Presenteeism or working while sick can cause productivity loss, poor health, exhaustion and workplace epidemics . While the contrasting subject of absenteeism has historically occurred extensively in the management of science , it has only recently been studied. [1]

Certain occupations such as welfare and teaching are more prone to presenteeism. Doctors may be waiting for work while feeling sick of being irreplaceable. Jobs with large workloads are associated with presenteeism. People whose self-esteem is based on performance, as well as workaholics , typically have high levels of presenteeism.

Presenteeism can have many motives. [1] An employee may come to work because they simply need money and can not afford to take care of illness. In addition, one could go to work due to a love and devotion to the job. In this case, presenteeism could be considered an act of organizational citizenship and inspire admiration from colleagues. [1]

Construct validity

Scholars have provided various other descriptions of the concept. For instance, Simpson claimed that presenteeism is “the tendency to stay at work beyond the time needed for effective performance on the job.” [2] Aronsson, Gustafsson, and Dallner wrote that it works even when it feels unhealthy. [3] In a recent review of the literature, Johns highlighted the lack of agreement between the definitions. [1] The author claims that many of the definitions are lacking and that the term is more often defined as it works. He further Top Noted That definitions of presenteeism, qui are centered there Attending work while sick, more-have received evidence of construct validity. In other words, when defined as work while sick, presenteeism seems to report more to logical outcome variables and correlates. [1]

Simply viewing presenteeism has a negative action that leads to a reduction in the likelihood [1]

Relationship with absenteeism

In some cases, scholars report presenteeism to absenteeism , which is the tendency to show up for scheduled work. [1] Furthermore, Johns described the notion that some believe that the factors that reduce absenteeism will increase presenteeism. [1] He stated, however, that this is plausible but not always the case because he pointed out that Aronsson et al. found high rates of presenteeism in industries where absenteeism was also high. [3]

In addition, research that examines absenteeism is at times used to draw conclusions about presenteeism. For example, Virtanen, Kivimaki, Elovainio, Vahtera, and Ferrie found that workers exhibited higher rates of absenteeism than they became permanent workers. [4] The authors thought that this increase could be attributed to the preexisting levels of presenteeism. However, they did not directly measure presenteeism. Commenting on such research behavior, Johns said in his review of the literature that researchers should not infer presenteeism from absenteeism data. Instead, the author noted that both constructs should be measured at the same time. [1]


Temporary and permanent employment

Temporary and permanent employment are often considered when discussing the antecedents of presenteeism. More SPECIFICALLY, Researchers Studied thesis-have positions with the Thought That Lack of job security will because Those Who do not-have permanent positions to come to work more Often Even If They Are Sick. [1] This hypothesis, however, has not received complete support. Aronsson et al. discovered that they are more likely to be in those positions. [3] In contrast, Aronsson and Gustafson found no effect of job type. [5]Furthermore, Heponiemi et al. Bockerman and Laukkanen supported this finding. [6] [7] Based on these inconclusive results, Johns noted that researchers had to reconsider the job insecurity hypothesis. [1]

Occupations and work environments

Individuals working in certain occupations may be more prone to presenteeism. In a study in Sweden, Aronsson et al. founding the highest rates of presenteeism. [3] The authors pointed out that these people are working with people in the vulnerable population such as the elderly. Outside of education and healthcare, most of the occupations had lower rates of presenteeism; however, the results did not suggest that higher levels of stress , higher levels of presenteeism. Some work environments may stimulate presenteeism. To explore this topic, Dew, Keefe, and Smaller quality-tested private hospital, a large public hospital, and a small factory. [8]In the private hospital, there is little pressure of management to exhibit presenteeism; However, a sense of family seems to exist between the staff, and a strong loyalty to coworkers, pushed employees to come to work while unhealthy. The public hospital had a remote management, but was fostered by “loyalty to professional image, colleagues, and the institution as a whole.” [8] Finally, in the factory, there is strong pressure of management for employees to exhibit presenteeism. Furthermore, workers often had few other employment options, which often resulted in increased presenteeism.

Ease of replacement

The ease with which one can be replaced also with the levels of presenteeism. Specifically, if one feels that it is more difficult to wait for work while sick. [5] [7] Doctors are often examined in this regard. For example, Jena et al. The authors of the study of high performance of presenteeism, which they concluded, were the result of feeling irreplaceable. [9] Further extending the examination of the medical field, McKevitt, Morgan, Dundas, and Holland study of health professionals and more than 80 percent of respondents had worked while ill. Individuals listed some of the reasons they had not taken sick days, and many cited fact that they felt large pressure to work. [10]In Some cases, General Practitioners Did not want to burden Their partners, And Many felt a strong commitment to the job Them That Prevented from Taking sick leave .

Workloads and job demands

Jobs that have large workloads and many demands are often associated with higher levels of presenteeism. Caverely, Cunningham, and Macgregor firms Canadian firms and noted that this is often the result of job insecurity. [11]Instead they felt they had to come back to work because they had a lot of workloads, many deadlines, and often very little backup support. Complementing this finding, McKevitt et al. They would have worked their way up if they did not go to their job. [10] Moreover, Demerouti, Le Blanc, Bakker, Schaufeli, and Hox, have had a positive relationship with presenteeism. [12] In the case of this study, the authors defined job demands as aspects of the job that require physical and / or psychological effort.


Those who exhibit workaholism tend to demonstrate higher levels of presenteeism. As defined by Schaufeli, Bakker, van der Heijden, and Prins, workaholics tend to work excessively and compulsively, and they are internally motivated to work to an excessive extent. [13] In addition to their high levels of presenteeism, Schaufeli et al. They are not defined as workaholics. [13]

Performance-based self-esteem

Performance-based self-esteem (PBSE) has also been considered another antecedent of presenteeism. This term describes the idea that individuals’ self-esteem may depend on their performance. [14] Employees who demonstrate high levels of this construct to their worth while on the job. Love et al. found that PBSE positively predicted presenteeism; However, the authors also found that the relationship between PBSE and presenteeism was high. [14] This finding suggests that demanding work environments could interact with higher levels of performance. [14]

Health factors

Certain health factors serve as risk factors for presenteeism as opposed to absenteeism. Boles, Pelletier, and Lynch examined a variety of emotional and physical symptoms and reported high rates of stress. [15] Those with poorer diet and less effective fulfillment of these conditions than prescribing these conditions. The researchers noted that patients with diabetes reported to report higher levels of absenteeism . Individuals who share part of the physical activity were more likely to report higher levels of both absenteeism and presenteeism compared to those who took part in some physical activity.


Productivity loss

One consequence of presenteeism is productivity loss, and scholars have attempted to estimate these productivity numbers. While considering productivity decreases, however, it is implied that losses are measured relative to not having a particular sickness or health issue. [1] Also, in comparison to being absent from a job, those exhibiting presenteeism may be far more productive. Nonetheless, a large study by Goetzel et al. estimated that on average in the United States, an employee’s presenteeism costs or lost on-the-job productivity are approximately $ 255. [16]Moreover, the authors argue that they may be attributable to on-the-job productivity losses. Complementing that study, Schultz and Edington provided a detailed review of the effects of certain health conditions on productivity. [17] These authors examined conditions such as allergies, arthritis, chronic pain, diabetes, and mental health disorders. The studies in the review showed, for example, that increases in pollen are associated with decreased performance. [18] Moreover, Schultz and Edington noted that it is much easier to understand productivity than productivity. [17]

Poor health and exhaustion

Exhaustion and future poor health are often other consequences of presenteeism. For example, Bergstrom, Bodin, Hagberg, Aronsson, and Josephson found that sickness presenteeism was a risk factor for future sick leave . [19]Furthermore, in their study of job demands and presenteeism, Demerouti et al. found that presenteeism resulted in increased exhaustion. [12]

Presenteeism can also have an effect on occupational injuries for workers. A 2012 study from the National Institute for Occupational Safety and Health showed that they were 28% less likely to be affected than those who were sick. [20]

Workplace epidemics

In the case of an infectious disease such as influenza, a culture of presenteeism will inevitably also lead to further infections throughout the workforce, compounding the ill-effects and leading to a much larger problem. In a 2014 survey by Canada Life Insurance, 80% of respondents reported that they had become ill. [21]

Measurement of presenteeism and its impact on productivity

Scholars have often measured presenteeism in terms of how often an individual attends work while unhealthy. For instance, Aronsson et al. They should have taken sick leave. [3] Respondents could choose from never, ounce, between two and five times, and more than 5 times. Other researchers reviewed the frequency of presenteeism by asking participants a similar question. The responses, however, were on a scale of “spells of one day presenteeism, spells of 2-4 day presenteeism, and spells of 5 day or more presenteeism.” [22]

Aside from measuring the frequency of presenteeism, researchers often look at the effects of poor health on job productivity. The Work Limitations Questionnaire (WLQ) is often used to perform this task. [23] With 25 items, it examines the extent to which respondents can handle time, physical, mental-interpersonal, and output demands. The Stanford Presenteeism Scale seeks to determine the effects of health on productivity. It measures participants’ abilities to concentrate and perform work despite having a primary health problem. [24]Using six items, they determine their extent to which they agree to their work. The scale measures two factors that the authors labeled as requiring work and avoiding distraction. Finally, another measure is used by the World Health Organization Health and Work Performance Questionnaire (HPQ). [25] This self-report measures acquires information about their performance and performance . The WLQ and HPQ have become the most popular instruments; [17] However , one of the two approaches has been created to estimate the effects of health on productivity. [26]

Implications for practice

Given the prominence and costs of presenteeism, scholars have suggested a variety of courses of action for employers. Companies should implement their programs for their employees and increase their productivity. These organizations, however, must be aware that the effects of these programs may have an immediate impact on their presentation as simply absenteeism. Firms must be cognizant of this fact when evaluating the effectiveness of their programs. [11] Complimenting this suggestion, Schultz and Edington wrote that they need to be educated effectively to better manage their health. [17] They also commented on the importance of high-risk health conditions. In theUnited States , one other proposed response In November 2006, San Francisco became the first jurisdiction to pass such a law. [27]

Future directions and research

While progress has been made in view of understanding presenteeism, many possible topics of inquiry still remain. In his literature review, Johns said that presenteeism had to be related to other constructs such as work attitudes and personality. [1] Additionally, lessons from absenteeism could be applied to presenteeism. For instance, absenteeism may be de fi ned as voluntary and involuntary, and may be considered as applying such ideas to presenteeism. Lastly, the construct could be related to other elements of the work. Specifically, how does presenteeism relate to telework ? Is an individual who works from home while he or she is sick exhibiting presenteeism?

See also

  • absenteeism
  • Karoshi
  • Leaveism
  • Construct validity
  • Perfect attendance award
  • Self-esteem
  • Sick leave
  • workaholic
  • Work-life balance
  • Workload


  1. ^ Jump up to:m Johns, G. (2010): Presenteeism in the Workplace: A review and research agenda. Journal of Organizational Behavior, 31, 519-542. doi : 10.1002 / job.630
  2. Jump up^ Simpson, R. (1998). Presenteeism, Power and Organizational Change: Long hours as a career barrier and the impact on the working lives of women managers. British Journal of Management , 9, S37-S50. doi:10.1111 / 1467-8551.9.s1.5
  3. ^ Jump up to:e Aronsson, G. Gustafsson, K., & Dallner, M. (2000). Sick but yet at work. An empirical study of sickness presenteeism. Journal of Epidemiology and Community Health , 54, 502-509. doi : 10.1136 / jech.54.7.502
  4. Jump up^ Virtanen, M. Kivimaki, M., Elovainio, J., Vahtera, J., & Ferrie, JE (2003). From insecure to secure employment: Changes in work, health, health related behaviors, and sickness absence. Journal of Occupational and Environmental Medicine, 60, 948-953. doi:10.1136 / oem.60.12.948
  5. ^ Jump up to:b Aronsson, G. & Gustafsson, K. (2005). Sickness presenteeism: Prevalence, attendance-pressure factors, and an outline of a model for research. Journal of Occupational and Environmental Medicine , 47, 958-966. doi : 10.1097 / 01.jom.0000177219.75677.17
  6. Jump up^ Heponiemi, T., Elovainio, M., Pentti, J., Virtanen, M., Westerlund, H., Virtanen, P., Oksanen, T., Kivimäki, M., Vahtera, J. (2010) . Association of contractual and subjective job insecurity with sickness presenteeism among public sector employees. Journal of Occupational and Environmental Medicine, 52, 830-835. doi:10.1097 / JOM.0b013e3181ec7e23
  7. ^ Jump up to:b Böckerman, P. & Lakkenen, E. (2010). What makes you work while you are sick? Evidence from a survey of workers. European Journal of Public Health , 20, 43-46. doi : 10.1093 / eurpub / ckp076
  8. ^ Jump up to:b Dew, K. Keefe, V., & Small, K. (2005). ‘Choosing’ to work when sick: Workplace presenteeism. Social Science & Medicine , 60, 2273-2282.
  9. Jump up^ Jena, A., Baldwin, D., Daugherty, S., Meltzer, D., & Arora, V. (2010). Presenteeism among resident physicians. Journal of the American Medical Association, 304, 1166-1168. doi:10.1001 / jama.2010.1315
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  12. ^ Jump up to:b Demerouti, E., Le Blanc, PM, Bakker, AB Schaufeli, WB, & Hox, J. (2009). Present but sick: A three-wave study on job demands, presenteeism and burnout. Career Development International , 14, 50-68. doi : 10.1108 / 13620430910933574
  13. ^ Jump up to:b Schaufeli, W. Bakker, A., van der Heijden, F., & Prins, J. (2009). Workaholism among medical residents: It is the combination of working excessively and compulsively that counts. International Journal of Stress Management , 16, 249-272. doi : 10.1037 / a0017537
  14. ^ Jump up to:c Love, J., Grimby-Ekman, A., Eklof, M., Hagberg, M., & Dellve, L. (2010). “Pushing oneself too hard”: Performance-based self-esteem as a predictor of sickness presenteeism among young adults and men-A cohort study. Journal of Occupational and Environmental Medicine , 52, 603-609. doi : 10.1097 / JOM.0b013e3181dce181
  15. Jump up^ Boles, M., Pelletier, B., & Lynch, W. (2004). The relationship between health risks and work productivity. Journal of Occupational and Environmental Medicine, 46, 737-745. doi:10.1097 / 01.jom.0000131830.45744.97
  16. Jump up^ Goetzel, RZ, Long, SR, Ozminkowski, RJ, Hawkins, K., Wang, S., & Lynch, W. (2004). Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions. Journal of Occupational and Environmental Medicine, 46, 398-412. doi:10.1097 /
  17. ^ Jump up to:d Schultz, AB, & Edington, DW (2007). Employee health and presenteeism: A systematic review. Journal of Occupational Rehabilitation, 17, 547-579. doi : 10.1007 / s10926-007-9096-x
  18. Jump up^ Burton, W., Conti, D., Chen, C. Schultz, A., & Edington, D. (2001). The impact of allergies and allergy treatment on productivity. Journal of Occupational and Environmental Medicine, 43, 64-71. doi:10.1097 / 00043764-200101000-00013
  19. Jump up^ Bergström, G., Bodin L. Hagberg, J., Aronnson, G., & Josephson, M. (2009). Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. Journal of Occupational and Environmental Medicine, 51, 629-638. doi:10.1097 / JOM.0b013e3181a8281b
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  21. Jump up^ Presenteeism: a ticking workplace timebomb?
  22. Jump up^ Munir, F., Yarker, J., Haslam, C., Long, H., Leka, S., Griffeths, A., & Cox, C. (2007). Work factors related to psychological and health-related distress among employees with chronic illnesses. Journal of Occupational Rehabilitation, 17, 259-277. doi:10.1007 / s10926-007-9074-3
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  25. Jump up^ Kessler, R., Barber C., Beck A., Berglund, P., Clearly, P., McKenas, D., Pronk, N., Simon, G., Stang., P., Ustun, T . & Wang, P. (2003). The World Health Organization Health and Work Performance Questionnaire (HPQ). Journal of Occupational and Environmental Medicine, 45, 156-174. doi:10.1097 / 01.jom.0000052967.43131.51
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  27. Jump up^ Zappone, christian “Paid sick leave may be next big cause.” CNN Money (November 17, 2006)

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