A Preliminary Investigation of Health and Work-Environment Factors on Presenteeism in the Workplace

Exploring the working conditions of disabled employees: a scoping review

PURPOSE

Disabled people are often overlooked in considerations about work design, which contributes to their exclusion from the labor market. This issue also reflects within research, as the body of knowledge on the working conditions of disabled employees remains relatively limited.

METHODS

A scoping review was conducted to assess the research landscape concerning the working conditions of disabled employees. Five databases have been searched, focusing on relevant studies published between 2017 and 2022.

RESULTS

One hundred fourteen studies were included in the review. It was found that social aspects of work appeared within a substantial portion of the examined studies. Furthermore, it became evident that the interplay of accessibility and flexibility provides an important dynamic to make work design both inclusive and feasible.

CONCLUSION

The recurrent prominence of social aspects, accessibility, and flexibility across the studies shows common challenges and potentials within the work situation of disabled employees. This suggests avenues for future research and inclusive work design.

Health and Productivity Management in Hospital Organizations and Work Engagement of Nurses

Objective

In Japan, there is an urgent need to strengthen efforts to retain nurses and prevent high turnover. The Japan Nurses Association has set the goal of creating a supportive work environment for nurses to work with peace of mind and improve outcomes throughout their lives. Against this background, we examined the relationship between nurses' health and productivity management and their work engagement (WE) in Japanese hospital organizations.

Design

A cross-sectional design was used.

Methods

A web-based survey was administered to full-time employed nurses working in Japanese hospitals with 100 or more beds.

Results

Total WE scores were analyzed as the objective variable; WE crude odds ratios (ORs) were significantly higher in the high group than in the low group for all indicator items related to a healthy workplace culture. For adjusted ORs, propensity scores were calculated from gender, age, years of service, years of experience, job title, marital status, work shift, frequency of exercise per week, and hours worked per week and used as moderator variables. The results showed that the adjusted ORs for the high group were significantly higher than the adjusted ORs for the low group for all items except "participation of the person in charge from the planning stage of the initiative" and "reflection of the person in charge's opinion in the planning of the initiative."

Conclusions

This study suggests that health and productivity management initiatives in hospital organizations may positively impact nurses' WE. Furthermore, it suggests that these initiatives may contribute to improving nurse retention and preventing turnover.

Work limitations and associated factors in rheumatoid arthritis, axial spondyloarthritis, osteoarthritis and fibromyalgia

INTRODUCTION

Rheumatic and musculoskeletal diseases (RMD) impact on work participation. The aims of this study were to: examine work limitations of working people with: rheumatoid arthritis, axial spondyloarthritis (axSpA), osteoarthritis, or fibromyalgia using the Workplace Activity Limitations Scale (WALS, a measure of presenteeism); and identify personal, functioning and disability, and work contextual factors associated with presenteeism.

METHODS

Secondary analysis was conducted of a cross-sectional survey including work outcome measures (WORK-PROM study). A literature review identified variables (coded to ICF) to include in multivariable regressions examining factors associated with presenteeism.

RESULTS

Moderate to high WALS scores were identified in: 93.60% with FM; 69.90% OA; 65.20% RA; and 46.80% axSpA (n = 822). Similarities in work limitations were noted across conditions, although some more problematic in specific RMD. Participants received help with about a quarter of activities (27%RA; 25%FM; 23%OA; 17%axSpA) and work adaptations for less than a fifth causing difficulty (18%FM; 14%RA; 14%OA; 9%axSpA). Literature review identified 33 variables in the WORK-PROM dataset to include in multivariable regressions. Factors associated with higher WALS scores were worse: functional limitations, job strain, pain, difficulties with mental-interpersonal job demands, perceived health status, work-life balance, greater need for work accommodations and lack of perceived work support.

DISCUSSION

This study extends understanding of work limitations of working people with these four RMD, the extent of help and adaptations received, need for more work accommodation support, and focus on work support, work rehabilitation, and healthy workplace practices to help keep people working.

Changes in sick leave utilization at an academic medical center during the COVID-19 pandemic

Purpose

The coronavirus disease 2019 (COVID-19) pandemic drastically changed work arrangements, but COVID-19's impact on employee leave utilization is unclear. The authors sought to understand how sick leave and vacation leave utilization changed during the pandemic among clinical and non-clinical departments at an academic medical center (AMC).

Design/methodology/approach

Clinical departments were defined as work units with a primary mission of providing direct patient care. Per-person, per-month leave utilization data were obtained from the AMC's time-keeping system for 3 clinical departments and 4 non-clinical departments in the first 12 months of the pandemic and the preceding 12 months. Monthly data for each department were analyzed with mixed-effects regression.

Findings

Available data represented 402 employees from 3 clinical departments and 73 employees from 4 non-clinical departments. The authors found no statistically significant change in sick leave utilization among either clinical or non-clinical departments. Vacation leave utilization decreased during the pandemic by 5.9 h per person per month in non-clinical departments (95% confidence interval [CI]: −8.1, −3.8; p < 0.001) and by 3.0 h per person per month in clinical departments (95% CI: −4.3, −1.7; p < 0.001).

Originality/value

Among employees in clinical departments, the authors found no increase in sick leave utilization and a decrease in vacation utilization. These findings are concerning for presenteeism, risk of burnout or understaffing resulting in workers' inability to take time away from work in clinical departments.

The health-performance framework of presenteeism: A proof-of-concept study

There is emerging research that considers presenteeism as a neutral behavior that has both positive and negative predictors and outcomes for individuals and organizations. This neutral perspective diverges from the traditional negative view of presenteeism and is aligned with the Health-Performance Framework of Presenteeism (HFPF) in which presenteeism is considered to be an adaptive behavior that aims to balance health limitations and performance demands. This proof-of-concept study aims to investigate the existence of different profiles of presentees based on their common health problems (mental and physical) and performance, and differences in attendance and job stressors among these subgroups. Latent profile analysis with 159 clerical employees and managers from the UK private sector supported the HPFP and revealed four profiles: those reporting a good health and high performance were labeled functional presentees (who represented 19% of the sample), those with poor health and low performance were the dysfunctional presentees (14%), those with relatively high performance but poor health were labeled overachieving presentees (22%), and those with average scores on both dimensions were the average Joe/Jane presentees (45%; a new profile based on this sample). There was no profile in the present sample that corresponded to therapeutic presenteeism, characterized by low performance but relatively good health. Although average Joe/Jane presentees were comparable to functional presentees in exposure to most job stressors, they reported poorer pay and benefits, and more health problems than the latter. Average Joe/Jane presentees reported the lowest number of days of presenteeism. No difference was found in absenteeism across profiles, highlighting difficulties in measuring presenteeism using a count-measure, since three profiles presented a similar number of days of presenteeism yet contrasted health-performance configurations. Dysfunctional presentees were systematically more exposed to job stressors compared to functional presentees. The results support the HPFP proposition for different subgroups of presentees who are influenced by their work environment. The study takes a person-centered approach, disentangle presenteeism from the total count of presenteeism days, offering implications for management and intervention practice. Presenteeism can have a bright side and be functional in certain contexts when the appropriate resources are available.

The Interplay Between Poor Sleep and Work-Related Health

Objectives

Sleep disorders can arise from work. Employees who experience work overload are more likely to develop sleep problems. Poor sleep leads to decreased performance, sick leave, and accidents. Therefore, sleep disorders may be linked to workplace hazards as well as decreased occupational health, however, the relationship remains unknown.

Methods

This relationship was examined using secondary data analysis of aggregated survey data from 97 companies based in Germany between 2003 and 2020 as part of Workplace Health Management project. Two extreme groups with respect to sleep problems were analyzed (N = 4,865 + 9,795). The survey “Diagnosis of corporate health” contained 137 individual questions which recorded all relevant working conditions, aspects of health, and one question relating to insomnia traits. A one-way analysis of variance was used to examine whether and to what extent the potentials, hazards, and health aspects differed between employees depending on their perceived sleep problems. In addition, multiple linear regressions were used to determine whether and to what extent work characteristics affect various health aspects for both good and poor sleepers.

Results

In total, 49.7% of staff reported moderate difficulty falling and/or remaining asleep. These poor sleepers perceived all health potentials worse than good sleepers, especially on scales such as fair assessment, work climate, and learning at work. Furthermore, poor sleepers perceived health hazards (physical environmental stress, job insecurity, and time pressure) more whilst positive health indicators (joy of work and confidence) were perceived less.

Conclusion

Overall, the determination of sleep difficulties could be used as a substantial health indicator. Also, these sleep problems are reported more frequently in certain occupations compared to others, which could mean that the perception of sleep health varies between professions. Therefore, it is important to implement specific recommendations for each industry in order to improve working conditions for poor sleepers which in turn, improves their health.

Associations between physical work environment, workplace support for health, and presenteeism: a COVID-19 context

Objective

Presenteeism has, in a larger sense, been viewed as a negative behaviour, although a limited body of studies suggests and reports its positive implications in an organizational context. This study assessed the association between the physical work environment (PWE) and presenteeism as well as the moderating influence of workplace support for health (WSH) on this relationship.

Methods

This study adopted the cross-sectional design alongside a sensitivity analysis and techniques against common methods bias. The study population was employees of private and public organizations in Accra, Ghana. A total of 590 employees participated in the study and hierarchical linear regression was used to present the results.

Results

PWE had a positive relationship with presenteeism (β = 0.15; t = 3.04; p < 0.05), which means that higher presenteeism was associated with larger PWE scores. WSH positively moderated the relationship between PWE and presenteeism (β = 0.23; t = 4.84; p < 0.001).

Conclusions

Organizations with more satisfactory work environments may serve as preferred protective places for employees during a pandemic, more so within organizations with higher WSH. Interventions rolled out to improve PWE and to provide WSH can attenuate the potential negative influences of presenteeism on individual health and organizational productivity.

Risk factors associated with respiratory infectious disease-related presenteeism: a rapid review

BACKGROUND

Workplace transmission is a significant contributor to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. Previous studies have found that infectious illness presenteeism could contribute to outbreaks in occupational settings and identified multiple occupational and organisational risk factors. Amid the COVID-19 pandemic, it is imperative to investigate presenteeism particularly in relation to respiratory infectious disease (RID). Hence, this rapid review aims to determine the prevalence of RID-related presenteeism, including COVID-19, and examines the reported reasons and associated risk factors.

METHODS

The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in English and Chinese. Database searches included MEDLINE, EMBASE, Web of Science, China Knowledge Resource Integrated Database (CNKI) and preprint databases MedRxiv and BioRxiv.

RESULTS

The search yielded 54 studies, of which four investigated COVID-19-related presenteeism. Prevalence of work presenteeism ranged from 14.1 to 55% for confirmed RID, and 6.6 to 100% for those working with suspected or subclinical RID. The included studies demonstrated that RID-related presenteeism is associated with occupation, sick pay policy, age, gender, health behaviour and perception, vaccination, peer pressure and organisational factors such as presenteeism culture.

CONCLUSIONS

This review demonstrates that presenteeism or non-adherence to isolation guidance is a real concern and can contribute to workplace transmissions and outbreaks. Policies which would support workers financially and improve productivity, should include a range of effective non-pharmaceutical inventions such as workplace testing, promoting occupational health services, reviewing pay and bonus schemes and clear messaging to encourage workers to stay at home when ill. Future research should focus on the more vulnerable and precarious occupational groups, and their inter-relationships, to develop comprehensive intervention programs to reduce RID-related presenteeism.

Effect of Psychological Distress on the Association of Workplace Social Capital with Presenteeism and Sickness Absence

Greater workplace social capital (WSC) can be related to workers' health and productivity. We sought to clarify the association between horizontal WSC and presenteeism and sickness absence (SA) and to examine the effects of psychological distress on these associations among Japanese workers. A cross-sectional study was conducted in 2017 at seven large Japanese companies. Logistic regression analysis was performed with presenteeism and SA as the dependent variables, horizontal WSC as an independent variable, and sociodemographic characteristics and psychological distress as covariates. After adjustment for sociodemographic characteristics, the results showed that greater horizontal WSC was associated with lower presenteeism and SA. The odds ratios for the relationship between horizontal WSC and presenteeism and that between horizontal WSC and SA dropped moderately after adjustment for psychological distress but remained significant. Further exploration of the factors underlying the relationship between WSC and productivity is needed to confirm if WSC enhances workers' health and productivity and to inform the development of effective occupational health initiatives.

Work-Related Factors Affecting the Occurrence of Presenteeism － Recent Research Trends and Future Directions

Productivity loss due to presenteeism accounts for a large proportion of economic losses caused by workers' health problems. To reduce presenteeism, it is necessary to identify its causes, but, in contrast to the large amount of research on the effects of diseases and lifestyles, there is not enough research on the effects of work-related factors on presenteeism. In this study, those factors include the work environment and the work-related psychological status of workers. The purpose of this review was to identify research trends in presenteeism, defined as work-related productivity loss, and to examine future directions for presenteeism research. We conducted a search with only the keyword "presenteeism" using MEDLINE/PubMed for the last 5 years and extracted 30 relevant articles, most of which were cross-sectional studies. The articles were categorized into the following themes: 1) studies on the associations of various stress models and factors with presenteeism; 2) studies on the mediators and the pathways of association between stress factors and presenteeism; 3) studies on the relationships between organizational factors and presenteeism; and 4) studies on the link between workers' positive and negative psychological status and presenteeism. Our findings showed that, over the last 5 years, the relationship between psychological stress and presenteeism has been extended to include a variety of stress models and stressors. In addition, by putting many models and factors into a single statistical model and adjusting for their interrelationships, important factors have been examined by ensuring that a significant relationship with presenteeism remains. As there is still a lack of longitudinal studies necessary to discuss causality, more research of higher quality is needed.

What are the health and socioeconomic impacts of allergic respiratory disease in Tasmania?

Objective The aim of this study was to quantify the direct and indirect costs of asthma and allergic rhinitis (AR) for 2018 in Tasmania. Methods We used publicly available data, and Tasmanian-specific values where available, to estimate direct and indirect costs of both diseases. Direct costs included outcomes such as emergency department (ED) presentations, hospitalisations, general practice visits and medication use. Indirect costs included premature mortality and lost productivity. Results Direct health impacts for both conditions combined included 1454 ED presentations, 682 hospitalisations, 72446 general practice visits and 7122 specialist visits. Indirect health impacts included 13 deaths and between 483000 and 2.8 million days of lost productivity. Total costs ranged between A$126.5 million and A$436.7 million for asthma and between A$65.3 million and A$259.7 million for AR. Per-person annual costs ranged between A$1918 and A$6617 for asthma and between A$597 and A$2374 for AR. Conclusions The main financial burden due to asthma and AR was related to productivity losses from presenteeism and absenteeism. The magnitude of the economic impacts of AR and asthma warrants further analysis to produce a national-level assessment. Such analyses could identify cost-effective interventions that produce highest benefits for the management of these conditions in our community. What is known about the topic? Allergic respiratory diseases, and particularly asthma and AR, pose a significant health burden, with effects including asthma-related hospital admissions, significant pharmaceutical expenditure and lost workforce and school education productivity. Australia, and particularly Tasmania, has a high prevalence of these conditions, but no recent studies have appraised or estimated their health impacts and costs. What does this paper add? This paper proposes a unique and transparent costing model that allows the costs of these conditions to be estimated while accounting for restrictions in data availability. The model is used to provide the first comprehensive costings of asthma and AR in Tasmania, Australia. We identified that the estimated health costs are dominated by productivity losses from presenteeism and absenteeism, and that total per person costs are higher for a person with asthma compared to one with AR. What are the implications for practitioners? This analysis has the potential to guide cost-effective interventions by identifying where the highest benefits may be obtained when managing these conditions in our community.

Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study

Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work.

Identification of work accommodations and interventions associated with work productivity in adults with migraine: A scoping review

OBJECTIVE

To identify factors associated with work productivity in adults with migraine, and accommodations or interventions to improve productivity or the workplace environment for them.

METHODS

We conducted a scoping review by searching MEDLINE, Embase, PsycINFO, Cumulative Index of Nursing and Allied Heath Literature, and Web of Science from their inception to 14 October 2019 for studies of any design that assessed workplace productivity in adults with migraine.

RESULTS

We included 26 articles describing 24 studies after screening 4139 records. Five prospective cohort studies showed that education on managing migraine in the workplace was associated with an increase in productivity of 29-36%. Two studies showed that migraine education and management in the workplace were associated with increased productivity (absenteeism decreased by 50% in one study). One prospective cohort study showed that occupational health referrals were associated with more than 50% reduction in absenteeism. Autonomy, social support, and job satisfaction were positively associated with productivity, while quantitative demands, emotional demands, job instability, and non-conducive work environment triggers are negatively associated with productivity in workers with migraine.

CONCLUSION

Despite migraine being the second leading cause of disability worldwide, there is a paucity of strong data on migraine-related work factors associated with productivity.Registration: None (scoping review).

Job insecurity is associated with presenteeism, but not with absenteeism: A study of 19 720 full-time waged workers in South Korea

OBJECTIVE

This study examined whether perceived job insecurity was associated with absenteeism and presenteeism, and how these associations varied when the differential cutoff was applied to define absenteeism and presenteeism.

METHODS

We analyzed a nationally representative dataset of 19 720 full-time waged workers from the 4th Korean Working Conditions Survey (2014). As an independent variable, perceived job insecurity was assessed. As dependent variables, absenteeism and presenteeism were measured. Seven differential cutoffs (from "1 day" to "7 days") were used when defining absenteeism and presenteeism. A Poisson regression model with a robust error variance was applied for the analysis.

RESULTS

When "1 day" was cutoff to define absenteeism and presenteeism, job insecurity was not associated with both absenteeism (PR: 1.07, 95% CI: 0.97, 1.16) and presenteeism (PR: 1.05, 95% CI: 1.00, 1.10). When the higher cutoff was used, the association between job insecurity and absenteeism was attenuated and remained statistically nonsignificant. However, statistically significant associations between job insecurity and presenteeism were observed when the differential cutoff was used: "2 days" (PR: 1.07, 95% CI: 1.01, 1.13), "3 days" (PR: 1.14, 95% CI: 1.06, 1.22), "4 days" (PR: 1.15, 95% CI: 1.05, 1.26), "5 days" (PR: 1.18, 95% CI: 1.06, 1.30), "6 days" (PR: 1.17, 95% CI: 1.02, 1.33), and "7 days" (PR: 1.17, 95% CI: 1.02, 1.34).

CONCLUSION

This study found that perceived job insecurity was associated with presenteeism, but not absenteeism. Furthermore, the association differed by cutoff applied to define presenteeism among full-time waged workers in South Korea.

PERCEPTIONS OF DOMESTIC WORKERS ON LABOR RIGHTS AND IMPACTS ON THEIR WORKING AND HEALTH CONDITIONS

ABSTRACT Objective: to understand the perceptions of domestic workers on the legislative changes and impacts on their working and health conditions. Method: a qualitative study, conducted in a city in the inland of São Paulo, between December 2016 and March 2017, conducted through individual interviews with 15 domestic workers, using the snowball strategy and theoretical saturation sampling. For data analysis, Hermeneutics-Dialectics was adopted. Results: domestic workers face precarious working and health conditions, permeated by a lack of information about their rights at work, as well as discrimination, devaluation, musculoskeletal problems, mental suffering and presenteeism. Improvements in recent years have been reported, but the workers claim greater reach for formal registration and valuation for domestic work. Conclusion: constant evaluation and dissemination of the legislative changes with the domestic workers is essential, so that chronic situations of devaluation and precariousness of domestic work are replaced by the empowerment and transformation capacity of these women.

Sickness presenteeism: Are we sure about what we are studying? A research based on a literature review and an empirical illustration

BACKGROUND

There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed.

METHODS

A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016).

RESULTS

Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous.

CONCLUSIONS

Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.