# Evaluation of the Relationship Between Anemia and Subjective Symptoms in White-Collar Workers

## TL;DR

This study shows that even mild anemia in white-collar workers is linked to symptoms like dizziness and fatigue, which can affect work performance.

## Contribution

The study reveals that mild anemia is significantly associated with subjective symptoms in white-collar workers, emphasizing the need for early detection.

## Key findings

- Anemia was significantly associated with dizziness, palpitation/dyspnea, and edema in white-collar workers.
- Mild anemia showed increased odds ratios for all three symptoms compared to non-anemic individuals.
- The study highlights the potential impact of anemia on work productivity through presenteeism and absenteeism.

## Abstract

Introduction: Anemia has been shown to reduce workers’ performance and health. However, the relationship between anemia and subjective symptoms remains poorly understood. This study investigated the prevalence of anemia and subjective symptoms and the association between anemia and subjective symptoms among white-collar workers.

Methods: This study analyzed health examination data of Japanese white-collar workers (n= 103,530) from April 2023 to March 2024. The prevalence of three subjective symptoms, dizziness, palpitation/dyspnea, and edema, was compared among three categories without anemia (i.e., male hemoglobin value: 13 g/dL or female hemoglobin value: 12 g/dL), mild anemia (i.e., male hemoglobin value: 12-12.9 g/dL or female hemoglobin value: 11-11.9 g/dL), and moderate or severe anemia (i.e., male hemoglobin value: <12 g/dL or female hemoglobin value: <11 g/dL). To examine the association between anemia and three subjective symptoms, we performed multivariate logistic regression analysis with the presence or absence of subjective symptoms as the dependent variable. Additionally, a sex-based subgroup analysis was conducted.

Results: Among the participants, 5.1% had mild anemia, while 1.8% had moderate or severe anemia. Dizziness, palpitation/dyspnea, and edema were reported by 4.5%, 3.2%, and 7.4%, respectively. Anemia was significantly associated with all three subjective symptoms. Regarding dizziness, the multivariate odds ratio (OR) of mild anemia (OR: 1.28, 95%confidence interval, CI: 1.14-1.42) and moderate or severe anemia (OR: 1.56, 95% CI: 1.33-1.84) were >1. For palpitation and dyspnea, the multivariate OR of mild anemia (OR: 1.21, 95% CI: 1.05-1.39) and moderate or severe anemia (OR: 1.74, 95% CI: 1.44-2.11) were >1. Regarding edema, the multivariate OR of mild anemia (OR: 1.19, 95% CI: 1.09-1.30) and moderate or severe anemia (OR: 1.24, 95% CI: 1.09-1.43) were >1.

Conclusions:Anemia was associated with the three subjective symptoms even in mild conditions. These results may contribute to reduced work productivity, particularly through presenteeism and absenteeism. The study findings highlight the importance of early detection and treatment through health checkups, dietary interventions, and iron supplementation.