Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016

To what extent do job insecurity, income satisfaction, and self-rated health mediate the association between low income and presenteeism in Germany? A gendered analysis

PURPOSE

Low income is considered a possible determinant of presenteeism, explained by poor working and living conditions, increased levels of uncertainties and anxiety, and poor health status. We aimed to examine the association between low income and presenteeism by gender and to explain their association using different mediators.

METHODS

A total of 14,299 employees aged 18-65 from the 6th BIBB/BAuA Employment Survey 2012 were used, and mediation analyses with inverse odds weighting stratified by gender were conducted.

RESULTS

Low income was significantly associated with presenteeism for men at a significant level of α < .05 (β: 0.376; 95%-CI 0.148-0.604) and for women at a significant level of α < .10 (β: 0.120; 95%-CI - 0.015-0.255). The total effect (TE) was fully and significantly mediated for women when all mediator-weights were considered, whereas for men the consideration of single mediator-weights led to a full and significant mediation of the association between low income and presenteeism. Self-rated health status and income satisfaction contributed the most to the differences in presenteeism by low income with a proportion mediated of 96.3% (men) and 169.2% (women) for self-rated health and 101.6% (men) and 162.5% (women) for income satisfaction.

DISCUSSION

The results indicated a strong association between low income and presenteeism, in particular for men. Self-rated health and income satisfaction were the most important mediators of this association. The results underline not only the relevance of occupational health management and preventive measures, but also the need of a public debate about employment traditions, possibly resulting in role conflicts among men, and wage equality to prevent presenteeism of low-income earners.

Sickness Presenteeism and Psychosocial Risk Factors According to Inequality Axes

OBJECTIVE

To assess the association between psychosocial risk factors (PSRs) and sickness presenteeism (SP) and examine possible differences according to the major axes of inequality in the labor market. Methods: Cross-sectional study based on a representative sample of the Spanish salaried population. Results: Although nearly all PSR show crude associations with SP, when adjusted for every other PSR, only the workers exposed to lack of role clarity (adjusted prevalence ratio [aPR], 1.30; 95% confidence interval [CI], 1.01 to 1.68), having role conflicts (aPR, 1.45; 95% CI, 1.19 to 1.77) and lack of sense of community at work (aPR, 1.30; 95% CI, 1.06 to 1.59) show a significant association. Conclusions: After adjusting for all PSR, those significantly associated to SP belong to the interpersonal relationships domain. Some of the PSR effects change according to the segmentation axes analyzed.

Sickness presenteeism explained by balancing perceived positive and negative effects

Within the ever-growing body of research on sickness presenteeism, studies of perceived consequences are scarce and equally rare are joint considerations of beneficial and harmful effects. This study examined how experienced and expected consequences of the behavior are related to presenteeism. Positive and negative effects were considered simultaneously and comprehensively. This approach allowed us to capture the trade-off process of individuals in deciding to work or call in sick when ill. In a cross-sectional online survey, 591 working adults in Germany rated a thoroughly developed pool of specific experienced or potential consequences of working while sick and gave an overall judgment of effects. The results show that perceptions of effects are consistent with behavior. Individuals who exhibit presenteeism do so primarily because of work-related effects such as the completion of one’s work tasks and the meeting of deadlines. Few specific effects stand out and can largely explain attendance behavior and the overall assessment of effects. The findings are consistent with the assumptions of the health belief model and the expectancy value theory of work motivation and they relate to the health-performance framework. They demonstrated that benefits and costs of the behavior are simultaneously weighed in the decision to engage in presenteeism or not.

The impact of national legislation on psychosocial risks on organisational action plans, psychosocial working conditions, and employee work-related stress in Europe

Work-related psychosocial hazards are recognised as a key priority in the future of work. Even though European Union (EU) legislation requires employers to assess and manage all types of risks to workers' health and safety associated with all types of hazards in the work environment, it does not include clear reference to psychosocial risks and work-related stress. In several EU member states, there is now more specific legislation on psychosocial risks that clarifies employer responsibilities. The aim of this study is to explore whether the introduction of specific legislation on psychosocial risks and/or work-related stress is related to organisations implementing action plans to prevent work-related stress, and in turn, better psychosocial working conditions (job demands and resources), and less reported work-related stress in the workforce. It does so by comparing EU member states and candidate countries that have introduced more specific legislation to those that have not, conducting multilevel modelling analysis by linking two representative European-level datasets, the 2014 employer European Survey of Enterprises on New & Emerging Risks and the 2015 employee European Working Conditions Survey. Findings indicate that the presence of specific national stress legislation is associated with more enterprises having a work-related stress action plan. The existence of action plans was found to be associated with increased job resources but not decreased job demands. Furthermore, only in those countries with specific national legislation on stress, job resources were found to be associated with less reported stress through the existence of organisational action plans. Findings lend support to the argument for more specific legislation on psychosocial risks/work-related stress in the EU. However, they also raise questions on whether current interventions implemented at organisational level to deal with work-related stress may be geared more towards the development of individual resources and less towards better work organisation and job design.

Association of Preference and Frequency of Teleworking with Work Functioning Impairment: A Nationwide Cross-Sectional Study of Japanese Full-Time Employees

OBJECTIVE

We examined whether teleworking preference and frequency were associated with work functioning impairment.

METHODS

This online cross-sectional study was conducted using a self-administered questionnaire among 27,036 full-time Japanese workers. The Work Functioning Impairment Scale was used to measure work functioning impairment, and we performed multilevel logistic regression analysis.

RESULTS

Higher odds ratios for work functioning impairment were observed among employees who preferred to telework compared with those who preferred working in the workplace. A similar trend was observed among employees who teleworked four or more days a week compared with those who almost never teleworked. When teleworking preference and frequency were adjusted, only teleworking preference was associated with work functioning impairment.

CONCLUSIONS

A preference for teleworking was associated with work functioning impairment and one factor that increased the teleworking frequency.

Cross-level effects of health-promoting leadership on nurse presenteeism: The mediation and moderation effect of workload and performance pressure

This study examines the cross-level influence mechanism of leaders’ health-promoting leadership on subordinates’ presenteeism among nursing industry. A multilevel mediated moderation model was hypothesized to explore whether health-promoting leadership is associated with subordinates’ presenteeism via the workload of subordinates, and how leader’s performance pressure plays the role in the model. Questionnaires were distributed to 110 nursing teams, which including 110 chief nurses and 660 subordinate nurses. Our findings showed that although health-promoting leadership has no direct impact on presenteeism, health-promoting leadership has an indirect impact on presenteeism via workload, and workload acts as a complete mediator. Meanwhile, performance pressure moderated the relationship between health-promoting leadership and workload. With an increase in performance pressure of leaders, the negative impact of health-promoting leadership on nurse workload gradually weakened. In this multilevel mediated moderation model, the mediated moderating effect of performance pressure was significant and the moderating effect was completely mediated, which means that the interaction between health-promoting leadership and performance pressure can affect presenteeism through workload. When leaders were under high performance pressure, the protective effect of health-promoting leadership on workload would be inhibited. These findings contribute to enriching the research on presenteeism, providing insight into how the health development of employees and performance demands of leaders may be balanced, and affording fresh thoughts for effective prevention and treatment of nurse presenteeism.

Analysis of zero inflated dichotomous variables from a Bayesian perspective: application to occupational health

BACKGROUND

Zero-inflated models are generally aimed to addressing the problem that arises from having two different sources that generate the zero values observed in a distribution. In practice, this is due to the fact that the population studied actually consists of two subpopulations: one in which the value zero is by default (structural zero) and the other is circumstantial (sample zero).

METHODS

This work proposes a new methodology to fit zero inflated Bernoulli data from a Bayesian approach, able to distinguish between two potential sources of zeros (structural and non-structural).

RESULTS

The proposed methodology performance has been evaluated through a comprehensive simulation study, and it has been compiled as an R package freely available to the community. Its usage is illustrated by means of a real example from the field of occupational health as the phenomenon of sickness presenteeism, in which it is reasonable to think that some individuals will never be at risk of suffering it because they have not been sick in the period of study (structural zeros). Without separating structural and non-structural zeros one would be studying jointly the general health status and the presenteeism itself, and therefore obtaining potentially biased estimates as the phenomenon is being implicitly underestimated by diluting it into the general health status.

CONCLUSIONS

The proposed methodology is able to distinguish two different sources of zeros (structural and non-structural) from dichotomous data with or without covariates in a Bayesian framework, and has been made available to any interested researcher in the form of the bayesZIB R package ( https://cran.r-project.org/package=bayesZIB ).

Factors Associated With the Presenteeism of Single-Person Household Employees in Korea: The 5th Korean Working Conditions Survey (KWCS)

OBJECTIVE

The number of single-person households is rapidly increasing worldwide. Many workers from these households have to work even when they are sick, leading to presenteeism. The study aimed to identify factors affecting presenteeism in workers from single-person households.

METHODS

This study is a retrospective survey, a secondary data analysis using data from the 5th Korean Working Conditions Survey of 2017.

RESULTS

Of 2156 workers, 366 (17%) showed presenteeism and 1790 (83%) did not. Multiple logistic regression analysis showed that being a woman, subjective health status being moderate or good, presence of disease, longer commuting hours, and longer working hours per week are related to presenteeism.

CONCLUSIONS

To reduce the presenteeism of workers from single-person households, specific programs and organizational policies can be developed.

Reasons for presenteeism in different occupational branches in Sweden: a population based cross-sectional study

Objective

To compare the prevalence and reasons for presenteeism in occupations in three branches defined as employees handling people, handling things or handling symbols.

Method

A cross-sectional population-based cohort study was conducted. The study group was drawn from a representative sample (n = 6230) aged 16–64, who had been interviewed in 2015 or in 2017 for the Swedish Work Environment Surveys (SWES). The odds ratios (ORs) stratified by occupational category for reasons of presenteeism, with 95% confidence intervals (CI), were estimated using binomial multiple logistic regression analysis.

Results

The study showed that presenteeism was more common among employees handling people (74%), when compared to employees handling things (65%) or handling symbols (70%). The most common reason for presenteeism among employees handling people was “I do not want to burden my colleagues”, while “Because nobody else can carry out my responsibilities” was most common in the other two categories. After control for socio-demography, work environments and health, the differences in reasons mostly remained significant between the three occupational categories.

Conclusion

The differences between occupational categories are important for prevalence and reasons for presenteeism. As presenteeism affects the future health of employees and the productivity of the work unit, attempts to reduce presenteeism may be important. Because the reasons vary between occupations, customized preventive measures should be applied in different occupational settings. Among employees handling people, covering up for absence in work team is relevant, while among employees handling symbols and handling things the corresponding focus could be on shared responsibilities for specific tasks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01701-2.

Working While Ill Is Not Always Bad-Positive Effects of Presenteeism

Presenteeism-going to work while ill-is a widespread phenomenon worldwide. Previous research has concentrated mainly on its negative effects. This study investigates the positive consequences of presenteeism derived from a comprehensive content model of presenteeism that was developed on the basis of negative effects. In a quantitative online-survey employees (N = 181) rated the degree of experienced or potential positive effects depending on whether they had worked while ill (75%) or not (25%) during the previous year. Results revealed that all postulated positive effects described in the content model were relevant. Most positive effects were rated significantly higher by participants who had shown presenteeism in comparison to those who had not. The positive effects significantly predicted presenteeism propensity (adjusted R ² = 0.20) for participants having shown presenteeism. In addition, an overall rating of positive effects was significantly related to presenteeism, however, to a lesser degree. Overall, the results demonstrate the applicability of the content model to positive effects of presenteeism. They point to the need for further investigation of them and their consideration for the management of presenteeism.

Presenteeism among health care workers: literature review

Presenteeism is an occupational and psychosocial phenomenon with negative impact on the work environment. In addition to causing losses in productivity losses, it also has implications for the state of health of workers. Therefore, presenteeism is likely to become a serious public health problem. The aim of the present study was to discuss the implications, means for evaluation and impact of presenteeism on the health and work of health care workers. We performed a literature search in database PubMed using keywords presenteeism, absenteeism, nurse presenteeism, physician presenteeism, sickness presenteeism, physician health organization, and working sick. We conclude that adequate assessment, raising the health managers' awareness about the risks and harms associated with this phenomenon, and developing management tools will contribute to reduce the impact of presenteeism. This seems to be the proper path to make this problem more visible and hinder its growth.

Factors Related to Presenteeism among South Korean Workers Exposed to Workplace Psychological Adverse Social Behavior

Presenteeism negatively affects both individuals and society. This study identified factors of presenteeism among workers in South Korea, especially in relation to exposure to adverse social behaviors. Here, an adverse social behavior refers to any forms of workplace violence or intimidation. This study used the data from 23,164 full-time salaried employees, who participated in the fifth Korean Working Conditions Survey. This study attempted to predict presenteeism based on the exposure to adverse social behaviors and working conditions using logistic regression. Presenteeism was reported in 15.9% of the sample. Presenteeism was significantly higher among workers with the following characteristics: females, aged 40 years or older; middle school graduates; over 40 working hours a week; shift workers; no job-related safety information received; exposure to adverse social behavior and discrimination; and those with a high demand for quantitative work, low job autonomy, high emotional demands, and high job stress. The workers exposed to adverse social behavior showed a higher prevalence of presenteeism (41.2%), and low job autonomy was the most significant predictor of presenteeism. The findings of this study suggest that allowing enough autonomy in job-related roles may help alleviate presenteeism among those who have experienced adverse social behavior at work.

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.

Millennials: sickness presenteeism and its correlates: a cross-sectional online survey

OBJECTIVE

Sickness presenteeism (SP) is a well-documented phenomenon in the current workforce. However, little is known about the SP of future employees (Millennials). We investigated rate and propensity of presenteeism and health-related and work-related correlates in university students to obtain information about the relevance of SP in the future workforce. Sickness presenteeism (SP) refers to going towork while ill.¹ DESIGN AND SETTING: We administered a cross-sectional online survey in August 2018 involving self-assessments of health-related and work-related behaviour. As planned, we analysed rates, instances and propensities of presenteeism and absenteeism. The target population was Millennial university students.

RESULTS

749 German university students, average age 24.7±3.6 years, 49.5% women, mean academic progress 4.5±2.7 semesters, <1% without work experience, 15.4±10.3 mean weekly working hours. Presenteeism rates in the complete sample were 64% at school and 60.4% at work. For the subsample of participants who reported sickness, presenteeism rates were 87.9% at school and 87% at work. Presenteeism propensity among them was 0.67±0.34 at school and 0.68±0.35 at work. SP at school and at work was significantly correlated with subjective health (r=0.29, p=0.000 and r=0.25, p=0.000) and locus of control (r=-0.20, p=0.000 and r=-0.26, p=0.000). Age and sex adjusted multiple regression analysis showed that subjective health explained 9.7% of the variance in SP at school (B=0.049, p=0.000) and 8.1% of the variance in SP at work (B=0.037, p=0.000).

CONCLUSIONS

The SP rates of the future workforce were in line with previous research on older employees, whereas the presenteeism propensities we found here were higher. Across all analyses, subjective health proved to be associated with presenteeism. Thus, the relevance of SP will remain constant or might even increase with regard to the future workforce. Programmes offering health education should be implemented to sensitise this generation as early as possible.

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.

The Effectiveness of a Multidisciplinary Exercise Program in Managing Work-Related Musculoskeletal Symptoms for Low-Skilled Workers in the Low-Income Community: A Pre-Post-Follow-Up Study

Studies on work-related musculoskeletal symptoms (WRMSs) have been conducted mainly on different types of workforce but not many on low-skilled workers. The purpose of this study was to evaluate the effectiveness of a multidisciplinary exercise program in decreasing the number of body parts with WRMSs for low-skilled workers. This study used a repeated-measures, single-group design. One hundred and five (105) workers participated in eight weekly 90-min sessions (including 45-min workshops and 45-min exercises) in low-income community settings. The exercise program involved a 21-movement stretching exercise and a 10-movement muscle-strengthening exercise. Questionnaire and health-assessment data were collected at the baseline (N = 105) and immediately after the 8-week program (n = 86). The average age of the 105 participants was 50.5 ± 8.7 years (ranging from 31 to 67). Over 80% (n = 87) of them were female, 68.6% (n = 72) were married, and 68.6% (n = 72) had completed secondary school. They reported an average of three body parts with WRMSs at baseline (T0). By the end of the eight weeks (T1), the participants had reduced the number of WRMS-affected body parts, job stress, and incidences of working through pain, and had improved spine flexibility and handgrip strength. The factors significantly affecting the reduction in the number of body parts with WRMSs were change in the workstyle of working through pain, and self-rated health status. Our study has demonstrated that a community-based multidisciplinary program can reduce the number of body parts affected by WRMSs in low-skilled workers in low-income communities.