Skip to main content
Log in

Workplace bullying and sickness presenteeism: cross-sectional and prospective associations in a 2-year follow-up study

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate exposure to workplace bullying as a potential risk factor for sickness presenteeism (SP), i.e. working while ill.

Methods

This study is based on data collected through self-reported questionnaires in a 2-year prospective study on employees in Denmark. At baseline, 3363 employees (45.7 % response rate) answered to a questionnaire on their psychosocial work environment and health status. After 2 years, 1664 of the respondents also completed a follow-up questionnaire (49.5 % of the total baseline respondents). After excluding participants with missing values, the final samples were composed of 2865 and 1331 participants in the cross-sectional and prospective analyses, respectively.

Results

Modified poisson regression analyses showed that frequent (i.e. daily or weekly) exposure to workplace bullying was associated with reporting 8 or more days of SP in the preceding year in both the cross-sectional and the prospective analysis, also when controlling for several confounders including health-related variables. However, the prospective relationship became non-significant after adjustment for baseline SP.

Conclusion

This study provides indications of a significant relationship between exposure to frequent workplace bullying and SP, although causal connections could not be established. Methodological and theoretical considerations about study findings are provided, which could be of benefit to future studies examining the impact of being a target of workplace bullying on SP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Agudelo-Suarez AA, Benavides FG, Felt E, Ronda-Perez E, Vives-Cases C, Garcıa AM (2010) Sickness presenteeism in Spanish-born and immigrant workers in Spain. BMC Public Health 10:791

    Article  Google Scholar 

  • Aronsson G, Gustafsson K (2005) Sickness presenteeism: prevalence, attendance pressure factors, and an outline of a model for research. J Occup Environ Med 47:958–966

    Article  Google Scholar 

  • Aronsson G, Gustafsson K, Dallner M (2000) Sick but yet at work: an empirical study of sickness presenteeism. J Epidemiol Community Health 54:502–509

    Article  CAS  Google Scholar 

  • Aronsson G, Gustafsson K, Mellner C (2011) Sickness presence, sickness absence, and self-reported health and symptoms. Int J Workplace Health Manag 4:228–243

    Article  Google Scholar 

  • Bergström G, Bodin L, Hagberg J, Aronsson G, Josephson M (2009a) Sickness presenteeism today, sickness absence tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 51:629–638

    Article  Google Scholar 

  • Bergström G, Bodin L, Hagberg J, Lindh T, Aronsson G, Josephson M (2009b) Does sickness presenteeism have an impact on future general health? Int Arch Occup Environ Health 82:1179–1190

    Article  Google Scholar 

  • Biron C, Brun JP, Ivers H (2006) At work but ill: psychosocial work environment and wellbeing determinants of presenteeism propensity. J Public Ment Health 5:26–37

    Article  Google Scholar 

  • Böckerman P, Laukkanen E (2010) What makes you work while you are sick? Evidence from a survey of workers. Eur J Public Health 20:43–46

    Article  Google Scholar 

  • Bowling NA, Beehr TA (2006) Workplace harassment from the victim’s perspective: a theoretical model and meta-analysis. J Appl Psychol 91:998–1012

    Article  Google Scholar 

  • Cassidy T, McLaughlin M, McDowell E (2014) Bullying and health at work: the mediating roles of psychological capital and social support. Work Stress 28:255–269

    Article  Google Scholar 

  • Claes R (2011) Employee correlates of sickness presence: a study across four European countries. Work Stress 25:224–242

    Article  Google Scholar 

  • Clausen T, Hogh A, Borg V (2012) Acts of offensive behaviour and risk of long-term sickness absence in the Danish eldercare services: a prospective analysis of register-based outcomes. Int Arch Occup Environ Health 85:381–387

    Article  Google Scholar 

  • Clausen T, Hogh A, Carneiro IG, Borg V (2013) Does psychological well-being mediate the association between experiences of acts of offensive behaviour and turnover among care workers? A longitudinal analysis. J Adv Nurs 69:1301–1313

    Article  Google Scholar 

  • Collins SM, Karasek RA, Costas K (2005) Job strain and autonomic indices of cardiovascular disease risk. Am J Ind Med 48:182–193

    Article  Google Scholar 

  • Conway PM, Høgh A, Rugulies RE, Hansen ÅM (2014) Is sickness presenteeism a risk factor for depression? A Danish 2-year follow-up study. J Occup Environ Med 56:595–603

    Article  Google Scholar 

  • Deery S, Walsh J, Zatzick C (2014) A moderated mediation analysis of job demands, presenteeism and absenteeism. J Occup Organ Psychol 87:352–369

    Article  Google Scholar 

  • Demerouti E, Le Blanc PM, Bakker AB, Schaufeli WB, Hox J (2009) Present but sick: a three-wave study on job demands, presenteeism and burnout. Career Dev Int 14:50–68

    Article  Google Scholar 

  • D’Errico A, Viotti S, Baratti A, Mottura B, Barocelli AP, Tagna M, Sgambelluri B, Battaglino P, Converso D (2013) Low back pain and associated presenteeism among hospital nursing staff. J Occup Health 55:276–283

    Article  Google Scholar 

  • Djurkovic N, McCormack D, Casimir G (2008) Workplace bullying and intention to leave: the moderating effect of perceived organisational support. Hum Res Manag J 18:405–422

    Article  Google Scholar 

  • Einarsen S, Nielsen MB (2014) Workplace bullying as an antecedent of mental health problems: a five-year prospective and representative study. Int Arch Occup Environ Health 88:131–142

    Article  Google Scholar 

  • Einarsen S, Skogstad A (1996) Bullying at work: epidemiological findings in public and private organizations. Eur J Work Organ Psychol 5:185–201

    Article  Google Scholar 

  • Einarsen S, Hoel H, Zapf D, Cooper CL (2011) The concept of bullying and harassment at work: the European tradition. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and harassment in the workplace: developments in theory, research, and practice, 2nd edn. CRC Press, Boca Raton, pp 3–40

    Google Scholar 

  • Elstad JI, Vabø M (2008) Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scand J Public Health 36:467–474

    Article  Google Scholar 

  • Eurofound (2012) Health and well-being at work: a report based on the fifth European Working Conditions Survey. Dublin, pp 55–57

  • Gosselin E, Lemyre L, Corneil W (2013) Presenteeism and absenteeism: differentiated understanding of related phenomena. J Occup Health Psychol 18:75–86

    Article  Google Scholar 

  • Greenland S (2004) Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case–control studies. Am J Epidemiol 160:301–305

    Article  Google Scholar 

  • Gustafsson K, Marklund S (2011) Consequences of sickness presence and sickness absence on health and work ability: a Swedish prospective cohort study. Int J Occup Med Environ Health 24:153–165

    Article  Google Scholar 

  • Hansen CD, Andersen JH (2008) Going ill to work—What personal circumstances, attitudes and work-related factors are associated with sickness presenteeism? Soc Sci Med 67:956–964

    Article  Google Scholar 

  • Hansen CD, Andersen JH (2009) Sick at work—a risk factor for long-term sickness absence at a later date? J Epidemiol Community Health 63:397–402

    Article  CAS  Google Scholar 

  • Hansen ÅM, Høgh A, Persson R (2011) Frequency of bullying at work, physiological response, and mental health. J Psychosom Res 70:19–27

    Article  Google Scholar 

  • Hansen ÅM, Høgh A, Garde AH, Persson R (2013) Workplace bullying and sleep difficulties: a 2-year follow-up study. Int Arch Occup Environ Health 87:285–294

    Article  Google Scholar 

  • Heponiemi T, Elovainio M, Pentti J, Virtanen M, Westerlund H, Virtanen P, Oksanen T, Kivimäki M, Vahtera J (2010) Association of contractual and subjective job insecurity with sickness presenteeism among public sector employees. J Occup Environ Med 52:830–835

    Article  Google Scholar 

  • Hobfoll SE (1989) Conservation of resources: a new attempt at conceptualizing stress. Am Psychol 44:513–524

    Article  CAS  Google Scholar 

  • Hobfoll SE (2001) The influence of culture, community, and the nested-self in the stress process: advancing conservation of resources theory. Appl Psychol Int Rev 50:337–421

    Article  Google Scholar 

  • Hoel H, Salin D (2003) Organisational antecedents of workplace bullying. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and emotional abuse in the workplace: international perspectives in research and practice. Taylor and Francis, New York, pp 203–218

    Google Scholar 

  • Hoel H, Sheehan MJ, Cooper CL, Einarsen S (2011) Organizational effects of workplace bullying. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and harassment in the workplace: developments in theory, research, and practice, 2nd edn. CRC Press, Boca Raton, pp 129–148

    Google Scholar 

  • Høgh A, Dofradottir A (2001) Coping with bullying in the workplace. Eur J Work Organ Psychol 10:485–495

    Article  Google Scholar 

  • Høgh A, Hoel H, Carneiro IG (2011a) Bullying and employee turnover among health-care workers. A three-wave prospective study. J Nurs Manag 19:742–751

    Article  Google Scholar 

  • Høgh A, Mikkelsen EG, Hansen ÅM (2011b) Individual consequences of workplace bullying/mobbing. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Workplace bullying: development in theory, research and practice, 2nd edn. CRC Press, Boca Raton, pp 107–128

    Google Scholar 

  • Høgh A, Giver H, Hannerz H, Pedersen BH (2012a) Bullying and violence as predictors of drop out in the elder care two years later. Scand J Caring Sci 26:730–737

    Article  Google Scholar 

  • Høgh A, Hansen AM, Mikkelsen EG, Persson R (2012b) Exposure to bullying behaviour at work, psychological stress reactions and physiological stress response. J Psychosom Res 73:47–52

    Article  Google Scholar 

  • Janssens H, Clays E, Kittel F, De Bacquer D, Casini A, Braeckman L (2012) The association between body mass index class, sickness absence, and presenteeism. J Occup Environ Med 54:604–609

    Article  Google Scholar 

  • Janssens H, Clays E, De Clercq B, De Bacquer D, Braeckman L (2013) The relation between presenteeism and different types of future sickness absence. J Occup Health 55:132–141

    Article  Google Scholar 

  • Johansson G, Lundberg I (2004) Adjustment latitude and attendance requirements as determinants of sickness absence or attendance. Empirical tests of the illness flexibility model. Soc Sci Med 58:1857–1868

    Article  Google Scholar 

  • Johns G (2010) Presenteeism in the workplace: a review and research agenda. J Organ Behav 31:519–542

    Article  Google Scholar 

  • Johns G (2011) Attendance dynamics at work: the antecedents and correlates of presenteeism, absenteeism, and productivity loss. J Occup Health Psychol 16:483–500

    Article  Google Scholar 

  • Jourdain G, Vézina M (2014) How psychological stress in the workplace influences presenteeism propensity: a test of the Demand–Control–Support model. Eur J Work Organ Psychol 23:483–496

    Article  Google Scholar 

  • Kivimäki M, Elovainio M, Vahtera J (2000) Workplace bullying and sickness absence in hospital staff. Occup Environ Med 57:656–660

    Article  Google Scholar 

  • Kivimäki M, Head J, Ferrie JE, Hemingway H, Shipley MJ, Vahtera J, Marmot MG (2005) Working while ill as a risk factor for serious coronary events: the Whitehall II study. Am J Public Health 95:98–102

    Article  Google Scholar 

  • Kivimӓki M, Virtanen M, Vartia M, Elovainio M, Vathera J, Keltikangas-Jӓrvinen L (2003) Workplace bullying and the risk of cardiovascular disease and depression. Occup Environ Med 60:779–783

    Article  Google Scholar 

  • Kristensen TS, Hannerz H, Hogh A, Borg V (2005) The Copenhagen Psychosocial Questionnaire—a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health 31:438–449

    Article  Google Scholar 

  • Landsbergis PA, Schnall PL, Warren K, Pickering TG, Schwartz JE (1994) Association between ambulatory blood pressure and alternative formulations of job strain. Scand J Work Environ Health 20:349–363

    Article  CAS  Google Scholar 

  • Larsen AD, Hannerz H, Obel C, Thulstrup AM, Bonde JP, Hougaard K (2011) Testing the association between psychosocial job strain and adverse birth outcomes-design and methods. BMC Public Health 11:255

    Article  Google Scholar 

  • Leineweber C, Westerlund H, Hagberg J, Svedberg P, Luokkala M, Alexanderson K (2011) Sickness presenteeism among Swedish police officers. J Occup Rehabil 21:17–22

    Article  Google Scholar 

  • Leineweber C, Westerlund H, Hagberg J, Svedberg P, Alexanderson K (2012) Sickness presenteeism is more than an alternative to sickness absence: results from the population-based SLOSH study. Int Arch Occup Environ Health 85:905–914

    Article  Google Scholar 

  • Lewis D, Gunn R (2007) Workplace bullying in the public sector: understanding the racial dimension. Publ Adm 85:641–665

    Article  Google Scholar 

  • Lutgen-Sandvik P, Namie G, Namie R (2009) Workplace bullying: Causes, consequences, and corrections. In: Lutgen-Sandvik P, Sypher BD (eds) Destructive organizational communication: processes, consequences, and constructive ways of organizing. Routledge, New York, pp 27–52

    Google Scholar 

  • McNutt LA, Wu C, Xue X, Hafner JP (2003) Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 157:940–943

    Article  Google Scholar 

  • Niedhammer I, David S, Degioanni S, 143 Occupational physicians (2006) Association between workplace bullying and depressive symptoms in the French working population. J Psychosom Res 61:251–259

    Article  Google Scholar 

  • Nielsen MB, Einarsen S (2012) Outcomes of workplace bullying: a meta-analytic review. Work Stress 26:309–332

    Article  Google Scholar 

  • Nielsen MB, Madsen IEH, Bultmann U, Christensen U, Diderichsen F, Rugulies R (2011a) Predictors of return to work in employees sick-listed with mental health problems: findings from a longitudinal study. Eur J Public Health 21:806–811

    Article  Google Scholar 

  • Nielsen MB, Notelaers G, Einarsen S (2011b) Measuring exposure to workplace bullying. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and harassment in the workplace: developments in theory, research, and practice, 2nd edn. CRC Press, Boca Raton, pp 149–174

    Google Scholar 

  • Nielsen MB, Magerøy N, Gjerstad J, Einarsen S (2014) Workplace bullying and subsequent health problems. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 134:1233–1238

    Article  Google Scholar 

  • Notelaers G, Vermunt JK, Baillien E, Einarsen S, De Witte H (2011) Exploring risk groups workplace bullying with categorical data. Ind Health 49:73–88

    Article  Google Scholar 

  • Notelaers G, Baillien E, De Witte H, Einarsen S, Vermunt JK (2012) Testing the strain Hypothesis of the Demand Control Model to explain severe bullying at work. Econ Ind Democr 34:69–87

    Article  Google Scholar 

  • Nyberg A, Westerlund H, Magnusson Hansson LL, Theorell T (2008) Managerial leadership is associated with self-reported sickness absence and sickness presenteeism among Swedish men and women. Scand J Public Health 36:803–811

    Article  Google Scholar 

  • Ortega A, Høgh A, Pejtersen JH, Feveile H, Olsen O (2009) Prevalence of workplace bullying and risk groups: a representative population study. Int Arch Occup Environ Health 82:417–426

    Article  Google Scholar 

  • Ortega A, Christensen KB, Hogh A, Rugulies R, Borg V (2011) One year prospective study on the effect of workplace bullying on long-term sickness absence. J Nurs Manag 19:752–759

    Article  Google Scholar 

  • Pagán R (2007) Is part-time work a good or bad opportunity for people with disabilities? A European analysis. Disabil Rehabil 29:1910–1919

    Article  Google Scholar 

  • Persson R, Hogh A, Hansen AM, Nordander C, Ohlsson K, Balogh I, Österberg K, Ørbæk P (2009) Personality trait scores among occupationally active bullied persons and witnesses to bullying. Motiv Emot 33:387–399

    Article  Google Scholar 

  • Rayner C, Hoel H, Cooper CL (2002) Workplace bullying: what we know, who is to blame, and what can we do?. Taylor and Francis, London

    Book  Google Scholar 

  • Rodríguez-Muñoz A, Baillien E, De Witte H, Moreno-Jiménez B, Pastor JC (2009) Cross-lagged relationships between workplace bullying, job satisfaction and engagement: two longitudinal studies. Work Stress 23:225–243

    Article  Google Scholar 

  • Royall RM (1986) Model robust confidence intervals using maximum likelihood estimators. Int Stat Rev 54:221–226

    Article  Google Scholar 

  • Taloyan M, Aronsson G, Leineweber C, Magnusson Hanson L, Alexanderson K, Westerlund H (2012) Sickness presenteeism predicts suboptimal self-rated health and sickness absence: a nationally representative study of the Swedish working population. PLoS ONE 7:e44721

    Article  CAS  Google Scholar 

  • Tuckey MR, Neall AM (2014) Workplace bullying erodes job and personal resources: between- and within-person perspectives. J Occup Health Psychol 19:413–424

    Article  Google Scholar 

  • Ware JE, Snow KK, Snow K, Kosinski M, Gandek B (1993) SF-36® health survey. manual and interpretation guide. New England Medical Center, The Health Institute, Boston

    Google Scholar 

  • Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 47:1063–1070

    Article  Google Scholar 

  • Zapf D, Einarsen SE (2005) Mobbing at work. Escalated conflicts in organizations. In: Fox S, Spector PE (eds) Counterproductive workplace behavior: investigations of actors and targets. American Psychological Association, Washington DC, pp 237–270

    Chapter  Google Scholar 

  • Zapf D, Gross C (2001) Conflict escalation and coping with workplace bullying: a replication and extension. Eur J Work Organ Psychol 10:497–522

    Article  Google Scholar 

  • Zapf D, Escartín J, Einarsen S, Hoel H, Vartia M (2011) Empirical findings on prevalence and risk groups of bullying in the workplace. In: Einarsen S, Hoel H, Zapf D, Cooper CL (eds) Bullying and harassment in the workplace: developments in theory, research, and practice, 2nd edn. CRC Press, Boca Raton, pp 75–105

    Google Scholar 

  • Zhang J, Yu KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 280:1690–1691

    Article  CAS  Google Scholar 

  • Zocchetti C, Consonni D, Bertazzi PA (1995) Estimation of prevalence rate ratios from cross-sectional data. Int J Epidemiol 24:1064–1065

    Article  CAS  Google Scholar 

  • Zou G (2004) A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 159:702–706

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from the Danish Council of Independent Research (Project no. DFF - 1319-00092) and the Danish Work Environment Research Funds (Project No. 20130023294/3). We are grateful to Kirsten Nabe-Nielsen (Department of Public Health, University of Copenhagen) and Laura Francioli (Department of Psychology, University of Copenhagen) for their support on a revised version of this article.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul Maurice Conway.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Conway, P.M., Clausen, T., Hansen, Å.M. et al. Workplace bullying and sickness presenteeism: cross-sectional and prospective associations in a 2-year follow-up study. Int Arch Occup Environ Health 89, 103–114 (2016). https://doi.org/10.1007/s00420-015-1055-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-015-1055-9

Keywords

Navigation