I CAN quite appreciate the impact of absenteeism as one area of concern to organisations, and perhaps the prompt that top management needs to promote management skills training.  I can also understand the apparent lack of focus on another potential agent of lost employee productivity, and loss of employer dollars.  I am speaking about the practice of employees coming to work when they are sick.  

According to Patricia Schaefer’s “The Hidden Costs of Presenteeism: Causes and Solutions”,  “presenteeism” is the term coined (by Cary Cooper, a psychologist and organisational management specialist) to define the practice of workers reporting to work when ill, and not operating to their usual level of productivity.
 I think we should all pause and examine the implications of a sick worker on the front line of let’s say medical institution or food service, who is required to interact with co-workers, patients or clients.  An ill worker on jobs such as those can compromise food safety, and/or infect co-workers and members of the public.

Schaefer points to presenteeism as accounting for annual losses to U.S. employers ranging from about US$150 to US$250 billion representing about 60 percent of the total cost of worker illness.  Harvard Business Review reporting in 2004 on a Tufts New England Medical Center study on assessing the impact of twenty-eight medical conditions on workers’ productivity identified ailments such as allergies, headaches, lower-back pain, arthritis, colds and the flu as causing losses to Lockheed Martin Corp of about US$34 million, with allergies and sinus trouble responsible for the highest losses to the company of US$1.8 million.
 Schaefer identifies three causes of presenteeism including employer expectations; little or no paid sick days; and dual-earner households.  The last refers to families where both spouses work and there is no one to take care of sick children thus causing employees to save up on their limited sick days for when the children are sick.  Saving up of sick days may prove problematic in some organisations where you either use them or lose them.  Patricia Pickett “The Costs of Presenteeism” argues that there are individuals who are ill, potentially contagious and not functioning at 100 percent, but still feel that they should be at work.  Pickett even applies the concept to people who work late or come into the office during their vacation, and goes as far as showing downsizing during periods of economic strain as one causal factor for the practice.

Generally it seems the accepted view that organisational climate and culture play a significant role in sick employees’ decision to not take time off from work.  Pickett identifies (i) the lack of paid sick days where people either can’t afford to take an unpaid day off work, or they don’t want to use their vacation time in order to stay home when they are ill; (ii) paid time off which may be treated as vacation and therefore will not be used for sick leave; (iii) workplace culture and policies which discourage or penalise employees for taking sick days, vacation or other types of days off (whether paid or unpaid), even if employees are technically entitled to them; (iv) overwhelmed and overworked employees who may feel that there is too much work, or so many deadlines, that it is impossible to take time off without making projects suffer.  This Pickett argues often happens in instances where there has been no cross-training and sick employees may feel that there is no one else to replace them while they’re away; (v) no work-at-home alternatives which offer telecommuting options when deadlines have to be met and the employee sick with a contagious illness should not be at work; (vi) perception of job protection by employees who may come into the office or stay late when they shouldn’t be, even if there isn’t a whole lot of extra work to do, because they want to be seen as working hard, which they believe will help them keep their jobs if layoffs are ever a consideration; (vii) denial by some people who still come into work because they convince themselves that although they are not feeling 100 percent, they are feeling well enough to come in to work.

Several solutions have been proposed to employers to help combat presenteeism including:  (i) sending home any employee who is clearly impaired; (ii) educating employees on what conditions require them to stay home, and when they may return; (iii) offering paid sick leave to address employees’ economic concerns; (iv) applying a balanced approach to prevent the abuse of sick days as well as the urge of a sick employee reporting for work; (v) offer flexible working options as a morale booster to the sick worker e.g. working from home;  (vi) cross-train employees to avoid feelings of indispensability; and (vii) consider punitive action against a worker who comes in sick despite your regulations, especially if she/he is in a public-facing situation.

Editor, although I find presenteeism to be a fascinating subject, space and time constraints prevent me from further elaboration except to say that both employees and employers could do well to acquaint themselves with the grave implications of presenteeism in the work place.