Why employees go to work even when ill

High job demands, stress and insecurity are among the main reasons why people go to work even when they are not well and are advised to rest, new research indicates.

The study aims to improve understanding of the key causes of employees going to work when sick known as presenteeism and to help make bosses more aware of the existence of the growing phenomenon.

According to the lead author Dr Mariella Miraglia, lecturer in organisational behaviour at University of East Anglia (UEA), presenteeism is associated with work and personal factors and not just medical conditions.

"Working while ill can result in negative job attitudes and withdrawal from work. However, the possible negative consequences of being absent can prompt employees to show up ill or to return to work when not totally recovered," Dr Miraglia explained.

A key finding is that presenteeism not only stems from ill health and stress but also from raised motivation like high job satisfaction and a strong sense of commitment to the organisation.

"This may motivate people to 'go the extra-mile', causing them to work more intensively, even when sick," the authors wrote.

One of the significant links to presenteeism is the severity of organisational 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.

In previous research presenteeism was associated with both negative and positive effects on employee productivity and welfare, with contradictory causes and consequences for individuals and organisations.

The research analysed data from 61 previous studies involving more than 175,960 participants, including the European Working Conditions Survey which sampled employees from 34 countries.

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," the authors noted.

Those who had a supportive work environment felt they did not have to go to work when ill, and were both more satisfied with their jobs and healthier.

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

"Workplace wellness and health programmes may be desirable to reduce stress and work-related illness.

Organisations may benefit from well-designed jobs that limit the level of demands to which employees are exposed to every day, for example by reducing excessive workload, time pressure and overtime work.

The management needs to understand what triggers presenteeism and what can be done to improve employees' health and productivity, said the paper published in the Journal of Occupational Health Psychology.

"Organisations may want to carefully review attendance policies which could decrease absence at the cost of increased presenteeism," the authors noted.