My Blog Of Knowledge: Pressure to Work When Sick Can Worsen Health

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D.on June 14, 2011

Pressure to Work When Sick Can Lead to Problems A relatively new issue associated with the workplace is the tendency, or the encouragement by management, to work through short-term illness.

This pressure to work through sickness, known as “presenteeism,” can have long-term negative effects on health and productivity, warns an editorial published in the British Medical Journal.

Sociologist Dr. Kevin Dew at Victoria University of Wellington in New Zealand, believes the evidence suggests that, for many, the pressure to work when sick is intense, and more effort is needed to prevent this health-debilitating behavior.

The behavior of working through sickness is more common in certain occupations, particularly those that involve caring and teaching, and is higher for those who have greater responsibility for patient care, he writes.

Similarly, workers who lack backup, and for whom work accumulates while they are absent, are more inclined to practice presenteeism. The current economic decline and fear of layoffs are overarching factors that foster presenteeism.

In America, the intense drive for enhanced productivity, the common practice of working in teams where expectations to be present are high, limited sick leave, high job demands, low levels of job satisfaction, fear of dismissal, and concerns about promotion opportunities contribute to the pressure to work at all costs.

According to Dew, certain medical conditions like depression and migraine are also linked with presenteeism because they are not seen as legitimate reasons for absence.

Evidence shows that presenteeism increases illness, including musculoskeletal pain, fatigue, depression, and serious coronary events. It also leads to exhaustion which, in turn, leads to more presenteeism.

In health care settings, presenteeism poses a particular concern because of the spread of infections, so preventive measures are taken, but Dew said that less attention has been paid to presenteeism and its prevention in other occupations.

“Presenteeism should be taken seriously if we are concerned with occupational health or workplace productivity,” he said.

“Presenteeism is a complex phenomenon that needs to be approached from several different levels including workplace culture, workplace policies, and carefully considered interventions from health practitioners.”

He suggests that senior staff can help by discouraging over-commitment to work and encouraging workers to allow sufficient recovery time from sickness.

Workers with poor health should receive special attention to avoid presenteeism, he added, because they are likely to have fewer resources to call on to resist its negative impact.

“Managers and occupational physicians need to be alert to the findings that even though presenteeism may have some positive effects in the short term … it is likely to be negative in the long term,” Dew said.

Source: British Medical Journal

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