A Lunch Break Time and Its Impact on Employees Health, Performance and Stress on Work

Abstract

Employees' health, performance, and stress problem have become a major issue in today's workplace globally. These problems are linked to various factors. In this study, we contributed the rationality of having a one-hour lunch break at the workplace. Drawing on extant literature, we developed a theoretical model in this study. The results showed a positive impact on employees' health, performance and reduced stress at work if the favorable one-hour lunch break is practiced. The study also gives support to prevent absenteeism, improve job satisfaction, and employees' positive attitude towards work.

Full text

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*Corresponding author: E-mail: aslam.shahzad@xmu.edu.my;
Journal of Pharmaceutical Research International
33(38B): 84-97, 2021; Article no.JPRI.70900
ISSN: 2456-9119
(Past name: British Journal of Pharmaceutical Research, Past ISSN: 2231-2919,
NLM ID: 101631759)
A Lunch Break Time and Its Impact on Employees
Health, Performance and Stress on Work
Saifullah Hakro
1
, Arif Jameel
2
, Abid Hussain
2
, Muhammad Shahzad Aslam
3*
,
Waris Ali Khan
4
, Saiqa Sadiq
5
and Asma Nisar
6
1
Department of Management Sciences, University of Okara, Pakistan.
2
School of Public Affairs, Zhejiang University, Hangzhou, China.
3
School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Selangor, 43900,
Malaysia.
4
Faculty of Business, Economics and Accountancy, Universiti Malaysia Sabah, KK, 88400, Sabah,
Malaysia.
5
School of Government, University of Utara Malaysia.
6
Faculty of Engineering, Universiti Malaysia Sabah, KK, 88400, Sabah, Malaysia.
Authors’ contributions
This work was carried out in collaboration among all authors. All authors read and approved the final
manuscript.
Article Information
DOI: 10.9734/JPRI/2021/v33i38B32102
Editor(s):
(1) Dr. Triveni Krishnan, National Institute of Cholera and Enteric Diseases, India.
Reviewers:
(1) Topwe Milongwe Mwene-Mbeja, University of Lubumbashi, Congo.
(2) Said Alavi Kolambil, Shri Jagdishprasad Jhabarmal Tibrewala University, India.
Complete Peer review History:
https://www.sdiarticle4.com/review-history/70900
Received 10 May 2021
Accepted 15 July 2021
Published 27 July 2021
ABSTRACT
Employees’ health, performance, and stress problem have become a major issue in today’s
workplace globally. These problems are linked to various factors. In this study, we contributed the
rationality of having a one-hour lunch break at the workplace. Drawing on extant literature, we
developed a theoretical model in this study. The results showed a positive impact on employees’
health, performance and reduced stress at work if the favorable one-hour lunch break is practiced.
The study also gives support to prevent absenteeism, improve job satisfaction, and employees'
positive attitude towards work.
Keywords: Lunchtime; employee’s physical health; mental health; performance; stress.
Original Research Article

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1. INTRODUCTION
In the competitive business era labor health,
performance, and stress work have become
major problems. These laborers' work-related
problems are lined with different factors.
Previous studies indicate an essential connection
between a long working week and health
symptoms [1]. Previous studies on the
relationship between working hours and fatigue
revealed a positive relationship between lengthy
hours working and fatigue, and poor work-life
balance linked with long hours working [2]. In
addition, sleep deprivation can lead to an
inflammatory response that may cause the
development of cardiovascular disease
processes [3]. One million people stress on the
job and five million extremely stress at work [4].
The mental and physical conditions also affect
productivity, effectiveness, personal health, and
quality of work [5]. Similarly, prior research
showed reducing “Blood Pressure” in
hypertensive involves falling risk of death and
disability, which enhances an important factor for
employee’s health [6]. “Working time satisfaction
is a direct measurement of the happiness that an
employed worker derives from his current
working time arrangements and dissatisfaction
may have behavioral consequences, for
example, not being able to realize the desired
working time or working time arrangement may
cause employees to change jobs” [7]. Unusual
working hours can be complicated participation in
work-life balance including social life [8].
Similarly, previous studies revealed that persons
who are satisfied with the length of their working
hours tend to be more satisfied with their jobs [9].
In addition, recent studies identified that shorter
breaks, such as weekends or breaks of different
lengths during the working day are beneficial for
recovery [10]. Lunch is most often the greatest
and therefore the most remarkable break during
the day in terms of recovery [11]. Moreover, not
only free time itself but also the activities or
experienced employees meet during the break
impact recovery levels [11], and few author
showed that few lunch break activities are
beneficial in terms of recovery [11]. Furthermore,
Moreover, not only free time itself but also the
activities or experienced employees meet during
the break impact recovery levels [11]. (A wordy
and repetitive sentence structure should be
avoided).
Besides the concept of “WHAT” is well
established literature in both management and
economics investigating the causes and
consequences of absenteeism [12]. Absenteeism
can be defined as the failure to report scheduled
work that is costly to employers in terms of lost
productivity. It is also associated with other
counterproductive behaviors, such as lateness,
reduced personal productivity, and turnover [13],
and some researchers simply measured the
number of times employees attend work while
feeling ill [14]. Others attempted to measure the
associated productivity loss by asking employees
directly about any reduced work performance
[15], the degree of lost efficiency [16], or any
work limitations stemming from going to work
while sick [17]. Importantly, depression, anxiety,
and emotional disorders, and overall mental
health have been cited as some of the strongest
correlates of presents [18]. The break is an
opportunity for employees to take a rest and
body off from work in the term of break time [19].
In addition, several work-related health hazards
result globally.
Fig. 1. Breakdown of the Estimated Fatal Work-Related Mortality by WHO Regions in 2015.
Source: [20]

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Fig. 2. Breakdown of the Estimated Fatal Work-Related Mortality by type of diseases in WHO
Regions in 2015 Source: [20]
Table 1. State Law for Adult Employees in Private Sector
State
Maximum hours before lunch break
Required length of
lunch break
California 5 30 minutes
Colorado 5 30 minutes
Connecticut If working week at least 7.5 consecutive hours after 1
st
two
hours, before last two hours
30 minutes
Delaware If working at least 7.5 consecutive hours: after 1
st
two hours,
before last two hours
30 minutes
Illinois For employees who work 7
1/2
hours or more, after 5 hours At least 20 minutes
Kentucky Between 3
rd
and 5
th
hours work Ordinarily 30 minutes
Maine 6 consecutive hours 30 minutes
Maryland 6 consecutive hours 30 minutes
Massachuse
tts
6 consecutive hours 30 minutes
Minnesota Sufficient unpaid time for employees who work 8 hours
consecutive hours or more
Not stated
Nebraska Within each 8 hours shift 30 minutes
Nevada During 8 hours continue 30 minutes
New York Noon-day period 60 minutes
North
Dakota
After 5 hours 30 minutes
Oregon Less than 7 hours: between 2
nd
& 5
th
hours; more than 7
hours, between 3
rd
and 6
th
30 minutes
Rhode
Island
Up to 6 hours-
Up to 8 hours-
20 minutes
30 minutes
Tennessee 6 or more consecutive hours 30 minutes
Vermont Employees are to be given “reasonable opportunity” during
work periods to eat & use toilet facilities
Not stated
Washington 5 consecutive hours 30 minutes
West
Virginia
5 consecutive hours 30 minutes
Guam 5 30 minutes

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Fig. 3. Model of the study
Globally domestic lunch break time’s length is
different including hidden. Table 1 shows the
overview of various laws about the meal/rest
break earlier. It shows every state has a variety
of rules for the different jobs/industries. The
labors working from early morning time 07:00,
80:00 or 80:30 or 90:00 to 05:30-06:00-07:00
including overtime work, and taking lunch at
different times such as between 12:00-13:00 or
13:00-14:00 with lunch break length between 10-
20-30-40 minutes. In this process, labor less than
one hour meal time length is included in the
stress meal break times. Therefore, the present
study aims to highlight the role of a one-hour
lunch break schedule. The one-hour break is
doing a positive impact on the employee’s
physical-mental health, performance and stress
work on laborers at work in the organization.
2. MATERIALS AND METHODS
In the study, we applied the conceptually
theoretical model, theory, and Figures and have
used the secondary data for the study validation.
According to Bowen [21], which states that
“Document analysis is a qualitative research
method that requires data to be examined and
interpreted to understand and develop empirical
knowledge from pre-existing documents”. The
model of the study has been shown in Fig 3.
Fig. 3 shows the one-hour lunch break schedule
is maintaining a positive impact on employee’s
physical health, psychological health,
performance, and stress on workers at work in
the organization.
Hypotheses.
The following conceptual propositions were
developed for the positive impact on the labor
health well-being and an organization including
domestic states well-being in the world.
Hypothese1 (H1). The workplace labors
one-hour lunch break schedule plays a
role in positively impacting employee’s
physical and mental health at work in the
organization.
Hypothese2 (H2). The workplace labors one-
hour lunch break schedule plays a role of
positively impacting employee’s performance and
employee’s stress on work in the organization.
3. RESULTS AND DISCUSSION
3.1 Labors Physical Health
One-hour lunch break time plays an important
role in positively impacting an employee’s
physical health. In this time labor can be body off
from work to take the meal, nape and walk which
can be a positive impact on employee’s physical
health at work [22,23]. According to Willert,
Thulstrup [24] reports that in occupational
settings, fatness and sleepiness make worse
motivation, mood, and job satisfaction and also
can lead to poor health outcomes. And [25]
reports that “In many countries, fatigue has
been identified as a contributing factor in a
significant proportion of road transport
accidents”. The labors' one-hour lunch break
time can be prevented from employee’s fatigue-
fatness to the positive impact on physical health.
However, prevent an employee’s fatigue, fatness
and positive impact on physical health can be by
one-hour lunch break time? It can be perceived
that in the one-hour lunch break time can take
the meal, nape or walk for body moment and
refreshment to get recharge to lead fatigue and
fatness. Fewer break time employees taking
meal and continue working can be increased
fatigues labors at work while in the less lunch
break time employees cannot do take a meal,
walk, and nape. In this fewer time employees just

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getting a meal and continue working including no
time for nape and walk to growing physical
fatigue laborers at work. According to [26]
states that in studies with workers fatigue and
overwork were identified as the main reasons for
not adopting an active behavior during
leisure time. And [27] reports that in South
Korean workers, over 75% of those employed do
not practice leisure-time physical activity
(LTPA), and work conditions, including
overwork, were an important constraint in the
lack of this practice. However, employees do
practice in term of less lunch break time.
While labors have enough lunch break time
yet he/she can be practiced likely walk-talk-
nap.
Plate 1. In a one-hour lunch break schedule he/she can walk
Plate 2. In less lunch break time physical fatigue labors

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According to [28], the study that physical
activities can be executed in different situations,
such as different forms of displacement, work
activities, domestic activities, or leisure activities.
[29], The beneficial effects of regular physical
activity, especially in leisure activities are well
established in the literature [30].
However, laborers can be done physical
activity in terms of fewer lunch break times? At
this time they cannot be able to do any activity
which can be boosting fatigue health at work.
And while in the one-hour lunch break times
schedule they can be done activities which can
be prevented in continue working including
fatigue. This time increases the employee’s
moment of body and rest which decreases
fatigue and fatness, and sleepiness to a positive
impact on the labors physical health. According
to [31] state that insufficient physical activity has
higher risks of chronic diseases, such as obesity
and cancer to both gender male and females.
[11], suggests that “might lead to either a broadly
energized state including reduced emotional,
motivational, and cognitive strain or reduced
physical and mental fatigue; together, they all
might contribute to reduced sleepiness
experiences”. And “Epidemiological surveys
implicate poor sleep as a predictor of
cardiovascular risk, and meta-analyses have
reported that shorter sleep duration, an emerging
condition in the western population, is associated
with a higher incidence of cardiovascular events”
[32].
Fig. 4 shows in term of less lunch break time,
labors continuing working in the term of sitting,
standing, and taking over heavy load, and poor
work spacing, heavy motors heating
temperature, motors noising, vibration and eating
meal continue working, no walk no rest which
can be increasing fatigue, fatness, and physical
health hazards. and while in the one-hour lunch
break time he/she can get a meal, walk, and
nape wherein prevents employees long hours
continue working and increases the body
moment which can be a positive impact on the
labors physical health at work.
Fig. 4. Lunch break times and employee’s physical health

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3.2 Labors Mental Health
One-hour lunch break time plays an important
role in managing laborers’ comfort ability-
freedom in solving much personal work which
can positively impact on the labors mental health
at work. In this time laborers can get
refreshments (i.e., nap, meal, walk-talk, and
personal work) which can be a positive impact on
laborers' mental health. And, while in less lunch
break time, he/she cannot get a meal, nap, and
walk-talk and solve personal works which can be
increased the negative impact on the employee’s
mental health at work. According to [33] state
that mental illness is pervasive and costly. In
England, the economic cost of mental illness in
the 2009-10 financial year has been estimated to
equal £105.2 billion, and similarly [34] In the
United States estimates for the period 2001 to
2003 indicate that serious mental illness is
associated with an annual loss in earnings
totaling $193.2 billion. Moreover, [35] In the
United States, for example, approximately half of
the overall cost of depression is attributable to
the reduced productivity of workers. And [36] the
establishment-level productivity is related to
workers’ average mental well-being (specifically
job satisfaction). And [37] states that mental
health-related productivity loss varies across
occupations. [38] reports that women generally
experience more internalizing problems, mental
health conditions, and general health issues than
men. And [39] mainly women are absent from
work more repeatedly. Mental illness [40], and
stress [41] are also associated with greater intra-
individual variability in sleep timing and duration,
and in adolescents, it is strongly associated with
poorer psychological wellbeing [42].
Employees in terms of less lunch break time
cannot be mentally uncomfortable. In this time
employees doing long hour’s speedy work and
no time to get a nap can be increasing mentally
tired employees at work. And while the one-hour
lunch break is a comfortable time about getting
the mental refreshment and comfortability at
work. A recent times study [18] reports people
with mental health problems have consistently
been found to have relatively high propensities to
be absent from work. And presenter is a related
concept, which has at various times been defined
in the literature either as i) the act of attending
work while ill [43]: or ii) “decreased on-the-job
performance due to the presence of health
problems” [44]. And [18] states that depression,
anxiety, and emotional disorders, and overall
mental health have been cited as some of the
strongest correlates of presents.
Plate 3. In less lunchtime mental health at work

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Fig. 5. Lunch break time and employees mental health
Fig. 5 shows in the lees then one-hour lunch
break time he/she cannot take a meal, walk or
nap wherein he/she to be mentally tired at work.
And in comfortable lunch break time, he/she can
take a meal, nap, and walk/talk which can a
positive impact on the employee’s mental health
at work. Moreover, in comfortable lunch break
time employees taking walks, nap, and
communicate with colleges may be created
friendly mentally fresh employees at work. And in
shorter break time they cannot solve personal
work which can side effect on the employee’s
mental health at work. For example, he/she want
to rest or solve personal work but could not get a
nap or solve personal work because of less lunch
break. In these short break times, employees
may are not mentally ready to continue work.
And while in the term of one-hour lunch break
time he/she can solve personal work (i.e., nap,
walk with colleges, talk with family and children,
or pick up children, or solve the personal work)
wherein he/she can be mentally ready and
satisfied to continue work. And while employees
will be physically-mentally satisfied at work, it
may a positive impact on employee absenteeism.
Such as prior study report that data from different
countries around the world indicate that mental
health problems are a cause of several
employees dropping out of work. In the
Netherlands, around 58% of work-related
disabilities are related to mental health [45]. In
the UK, it is estimated that around 30-40% of the
sickness absence is attributable to some form of
mental illness [46]. Mental health problems have
an impact on employers and businesses directly
through increased absenteeism, a negative
impact on productivity and profits, as well as an
increase in costs to deal with the issue [46]. And
the connection between the long working week
and health symptoms [1]. And fatigue and poor
work-life balance are shown due to long hours
working [2].
3.3 Labor’s Performance
“One-hour lunch breaks time” plays an important
role in positively impacting labors’ performance.
In this lunch break employees doing a body off
from work to get refreshment physical-mental
comfortability which positive impact on the labor
physical-mental health including prevents labor
fatigue at work. When labor will not be physically-
mentally fatigue at work thus he/she can be able
to give a better performance at work. And while
they will be physically-mentally active at work it
to be involved in positively impacting the
laborers’ performance at work. [47], reports that
intra-individual variability in sleep duration and

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timing has also been linked to worse cognitive
function and academic performance, and [48]
increased incidence and severity of affective
disorders such as depression.
Fig. 6 shows in term of labors less lunch break
time, taking meal and continue working, no time
for the nape and machines noised and vibration
to be increased fatigue employees and fatigue
performance; and while the “one hour lunch
break time” prevents fatigue and depression and
maintains positive impact on the labors physical-
mental health with which positively impacts on
the employee's performance at work. Moreover,
[51] human performance declines in the
afternoon (the so-called ‘post-lunch dip’). And,
[52]“Daytime sleepiness and nodding off also
occur at approximately 14:00–16:00 h”. And at
this time, often accidents and fatigue [53]. And “A
short nap, especially during the post-noon nap
zone, has been shown to restore alertness and
promote performance without the inconvenience
of sleep inertia that is associated with longer
naps” [54].
Plate 4. Indication of physically and mentally fatigued labors and fatigue performance. [49]
reports that a brief nap enhances subsequent alertness and performance during both times
periods of the day, [50], and night
Fig. 6. Lunch break time and employees performance

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3.4 Labor’s Stress on the Job
Labors' “one-hour lunch break time” plays an
important role in preventing stress on labor at
work in the organization. One million people's
stress on the job made ill them, and around five
million deeply stressed at work there [4].
Increasingly, however, research is indicating that
irregular sleep patterns are as detrimental as
insufficient sleep [55] Labors less lunch break
times to be involved in the stress work in the
organization. Such as work stress links with long
hours of work, alternation, violence, downsizing,
sexual harassment, and job shifts [56]. The
employee’s long hours work in terms of less
lunch break time to be stressful work. In terms of
less lunch break time, labors working between 8-
9 hours’ work to be involved in continue stress
work schedule including labors stress lunch
break time. In this break time he/she may not
take the refreshment (i.e., meal, nap, walk/talk,
and to solve personal work) wherein he/she may
feel physical-mental tired at work. When labors
are physically-mentally tired it may side effect on
labors performance at work. While labor is tired
and has poor performance wherein he/she may
feel stress at work. according to [57] states that
stress on the job, increasing the toll of
disadvantages, decreasing productivity, wastes
time on work and health care costs. According to
[58] reports that accumulating evidence shows
that there is also considerable intra-individual
variability in sleep timing, which may exceed
interindividual variability. And [59]. Intra-
individual variability often arises due to large
discrepancies between sleep timing on work vs.
free days, termed ‘social jetlag’.
Additionally, [60] reports that stigma was also
considered a source of perceived stress.
Consistent with this, previous studies have found
stigma to be related to stress not only in people
living with the infectious disease [61] but also in
the nurses caring for them [62].
Plate 5. Employee’s less lunch break time and its work stress
Fig. 7. Lunch break time employees stress on work

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Fig. 7 shows that one hour lunch break time
maintains laborers’ comfortability to prevent
stress in the organization; and while in the less
lunch break time increases suffering in taking
meal and continue working, no time for rest, no
time for walk-talk and personal work wherein
employees feels stress work in the organization.
[63] noticed that stress might mediate the linkage
of stigma to health outcomes. And [64] “chronic
stress usually manifests itself in various ongoing
physical and/or psychological symptoms” and
work stress rises “metabolism, blood pressure,
cholesterol level” an employee’s physical and
mental condition, and waste of time on the
working link with stress. In this viewpoint, it can
be perceived that the term of one-hour lunch
break time can help in preventing long hours
continue working, the risk of chest pain,
shoulders pain, back and neck pain, poor body
moments, eyes burning, depression, and
headaches which involves in reducing labor’s
stress on work. Moreover, in the one-hour lunch
break time can be maintained freedom-comfort
ability wherein he/she can be solving many
things (i.e., taking the meal, taking rest, taking
walk-talk and solving any kind of personal work)
which can be prevented stress on workers at
work.
4. CONCLUSIONS AND IMPLICATION
The positive impact on employee’s physical
health, psychological health, performance, and
low stress on work links with a one-hour lunch
break. Long hours work as 8 hours, 9 hours or 10
hours including overtime work with less than one
hours break time to be involved in long hour
continue work. This rest time conceders stress-
rest time likely unhealthy break side effects on
labors physical health-psychological health,
performance considers stress work in the
organization. such as the study indicated “the
connection of long working week and health
symptoms” [1]. Observationally, long hours of
work in a day is a sign of less lunch break which
is the actual long-hour work creates the health-
related problem. Such as long hours of work and
fatigue, and poor work-life balance are due to
long hours working [2]. Labor’s comfortable lunch
break time maintains physically-psychological
active labor. In this time he/she can solve many
things naps, meals, and walk-including personal
work. As suggested, “Sleep deprivation can lead
to an inflammatory response that may cause the
development of cardiovascular disease
processes” [3]. And “Mental-physical condition
effects on productivity, effectiveness, personal
health, and quality of work” [5]. While reducing
“Blood Pressure” in hypertensive involves in
falling risk of death and disability enhances
important factor for employee’s health [6]. And,
“Daytime sleepiness and nodding off also occur
at approximately 14:00–16:00 h” [52]. And at this
time, often accidents and fatigue occur [53]. The
one-hour lunch break time employees can be
managed a happy work environment, friendly
environment including the positive impact on
employees-organization profile. The study
suggested that labors physical health,
psychological health, performance, and stress
issue are controlled with the help of one hour
lunch break time, and this time maintains a
positive impact on employees in taking nape,
meal, rest, and walk and talk to solve personal
work and prevents in employees’ health and
performances issues. Lastly, this study
suggested that further fruitful outcomes for both
organization and labor can be achieved through
the “one-hour lunch break time schedule in the
futures study”.
CONSENT
It is not applicable.
ETHICAL APPROVAL
It is not applicable.
ACKNOWLEDGEMENTS
This work is supported by Xiamen University
Malaysia Research Fund (grant number
XMUMRF/2020-C6/ITCM/0005).
COMPETING INTERESTS
Authors have declared that no competing
interests exist.
REFERENCES
1. Sparks K, et al. The effects of hours of
work on health: A meta‐analytic review.
Journal of occupational and organizational
psychology. 1997;70(4):391-408.
2. White J, Beswick J. Working long hours.
Health & Safety Laboratory (HSL),
Sheffield; 2003.
3. Meier-Ewert HK, et al. Effect of sleep loss
on C-reactive protein, an inflammatory
marker of cardiovascular risk. Journal of

Hakro et al.; JPRI, 33(38B): 84-97, 2021; Article no.JPRI.70900
95
the American College of Cardiology. 2004
;43(4):678-683.
4. Jones J, et al. Self-reported work-related
illness in 2001/02: Results from a
household survey; 2003. Available:www.
hse. gov. uk/statistics/causdis/swi0102.
pdf.
5. Rees K. Journey of discovery: A
longitudinal study of learning during a
graduate professional programme (Ph. D.
thesis). Case W estern Reserve University,
Cleveland; 1997.
6. Launer LJ, et al. The association between
midlife blood pressure levels and late-life
cognitive function: the Honolulu-Asia Aging
Study. Jama. 1995;274(23):1846-
1851.
7. Bijwaard G, et al. Working time
preferences, labour market transitions and
job satisfaction. Flexibility and employment
security in Europe: labour markets in
transitions. 2008;255-277.
8. Greubel J, et al. Higher risks when working
unusual times? A cross-validation of the
effects on safety, health, and work–life
balance. International archives of
occupational and environmental health.
2016;89(8):1205-1214.
9. Booth AL, Van Ours JC. Job satisfaction
and family happiness: The part‐time work
puzzle. The Economic Journal.
2008;118(526):F77-F99.
10. Dababneh AJ, Swanson N, Shell RL.
Impact of added rest breaks on the
productivity and well being of workers.
Ergonomics. 2001;44(2):164-174.
11. Krajewski J, Wieland R, Sauerland M.
Regulating strain states by using the
recovery potential of lunch breaks. Journal
of Occupational Health Psychology. 2010
;15(2):131.
12. Harrison DA, Martocchio JJ. Time for
absenteeism: A 20-year review of origins,
offshoots, and outcomes. Journal of
management. 1998;24(3):305-350.
13. Thomas JC, Hersen M. Handbook of
mental health in the workplace. Sage;
2002.
14. Arnold D. Determinants of the annual
duration of sickness presenteeism:
Empirical evidence from European data.
Labour. 2016;30(2):198-212.
15. Stewart WF, et al. Cost of lost productive
work time among US workers with
depression. Jama. 2003;289(23):3135-
3144.
16. Hilton MF, et al. Mental ill-health and the
differential effect of employee type on
absenteeism and presenteeism. Journal of
Occupational and Environmental Medicine.
2008;50(11):1228-1243.
17. Adler DA, et al. Job performance deficits
due to depression. American Journal of
Psychiatry. 2006;163(9):1569-1576.
18. Burton WN, et al. The association of
worker productivity and mental health: A
review of the literature. International
Journal of Workplace Health Management.
2008;1(2):78-94.
19. Fritz C, Lam CF, Spreitzer GM. It's the little
things that matter: An examination of
knowledge workers' energy management.
Academy of Management Perspectives.
2011;25(3):28-39.
20. Saifullah H, Li J. Workplace employee’s
annual physical check-up and during hire
on the job to increase health care-
awareness perception to prevent diseases
risk: A work for policy implementable
option to global. Safety and Health at
Work; 2018.
21. Bowen GA. Document analysis as a
qualitative research method. Qualitative
research journal. 2009;9(2):27-40.
22. DiPilato IV, J. The Benefits of Lunch
Breaks; 2016.
23. De Bloom J, et al. Effects of park walks
and relaxation exercises during lunch
breaks on recovery from job stress: Two
randomized controlled trials. Journal of
Environmental Psychology. 2017;51:14-30.
24. Willert MV, et al. Sleep and cognitive
failures improved by a three-month stress
management intervention. International
journal of stress management. 2010
;17(3):193.
25. Dobbie K. Fatigue-related crashes: An
analysis of fatigue-related crashes on
Australian roads using an operational
definition of fatigue; 2002.
26. Silva K, et al. Barriers associated with
frequency of leisure‐time physical activity
among B razilian adults of different income
strata. Scandinavian journal of medicine &
science in sports. 2016;26(2):206-213.
27. Kim C, Cho Y. Working conditions and
leisure-time physical activity among waged
workers in South Korea: A cross-sectional
study. Journal of occupational health.
2015;14-0028-OA.
28. Lauer EE, et al. Meeting usdhhs physical
activity guidelines and health outcomes.

Hakro et al.; JPRI, 33(38B): 84-97, 2021; Article no.JPRI.70900
96
International journal of exercise science.
2017;10(1):121.
29. Hallal PC, et al. Evolution of the
epidemiological research on physical
activity in Brazil: A systematic review.
Revista de saude publica. 2007;41(3):453-
460.
30. Pedersen BK, Saltin B. Exercise as
medicine–evidence for prescribing
exercise as therapy in 26 different chronic
diseases. Scandinavian journal of
medicine & science in sports. 2015;25:1-
72.
31. Durstine JL, et al. Chronic disease and the
link to physical activity. Journal of sport
and health science. 2013;2(1):3-11.
32. Heslop P, et al. Sleep duration and
mortality: the effect of short or long sleep
duration on cardiovascular and all-cause
mortality in working men and women.
Sleep medicine. 2002;3(4):305-
314.
33. Health CFM. The economic and social
costs of mental health problems in
2009/10. Centre for Mental Health London;
2010.
34. Kessler RC, et al. Individual and societal
effects of mental disorders on earnings in
the United States: results from the national
comorbidity survey replication. American
Journal of Psychiatry. 2008;165(6):703-
711.
35. Greenberg PE, et al. The economic burden
of depression in the United States: how did
it change between 1990 and 2000?
Journal of clinical psychiatry.
2003;64(12):1465-1475.
36. Böckerman P, Ilmakunnas P. The job
satisfaction-productivity nexus: A study
using matched survey and register data.
ILR Review. 2012;65(2):244-262.
37. Darr W, Johns G. Work strain, health, and
absenteeism: a meta-analysis. Journal of
occupational health psychology.
2008;13(4):293.
38. Rosenfield S, Mouzon D. Gender and
mental health, in Handbook of the
sociology of mental health. Springer.
2013;277-296.
39. Patton E, Johns G. Women's absenteeism
in the popular press: Evidence for a
gender-specific absence culture. Human
Relations. 2007;60(11):1579-1612.
40. Foster RG, et al. Sleep and circadian
rhythm disruption in social jetlag and
mental illness, in Progress in molecular
biology and translational science. Elsevier.
2013;325-346.
41. Mezick EJ, et al. Intra-individual variability
in sleep duration and fragmentation:
Associations with stress.
Psychoneuroendocrinology.
2009;34(9):1346-1354.
42. Fuligni AJ, Hardway C. Daily variation in
adolescents' sleep, activities, and
psychological well‐being. Journal of
Research on Adolescence.
2006;16(3):353-378.
43. Johns G. Presenteeism in the workplace:
A review and research agenda. Journal of
Organizational Behavior. 2010;31(4):519-
542.
44. Schultz AB, Edington DW. Employee
health and presenteeism: a systematic
review. Journal of occupational
rehabilitation. 2007;17(3):547-579.
45. Gründemann R, Nijboer I, Schellart A. The
work-relatedness of drop-out from work for
medical reasons. Ministry of Social Affairs
and Employment, Den Haag; 1991.
46. Rajgopal T. Mental well-being at the
workplace. Indian journal of occupational
and environmental medicine.
2010;14(3):63.
47. Lack LC. Delayed sleep and sleep loss in
university students. Journal of American
College Health. 1986;35(3):105-
110.
48. Levandovski R, et al. Depression scores
associate with chronotype and social jetlag
in a rural population. Chronobiology
international. 2011;28(9):771-778.
49. Gillberg M, et al. The effects of a short
daytime nap after restricted night sleep.
Sleep. 1996;19(7):570-575.
50. Sallinen M, et al. Promoting alertness with
a short nap during a night shift. Journal of
Sleep Research. 1998;7(4):240-247.
51. Blake M. Time of day effects on
performance in a range of tasks.
Psychonomic science. 1967;9(6):
349-350.
52. Dinges DF, Broughton RJ. Sleep and
alertness: Chronobiological, behavioral,
and medical aspects of napping. Raven
Press; 1989.
53. Mitler MM, et al. Catastrophes, sleep, and
public policy: consensus report. Sleep.
1988;11(1):100-109.

Hakro et al.; JPRI, 33(38B): 84-97, 2021; Article no.JPRI.70900
97
54. DMSc MT, DMSc HA. Maintenance of
alertness and performance by a brief nap
after lunch under prior sleep deficit. Sleep.
2000;23(6):813.
55. Gooley JJ. How much day-to-day
variability in sleep timing is unhealthy?
Sleep. 2016;39(2):269-270.
56. Blaug R, Kenyon A, Lekhi R. Stress at
work: A report prepared for the work
foundation’s principal partners; 2007.
57. Levin-Epstein M. Tackle workplace stress
to improve productivity, reduce
absenteeism. Staff Leader.
2002;15(12):89-97.
58. Tworoger SS, et al. Factors associated
with objective (actigraphic) and subjective
sleep quality in young adult women.
Journal of psychosomatic research,
2005;59(1):11-19.
59. Wittmann M, et al. Social jetlag:
Misalignment of biological and social time.
Chronobiology international. 2006;23(1-2)
:497-509.
60. Gilbert DT, Fiske ST, Lindzey G. The
handbook of social psychology. Oxford
University Press. 1998;2.
61. Charles B, et al. Association between
stigma, depression and quality of life of
people living with HIV/AIDS (PLHA) in
South India–a community based cross
sectional study. BMC Public Health.
2012;12(1):463.
62. Hernandez SH, Morgan BJ, Parshall MB.
Resilience, stress, stigma, and barriers to
mental healthcare in US Air Force nursing
personnel. Nursing research.
2016;65(6):481.
63. Hatzenbuehler ML, Phelan JC, Link BG.
Stigma as a fundamental cause of
population health inequalities. American
journal of public health. 2013;103(5):813-
821.
64. Evoy K. The doctor is in: A chronic
stress audit. CA Magazine.
1998;131(5):30-2.
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