Going to Work When Sick May Lead to Future Absences

June 10, 2009

Employees who often go to work despite feeling sick have higher rates of future work absences due to illness, according to a study in the June Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).The findings raise the possibility that measures attempting to decrease work absences could inadvertently have the opposite effect, if they encourage workers to come to work when sick.

Led by Gunnar Bergström, Ph.D., of Karolinska Institutet, Stockholm, the researchers evaluated whether going to work despite illness—called "sickness presenteeism"—affects future sickness absenteeism. The study included two groups of workers: about 3,750 public sector employees, mainly female; and 2,500 private-sector employees, mainly male.

Workers with more days going to work sick also had more days absent because of illness. In the first year of the study, 19 percent of public sector workers and 13 percent of private sector workers had more than five sickness presenteeism days. For these workers, the risk of having more than 30 days of sickness absenteeism the following year was 40 to 50 percent higher, after adjustment for other factors.Recent studies have shown that sickness presenteeism is common—most employees say they go to work sick at least sometimes. Poor health is one likely risk factor for sickness presenteeism, but other job-related and personal factors could also play a role.

The new study suggests that employees with a lot of sickness presenteeism days also have more sickness absenteeism days. This may indicate the health-promoting aspects of taking sick leave when appropriate, as shown by previous studies.

The results also raise concerns that efforts to decrease sickness absence could wind up having the opposite effect. Discouraging workers from staying home when they are sick could lead to increased sickness presenteeism, and thus inadvertently increase sick leave. "This underscores the importance of sickness presenteeism in the evaluations of such interventions and considering the effects from a long-term perspective," Dr. Bergström and co-authors conclude.