Much attention has been focused on absenteeism. However, ‘presenteeism’ is also an issue, i.e. staying at work even when feeling sick. Analyses have shown that, the greater the work pressure, the higher the percentage of people who keep working when feeling sick.
Many studies have focused on the determinants of absenteeism. Only one study (Aronsson et al, 2000) examines factors causing presenteeism. Presenteeism is the feeling that one must show up for work even if one is too sick, stressed or distracted to be productive. New results are now available from a recent survey of the Dutch work force. The analyses follow and elaborate further the Swedish study by Aronsson.
In 2002, the second TNO Work Situation Survey was carried out, with over 4,000 employees and self-employed workers completing the questionnaire (a response rate of 45%). The survey questions had been tested in a previous study and included items related to demography, the work contract, the company, the work situation, and health and well-being.
The question on presenteeism was derived from Aronsson’s study: ‘During the last 12 months, did it happen that you went to work, even when you thought you should report sick?’ There were three response options: ‘no’; ‘yes, one time’; ‘yes, more than once’.
A large proportion of the Dutch work force (63.2%) reported being present at work but feeling sick. Analyses show that presenteeism is lower when workers consider that their health is good. This is to be expected but, interestingly, other strong explanatory factors include the work organisation itself as well as certain worker characteristics.
Working under pressure was strongly related to presenteeism: the higher the work pressure, the higher the level of presenteeism (see figure). It seems that work pressure not only implies feeling pressured at work, but also feeling pressured to attend. Other significant explanatory factors of high presenteeism are: being male, being young, having low or extremely high autonomy, and having low job security. Presenteeism was low among workers on a part-time contract with a low number of hours (eight hours or less per week), and also among workers who are satisfied with their pay.
It may thus be concluded that, although Dutch workers more often report being absent at work, compared with other European workers, a considerable number of Dutch workers who do feel sick decide not to absent themselves, but to attend work. Motivating factors include other work and worker-related factors, beyond simply good health or not feeling very sick. Work pressures to attend, high work pressure and the worker characteristics outlined above explain to a large extent the issue of presenteeism even when feeling ill.
Aronnson, G., Gustafsson, K. and Dallner, M., ‘Sick but yet at work; an empirical study of sickness presenteeism’, Journal of Epidemiological & Community Health , 54, 2000, pp. 502-9.