Endometriosis as a determinant of work disability in the Hungarian population: quantifying productivity loss and the need for workplace prevention strategies

Abstract

Objective: To quantify the impact of endometriosis on work productivity and work ability and to identify modifiable workplace targets for prevention-oriented strategies. Methods: This cross-sectional study, conducted between October 2024 and January 2025 in Hungary, compared 566 women with endometriosis to 447 controls using the Work Productivity and Activity Impairment ques tionnaire and the Work Ability Index (WAI). Productivity loss was monetised using the human capital approach based on national average wages. Results: Women with endometriosis reported significantly higher absenteeism (9.73% vs 5.84%) and pre senteeism (47.2% vs 38.4%) compared to controls. Affected individuals missed nearly twice as many work hours over four weeks (12.7 ± 31.3 vs 5.66 ± 12.6 h), resulting in an estimated annual income loss of 1757 per person. Total WAI scores were significantly lower (27.2 ± 4.48 vs 30.3 ± 4.29), with 42.0% of the endometriosis group classified in the “poor” work ability category, compared with 17.9% of controls (p < 0.01). Furthermore, 54% of participants reported that their employers had little to no knowledge of the condition. € Conclusion: Endometriosis is a major determinant of work disability and indirect economic costs. Structured workplace accommodations represent key tertiary prevention strategies to preserve labour force participation and mitigate the socioeconomic burden of the disease.