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Impacts of Presenteeism

When Sick Employees Show Up for Work, Productivity Suffers

December 9, 2015  By UEA

Do your employees feel pressured to work even while sick? Photo: Fotolia

January 2016 — High job demands, stress and job insecurity are among the main reasons why people go to work when they are ill, according to new research by a researcher at the University of East Anglia (UEA) in the U.K.

The study aims to improve understanding of the key causes of employees going to work when sick, known as presenteeism, and to help make managers more aware of the existence of the growing phenomenon, what triggers the behaviour, and what can be done to improve employees’ health and productivity.

A key finding of the study, published in the Journal of Occupational Health Psychology, is that presenteeism not only stems from ill health and stress, but from raised motivation – for example high job satisfaction and a strong sense of commitment to the organization. This may motivate people to “go the extra-mile,” causing them to work more intensively, even when sick.


One of the significant links to presenteeism is the severity of organizational policies used to monitor or reduce staff absence, such as strict trigger points for disciplinary action, job insecurity,
limited paid sick leave, or few absence days allowed without a medical certificate.

The research analyzed data from 61 previous studies involving more than 175,960 participants.

Lead author Dr. Mariella Miraglia, a lecturer in organizational behaviour at UEA’s Norwich Business School, argues that presenteeism is associated with work and personal factors, not just medical conditions. These factors are more strongly related to – and so are more able to predict – presenteeism than absenteeism.

In previous research, presenteeism has been associated with both negative and positive effects on employee productivity and welfare, with contradictory causes and consequences for individuals and organizations. It has been linked to errors, lower performance, exacerbating health problems and affecting wellbeing, with more productivity loss than absenteeism. The Centre for Mental Health calculated that presenteeism from mental ill health alone costs the U.K. economy about $30 billion a year.

“Working while ill can compound the effects of the initial illness and result in negative job attitudes and withdrawal from work,” said Miraglia, who worked with Dr. Gary Johns of Concordia University in Montreal. “However, the possible negative consequences of being absent can prompt employees to show up ill or to return to work when not totally recovered.”

Job demands, such as workload, understaffing, overtime and time pressure, along with difficulty of finding cover and personal financial difficulties, were found to be key reasons why people might not take a day off. Conflict between work and family, and vice versa, and being exposed to harassment, abuse and discrimination at work were also positively related to presenteeism. This is because these negative experiences can exacerbate stress and harm health, requiring employees to choose between going to work and staying away.

“Because presenteeism is more predictable than absenteeism, it is easy to modify by management actions,” Miraglia said.

“Workplace wellness and health programs may be desirable to reduce stress and work-related illness. Furthermore, although increasing job resources, such as job control and colleague, supervisor, and organisational support, can be helpful in tackling presenteeism through their positive impact on health, our results suggest that controlling job demands represents a key line of defence against the behaviour.”

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