controls, 51 years—family population. 100%—female MBC patients, EBC patients, controls, 99.9%—male from the family population (spouse).	MBC patients had significantly higher STD costs than EBC patients and the control groups. They had more sick leave costs than the control groups. Productivity loss and associated costs in MBC patients were substantially higher than in EBC patients or the general population.
(Selekler et al. 2013) Turkey	To measure productivity losses from absenteeism and presenteeism caused at a heavy manufacturing company.	Cross-sectional. Quantitative. SPSS, version 15.0.	7.200 employees with headache problems in a heavy manufacturing company. N.A.	The HALT Index was translated into the Turkish language (the existence of headaches as a health problem).	32.7 years (range 20-55). 94.4%—male.	Possible factors were the nature of the work—manual labour for two-thirds, often heavy—and the recurring schedule disturbances of shift work.
(Walsh et al. 2014) The U.S.	To explore and characterise the relationship between fatigue and presenteeism among employed participants of the Utah Psoriasis Initiative Arthritis (UPI Arthritis) registry.	Cross-sectional. Quantitative. N.A.	107 employees with a diagnosis of PsA. N.A.	The 8-item WLQ (a shortened version of the original 25-item WLQ) (WPL and Presenteeism). Question 1 from BASDAI#1: “How would you describe the overall level of fatigue/tiredness you have experienced?” (Fatigue). Question 1 from the PsAQOL#1: “I feel tired whatever I do” (fatigue). PGA (cutaneous psoriasis severity). Question 4 from the DLQI#4: “Over the past week, how itchy, painful, sore or stinging has your skin been?” (Psoriasis pain and itch). Question 4 from PsAQOL#4: “I feel there is no enjoyment in my life” (depressed mood).	47.0 years—no fatigue, 48.4 years—fatigue, 47.5 years—low fatigue, 48.0 years—high fatigue. 60.4%—males with no fatigue, 51.9% —males with fatigue, 62.8%— males with low fatigue, and 51.6%— males with high fatigue.	WPL was associated with fatigue. The association was not entirely explained by the evaluated musculoskeletal, cutaneous, or psychiatric manifestations of PsA.
(Song et al. 2015) The U.S.	To quantify WA and STD hours and costs associated with CVERP in U.S. employees with high cardiovascular risk.	Longitudinal. Quantitative. N.A.	5,808 WA-eligible, 21,006 STD-eligible, and 3,362 combined WA- and STD-eligible patients with CVERP and patients without CVERP. N.A.	N.A.	52.2-53.1 years. 81.3-86.8%—male.	During the first month of follow-up, patients with CVERP had more WA/STD-related hours lost compared with patients without CVERP. CVERP was associated with substantial work loss and indirect costs. Prevention or reduction of CVERP could result in WA- and STD-related cost savings for employers.
(Zhang et al. 2016) Canada	To measure and compare the relationship between chronic diseases and the number of absent workdays due to health problems and the associated costs.	Cross-sectional. Quantitative (the human capital approach). SAS, version 9.4.	28,678 employees with 16 chronic conditions (asthma, fibromyalgia, arthritis, back problems, migraine, COPD, diabetes, heart disease, cancer, intestinal or stomach ulcers, urinary incontinence bowel disorders, chronic fatigue syndrome, multiple chemical sensitivities, mood disorders, and anxiety disorders). N.A.	How many days of work have you missed because of a chronic condition? How many days … because of an injury? How many days … because of an infectious disease? How many days … because of another reason related to your own physical or mental health?	40.94 years. 45.4%—female.	The average number of absent workdays due to health problems was 1.35 days over 3 months. The 3 conditions with the greatest association with absent workdays were mood disorders, heart disease, and bowel disorders.
(Jammaers et al. 2016) Belgium	To get a fine-grained understanding of how disabled employees engage with the institutionalised discourse of disability as lower productivity.	Cross-sectional. Qualitative (in-depth semi-structured interviews). N.A.	30 disabled employees with chronic illnesses (chronic depression, fibromyalgia, dyslexia), hearing impairments, visual impairments, mobility impairments, wheelchair users, and 3 disability/diversity experts. Purposive sampling.	Could you describe how your disability affects your job? Would you say you have similar productivity compared with other colleagues performing a similar job? Do you think others in this organisation (colleagues/supervisor) believe that you are less productive?	N.A. 50%—male	Disabled employees performed their job welland even better than some other colleagues.
(Lysaght et al. 2017) Canada	To understand inclusion through work and productivity for persons with IDD.	Cross-sectional. Qualitative (semi-structured interviews). NVIVO (Grounded Theory approach).	Employees with IDD (Down’s syndrome, ASD, Asperger syndrome, a concurrent physical disability, Fragile X, mental health disability, foetal alcohol syndrome) and their caregivers (parents, siblings, support workers and a spouse). Purposive sampling.	The Scales of Independent Behaviour-Short Form (the level of independent functioning). Questions (participant’s experience of working, his/her attitudes toward work, choice of work, job satisfaction, and preferences, experiences at work).	34 years. 59.5%—male.	Productivity, whether paid or unpaid, can be an avenue to social inclusion. The experience of inclusion, particularly of belonging, depends on a successfully negotiated congruence between worker attributes and the social features and demands of the work environment.
(Merola et al. 2018) The U.S.	To compare the extent of disability benefits, use and resultant workplace productivity loss among U.S. adult patients with newly diagnosed MM who received oral versus injectable MM therapy.	Longitudinal. Quantitative. Stata MP, version 14.1.	299 patients with newly diagnosed MM (73 received oral therapy and 226 received injectable therapy). N.A.	CCI (comorbidity burden before each subject’s index date). WAB, STD, and LTD claim files (productivity loss).	52 years—patients who used oral chemotherapy, 51 years—patients who used injectable chemotherapy. 66%—male patients who used oral chemotherapy, 71%—male patients who used injectable chemotherapy.	Patients newly diagnosed with MM faced significant losses in productivity. Patients receiving injectable MM therapy used significantly more disability benefits and incurred higher production costs, compared with those receiving oral MM therapy.
(Wong et al. 2020) Malaysia	To determine the impact of migraine on productivity and monetary loss among employees in the banking sector.	Cross-sectional. Quantitative. SPSS, version 20.0.	598 employees with migraine in 2 multinational banking sectors. N.A.	IPAQ (demographic characteristics, anthropometric measurements and physical activity). ID Migraine Questionnaire (migraine). MIDAS (impact of migraine on work productivity and activities). WPAI Questionnaire.	39.7%—between 31 and 40 years of age. 71.9%—female.	The costs related to presenteeism were 3.5 times higher than with absenteeism.
(Keramat et al. 2020) Australia	To examine gender differences in the longitudinal association between obesity and disability with absenteeism in the workplace.	Longitudinal. Quantitative. Stata, version 14.0.	117,769 observations for 19,851 obese, overweight, and/or disabled workers. N.A.	The guidelines of the International Classification of Functioning, Disability and Health (ICF) under the WHO framework (the disability of an adult).	N.A. (in total). 51.1%—male.	Disability was positively associated with longer days of absence among male workers. The rate of absenteeism was 1.82, 1.61, and 2.63 times higher among overweight, obese, and female workers with disabilities, respectively, compared with their lower-weight counterparts.
(Haw et al. 2020) Philippines	To evaluate the burden and impact of migraine on work productivity in selected workplaces.	Cross-sectional. Quantitative. Stata IC, version 15.1.	511 employees who were suspected or diagnosed with migraine. N.A.	The ID-Migraine test (migraine). MIDAS questionnaire (migraine severity and impact on work productivity). SF-36 Questionnaire (QoL).	31.6 years. 67.5%—female.	Migraine poses a significant threat to work productivity. Many opportunities such as disease management and the introduction of alternative options for migraine treatment, may be introduced to help address these issues.
(Yuen et al. 2021) The USA	To assess the impact of acromegaly on employees’ health benefit (direct and indirect) costs and absenteeism.	Longitudinal. Quantitative. SAS Enterprise, version 7.15.	47 employed patients with an acromegaly diagnosis and 940 controls. N.A.	N.A.	47.8 years—employees with acromegaly, 45.7 years—employees without acromegaly. 40.4%—female employees with acromegaly, 46.7%—female employees without acromegaly.	The presence of acromegaly is associated with increased direct and indirect employee health benefit costs and increased work absenteeism.
(Shimizu et al. 2021) Japan	To assess the impact of migraine and other headache disorders and the cost and productivity losses in the workplace.	Cross-sectional. Quantitative. Stata, version 15.0.	2458 employees in IT companies with M, TTH, M/TTH, HA, and NHA. N.A.	SF-12x2 Japanese version (HRQoL). MIDAS (the severity of impact on work and daily life). WPAI Questionnaire (the severity of impact on work and daily life).	44.5 years—M, 46.9 years—TTH, 45.5 years—M/TTH, 44.2 years—HA, 46.0 years—NHA. N = 205—male with M, N = 1093—male with TTH, N = 61—male with M/TTH, N = 265—male with HA, N = 339—male with NHA.	This study revealed a high prevalence and disease burden among employees with migraine that is associated with substantial losses in productivity and employer cost. Presenteeism causes more economic losses than absenteeism.
(Bonafede et al. 2021) The USA	To examine the indirect burden of employed MS patients initiating DMT.	Longitudinal. Quantitative. WPS, version 4.1 and R, version 3.5.1.	DMT-treated MS patients (DMT users) and Direct-matched controls without MS. N.A.	N.A.	41.4 years—DMT users. 62.1%—female DMT users.	Compared with injectable DMT users, oral DMT users took twice as long to initiate therapy but had numerically lower absenteeism costs and significantly lower long-term disability costs in the first year after DMT initiation. Employed DMT users in the U.S. incurred an incremental increase in indirect burden compared with the matched control groups.
(Rodriguez Llorian et al. 2022) Canada	To analyse work productivity loss and costs, including absenteeism, presenteeism and unpaid work loss, as well as its association with clinical, sociodemographic, and work-related factors.	Cross-sectional. Quantitative. N.A.	512 employed people with MS. N.A.	VOLP Questionnaire (productivity loss components. EDSS (the severity of disease). MFIS (fatigue. PHQ-9 (depression). GAD-7 (anxiety). EQ-5D-5L (HRQoL utility).	39 years. 71%—female.	Total productivity time loss over 3 months averaged 60 hours per patient, with an hourly paid productivity loss that was greater than the wage loss. Fatigue retained significant associations with all productivity loss outcomes.

presents in detail the study purpose, research design, method, software for analysing the data, sample size, participants, sampling method, instruments, measurements, the mean age of the respondents, the percentage in terms of gender, and the key findings of the identified 22 studies.

5. Research Significance

Research findings indicated several workplace-related socioeconomic issues associated with job performance and productivity among employees with various impairments including workplace absenteeism and presenteeism, productivity loss (PL)/productivity time loss (PTL), and costs. Hence, there are several research significance either for theoretical or practical contribution.

In terms of theoretical significance, several research suggestions can be organised in the future to fulfil insufficient research related to disabled employees. Future research is suggested to focus on workplace-related socioeconomic issues associated with job performance and productivity among employees with disabilities since findings indicated that research related to job performance and productivity among employees with PWD (people with disabilities) working as employees are limited compared to employees that become PWD at work because of several diseases. This is important because according to Kensbock and Boehm (2016), research related to job performance among PWD employees is insufficient to be used as a guidance for job performance improvement. In fact, future research is suggested to do comparative research related to various disabilities among employees to prepare for organisational intervention as an effort to improve their job performance (Cavanagh et al. 2017).

Furthermore, another aspect that should be explored by future researchers is to conduct more research about disabled employees with several diseases including diabetes, migraine, gout, depression, chronic diseases, acromegaly, cardiovascular events and related clinical procedures (CVERP), psoriatic arthritis (PsA), multiple sclerosis (MS), and employees who received injectable multiple myeloma (MM) therapy; this is because these diseases were identified to have negative effects on job performance and productivity among disabled employees due to absenteeism and presentism. Meanwhile, several research topics that can be focussed on are studies related to factors resulting in low performance and productivity, prevention and control that can be used to avoid low job performance, and intervention and strategies to increase job performance and productivity.

Furthermore, future research should also explore research related to facilities that can help disabled employees to perform their jobs better. For example, Zahari et al. (2020) found that facilities that are prepared for disabled persons in heritage buildings in Malaysia are insufficient, causing barriers for disabled persons to enter those buildings. The research implicitly revealed that not only heritage buildings but many buildings for working organisations also did not provide sufficient facilities for disabled employees to support high job performance. Hence, research related to this area should also be explored.

On the other hand, in terms of practical significance, several interventions can be undertaken to increase job performance and productivity among disabled employees. For example, findings indicated that several diseases suffered by disabled employees are affecting their job performance and productivity; hence, the organisation can consider a few alternatives to overcome the problem. For instance, the organisation can offer early retirement, group support, suitable training programs, flexible working hours, work by objective, and healthy lifestyle campaigns among those disabled employees to prevent low job performance. This is supported by previous research findings, such as those by Hairodin et al. (2021) that indicated that the prevalence of successful ageing among public servants in Klang Valley Malaysia was seen in those of younger age, who were non-obese, physically active, and had good social support. The research implicitly suggested that those disabled employees caused by disease should be offered an early retirement plan.

Furthermore, Amin et al. (2020) found that there were several challenges faced by disabled women in Malaysia that are mostly working, including significant barriers concerning individual constraints, familial control, and societal barriers. The research implicitly suggested that those disabled working women should be offered a support group to increase their motivation in facing their life challenges, especially those affecting job performance. Meanwhile, Subhi et al. (2020) found that disabled employees can be trained to improve job performance; hence, suitable training programs that can help disabled employees to achieve high job performance should be offered by employers/organisations. In addition, Asmah et al. (2011) found that health interventions should be designed to focus on reducing stress and catered to various levels of education to improve healthy lifestyles among adults that are majority working in Selangor, Malaysia. In this paper, the research implicitly suggested that employees should be offered a healthy lifestyle in their working plan to increase job performance.

6. Conclusions

In conclusion, job performance and productivity are the main aspects expected from employees; however, research related to disabled employees is insufficient as compared to able-bodied employees, especially those related to workplace-related socioeconomic issues. Therefore, the objective of this article is to determine workplace-related socioeconomic issues associated with job performance and productivity among employees with various impairments. Using an SLR for Scopus and Web of Science (WOS) databases, 22 studies were selected based on inclusion criteria; the inclusion criteria were journal articles related to people with disabilities (based on their title, abstract, and keywords), full papers, English-language publications, and those articles that were published between the years of 2003 and 2022. Findings indicated that several workplace-related socioeconomic issues were identified, including employee productivity and performance, workplace absenteeism and presenteeism, productivity loss (PL)/productivity time loss (PTL), and costs. Furthermore, findings indicated that workplace performance was almost equal among employees with and without disabilities; however, research related to job performance and productivity among employees with PWD (people with disabilities) working as employees is limited compared to studies on employees that become PWD at work because of various diseases. Meanwhile, the level of absenteeism was considerably higher among disabled employees, such as those with acromegaly, migraine, gout, depression, cardiovascular events, and related clinical procedures (CVERP), and chronic diseases. In addition, the level of presenteeism was considerably higher among disabled employees, such as those with depression and migraine. Additionally, productivity loss and/or productivity time loss (PTL) was higher among disabled employees, such as those with depression, psoriatic arthritis (PsA), multiple sclerosis (MS), chronic migraine disease, and employees who received injectable multiple myeloma (MM) therapy. Finally, findings also indicated that the cost of productivity losses among disabled employees is high and should be overcome. Several research impacts were also discussed including future research suggestions and interventions.