Understanding sickness presenteeism: causes, risks and solutions: guidelines series

Working while not fully fit is not inherently harmful and can be beneficial, as long as the illness is neither contagious nor overly debilitating. Work benefits wellbeing in many ways, providing structure, purpose and opportunities to build confidence and self-esteem, while also facilitating social interaction and support. Working during recovery from illness or injury can also aid rehabilitation by helping employees gradually ease back into their roles via phased approaches. However, research shows that sickness presenteeism can have significant negative consequences. It can hinder recovery, increase the likelihood of future health issues and lead to higher absenteeism. Sickness presenteeism also raises health and safety concerns, as it can contribute to the spread of contagious disease in the workplace, as well as cause errors, accidents and injuries that affect not only the unwell employee but also their colleagues and the public. On a cultural level, working while sick can also increase pressure for others to do the same, normalizing unhealthy work practices.A recent guide published by the Society of Occupational Health [1] provides professionals in occupational health, human resources and related fields with a comprehensive overview of the causes, risks and management of sickness presenteeism. It examines its prevalence and highlights the key occupational, organizational and personal risk factors, along with how they can interact. The guide also examines the broader implications of working while unwell in on-site and remote work, focusing on employee health, performance and the wellbeing of others. This article summarizes the guide, presenting key points for practitioners on the causes, impact and management of sickness presenteeism. Selected citations are included, with more detailed references available in the guide.W H AT I S SI CK N E SS P R E SE N T E E I S M A ND HOW PR E VA LEN T IS IT ?Sickness presenteeism refers to attending work while unwell, whether due to physical or mental health issues, rather than taking time off to rest and recover. While awareness of its prevalence and impact is growing, sickness presenteeism remains difficult to quantify as it often goes unreported or unnoticed [2]. Reducing sickness absence remains a priority for many organizations, but presenteeism is not only more common but potentially more costly. A recent survey of over 1000 human resource professionals in the UK [3] found 76% had observed presenteeism among office-based workers and 78% among remote staff in the previous 12months. This trend seems particularly pronounced in cases involving mental health issues and other ‘hidden’ conditions [3, 4]. Moreover, the Institute for Public Policy Research [5] has estimated that, on average, 44 days of productivity are lost due to working while unwell, up from 35days in 2018.Increasing recognition of the prevalence and costs associated with sickness presenteeism highlights the importance of understanding the factors that drive people to work while ill and to develop effective strategies for identifying and mitigating this behaviour