# Present but Overlooked: A Scoping Review of Instruments and Approaches for Measuring Presenteeism Related to Alcohol, Tobacco, and Drug Use

## TL;DR

This paper reviews methods used to measure how alcohol, tobacco, and drug use affects workplace productivity when employees are present but not performing well.

## Contribution

The study provides a comprehensive overview of approaches and instruments for measuring ATOD-related presenteeism, highlighting the lack of standardization.

## Key findings

- Indirect approaches were more common than direct methods for measuring ATOD-related presenteeism.
- There was significant variation in instruments and reporting methods across studies.
- Standardization of approaches is needed to improve the interpretation and synthesis of findings.

## Abstract

The use of alcohol, tobacco, and other drugs (ATOD) can impact workplace productivity. Whilst presenteeism has a greater impact on productivity than absenteeism, it is less visible and often receives less attention. Measuring ATOD-related presenteeism is important for identifying the impact of AOD use and evaluating workplace AOD interventions. However, there is no standard approach to determining ATOD-related presenteeism. The aim of this scoping review was therefore to identify and describe different approaches and instruments used to determine ATOD-related presenteeism.

A scoping review of publications up to and including December 2024 was undertaken across three major databases: Scopus, Ovid Medline, and the Latin-American and Caribbean System on Health Sciences (LILACS). The population was workers for whom ATOD-related presenteeism was reported, the concept was presenteeism, and the context was the workplace.

The review included 27 original studies. The most common approach (n = 22 studies) was indirect, which involved examining differences in presenteeism between workers who did and did not use ATOD. Direct approaches—asking participants explicitly about their ATOD-related presenteeism—were less common (n = 5 studies) and focussed exclusively on alcohol. Across both approaches, there was substantial variation in instruments (n = 4 direct, n = 10 presenteeism, n = 18 ATOD), use of validated instruments, recall periods, and ways of reporting findings, which may compromise the interpretation and synthesis of studies.

This scoping review provides an evidence base for informing approach and instrument selection. It establishes the need for further research on the impact of different approaches and instruments on findings. This information is essential to encourage more rigorous and standardised approaches to determining ATOD-related presenteeism and evaluating workplace interventions.