Presenteeism: Why do people decide to work despite being sick?

The nature of work has changed rapidly in the last few years, mainly due to economic and social evolution, the globalisation of business practices, diversity in work and technological advances.

These changes have given rise to new challenges and problems for organisations and for employees, forcing the reshaping of the experience of people in their working lives in Western countries, and the reassessment of the understanding of the relationship dynamics. between the worker, his environment and his health.

Thus, there is a need for organisations to adapt to these environmental demands as the “survival of the fittest”. These changes and pressures have had negative consequences for the lives of workers, meaning that they are under increasing pressure to compete, adapt and learn new skills in order to meet the demands of their work.

In addition, in the wake of the global economic recession, a significant number of organisations have resized, trying to do more with less. Thus, the work environment has changed drastically, and it could be said that the prevalence of presenteeism associated with job insecurity may have increased.

The term presenteeism is used to refer to attendance at work, despite being sick, and to the decrease in productivity that can result from this act (Robertson & Cooper, 2011).

Other definitions indicate that this phenomenon can be described as when employees are physically present, but due to a physical or emotional problem, they become distracted to the point of reducing their productivity.

In the last decade, presenteeism has received increasing attention from academics and practitioners alike. Current findings suggest that presenteeism could be considered as a health problem not only caused by individual factors as medical research has often assumed, but also influenced by working conditions to a considerable degree.

The costs of presenteeism are high for both business and employee health and can result in significant productivity losses costing organisations billions of dollars a year. Different studies have calculated that the total economic burden of presenteeism for the United States economy ranges from 150 to 250 billion dollars per year (authors found that costs of presenteeism related to chronic conditions comprise approximately 61% of the overall cost of chronic conditions,7 or 6.8% of all of the labour costs, compared with 2.9% for medical care and 1% for absenteeism) and in the United Kingdom the costs amount to 15b pounds, losses that are much higher than those derived from absenteeism (Robertson & Cooper, 2011).

Recent researches carried out in Europe point out that the annual costs for presenteeism are predicted to be higher than for absenteeism, costing German companies 2399 Euro per employee for presenteeism and 1199 Euro per employee for absenteeism (Schmid et al 2017). Vänni et al. (2016) in a research conducted in Finland, conclude that the lowest annual presenteeism cost per employee was EUR 986 and the highest EUR 1302. The lowest number of presenteeism days per employee was 8.7 days and the highest number was 10.4 days in a year. Estimated losses to a company due to sickness absences and presenteeism ranged from EUR 4.6 million to EUR 5.6 million annually.

Presenteeism that is maintained continuously could trigger a spiral of deterioration in health conditions, becoming chronic in the long term. In other words, if employees go to work despite physical or psychological discomfort, depriving themselves of recovery opportunities, they could suffer even more due to the accumulation of tiredness and fatigue. By following this process, employees can further compound the problem of lost productivity as they continue to come to work despite illness recovery processes resulting in increased absenteeism rates, leading to increased downward spiral of productivity as employees do not perform their function to the fullest and, subsequently, over time, do not show up to work.

In the long term, presenteeism can cause serious problems in the physical and mental health of workers. Thus, there are significant associations between presenteeism and health risk factors such as stress, poor eating behaviour, smoking and alcohol consumption, blood pressure or diabetes. Some research has also found a relationship between presenteeism and the appearance of headaches, back and neck pain, stomach symptoms, fatigue, depressive symptoms, and malaise.

In this way, organisations should pay more attention to the act of presenteeism of employees to help deal with work stress and personal discomfort more effectively. However, despite the fact that there is a strong call for work design measures to avoid presenteeism, studies on this phenomenon are still scarce, and more research is necessary in order to develop more effective and effective worker health interventions, improve their productivity, also reducing losses for organisations.

Hugo Figueiredo-Ferraz

Director of Master’s degree in Occupational Health and Safety

Valencia International University (VIU)