Those of us who have been caring for our parents know very well the physical toll it takes. I helped care for my dad for 18 months. And after he died, one of the first things I did was make an appointment to see my own doctor. I had never felt so exhausted and worn out in my life.

Now, an important new study describes the health effects of caregiving on workers. And the picture is not pretty. Women caregivers over 50 are twice as likely to report fair or poor health than those not caring for elderly relatives. Men are more likely to smoke. Blue-collar workers are more likely to drink. And caregivers across the board report higher rates of depresssion, diabetes, hypertension, and pulmonary disease.

Overall, the study estimates these workers cost their employers an average of 8 percent more in health care costs, or $13 billion annually. And that’s on top of an earlier study that suggests absent or distracted caregivers cost their companies between $17 billion and $33 billion in lost productivity. The toll on these adult children and their employers is enormous.

The new report, called “The MetLife Study of Working Caregivers and Employer Health Care Costs” is a joint project of the MetLife Mature Market Institute, the National Alliance for Caregiving and the University of Pittsburgh.