"Using panel data from 2004 and 2011, the authors find an elevated incidence of work-related ailments (associated with bones, muscles, and joints) in U.K. establishments that use individual performance pay, even after accounting for establishment fixed effects. Fixed-effect estimates also confirm a positive relationship between absence due to illness and performance pay. The elevated rates of ailments associated with performance pay appear to reduce financial performance and product quality, even though performance pay has a positive net influence on financial performance. Thus, a hidden cost of performance pay is occupational health deterioration. Parallel results are absent for labor productivity and, in a smaller sample, for profit."

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