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Karen Higginbottom, Contributor

The Price Of Presenteeism

Are you one of those employees who turns up for work despite the fact that you aren’t well enough to do your job? Then you’re suffering from the insidious condition of presenteeism. There are far more studies on the cost of absenteeism in the workplace than presenteeism as it’s harder to quantify and define.

A year-long telephone survey of 29,000 working adults dubbed the American Productivity Audit calculated that the cost of presenteeism in the US to be more than $150 billion a year. Most studies confirm that presenteeism is far more costly than illness-related absenteeism or disability. Two Journal of the American Medical Association studies, found that on-the-job productivity lost resulting from depression and pain was roughly three times greater than the absence-related productivity loss attributed to these conditions.


A Green and Black study estimated that overall costs of ill health among the working population was over $141 billion in the UK. At the same time, absenteeism was estimated to cost around $11.8 billion a year and presenteeism around $21.2 billion.

The full cost of absenteeism is difficult to quantify but the impact of presenteeism is even harder to assess as it can be challenging to measure if someone is fully productive when at work if they are ill, says Rachel Suff, senior employment relations advisor at the Chartered Institute of Personnel and Development.

More evidence-based research is needed but there is a growing narrative emerging that presenteeism is indeed potentially more costly than absenteeism. There is no doubt that employees coming to work ill can have a negative impact on productivity as well as health.

Presenteeism is seen as the practice of employees using entitlements such as holiday allowances, banked flexi-time and rest days to take work that cannot be completed at work to their home to finish or being at work to catch up when they should not be, remarked Professor Paul Sparrow, emeritus professor of international human resources management at Lancaster University.

There are clearly very different ‘types’ of presenteeism—some people are there because they are in effect workaholics. They choose not to take the time they are entitled to for some reason. The issue really there is one of a lack of rest and recreation and the slow deleterious impacts that has on their well-being, performance and productivity.

Sparrow argues that there are some people who are there in body but not in either mind or heart or employees who are there through fear.

Here the impacts are more on engagement, service quality, mental health and stress. Certain work models such as on-demand business models, for example, Uber, can also transfer responsibility for well-being on to the individual rather than it residing with the employer.

The phenomenon of absenteeism and presenteeism are multi-dimensional, comments Sue Anderson, senior lecturer in management, leadership and organisation at Hertfordshire Business School, University of Hertfordshire.

Absence can be genuine (sickness, maternity/paternity, caring etc) or it can be symptomatic of an employee or multiple employees being disaffected with the employer, for example, having a reduced sense of commitment to them. Presenteeism is perhaps more concerning in that the presenting employee may have a negative effect on employee morale and therefore potentially performance. To address these issues requires both sensitivity and a good knowledge and understanding of the legal pitfalls.

Suff advises that employers look ‘under the skin’ of their attendance rates and patterns to fully understand the relationship between people’s health and well-being and engagement levels and their attendance at work. She recommends the following actions for employers:

  • Employers should gather intelligence from a range of sources, including the employees themselves
  • Line managers should be trained to be alert to employees who are unwell but still attending work.
  • Senior managers need to encourage a positive culture that encourages good attendance when people are well but supports people taking the necessary time off when they have a genuine illness within the organization’s supportive framework that encourages effective return to work practices.
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