Skip to main content
SpringerLink
Log in

Sickness presenteeism is more than an alternative to sickness absence: results from the population-based SLOSH study

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

Abstract

Purpose

Sickness presenteeism, defined as ‘going to work despite judging that one should have reported in sick’, is usually considered to be a complementary alternative to sickness absence. Nonetheless, several studies have reported a positive association between sickness absence and sickness presenteeism. The aim of the present study was to investigate whether the contemporaneous positive association between sickness absence and sickness presenteeism can be explained by illness, work incapacity, and/or work environment.

Methods

A cross-sectional study based on answers to a comprehensive questionnaire from 8,304 working women and men, those in the second wave of the nationally representative Swedish Longitudinal Occupational Survey of Health. Logistic regression was used to investigate the association between sickness presenteeism and sickness absence.

Results

Sickness absence was strongly associated with sickness presenteeism. Sickness absence of 1–7 days during a 12-month period more than doubled the odds of also having sickness presenteeism of more than 8 days during the same 12-month period (OR = 2.11; 95% CI: 1.79–2.49). Adjusting for age and sex did not attenuate the association; further adjustment for work environment, self-rated health, chronic diseases, and work capacity reduced the odds somewhat, but they remained highly significant (OR = 1.88; 95% CI: 1.56–2.25).

Conclusions

The results suggest that sickness presenteeism is not, as earlier hypothesised, just an alternative to sickness absence, given a certain level of health or work incapacity. Other, so far unknown explanations for both sickness absence and sickness presenteeism must be sought.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aronsson G, Gustafsson K (2005) Sickness presenteeism: prevalence, attendance-pressure factors, and an outline of a model for research. J Occup Environ Med 47(9):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 Commun Health 54:502–509

    Article  CAS  Google Scholar 

  • Aronsson G, Svensson L, Gustafsson K (2003) Unwinding, recuperation, and health among compulsory school and high school teachers in Sweden. Int J Stress Manag 10(3):217–234

    Article  Google Scholar 

  • Benyamini Y, Idler EL (1999) Community studies reporting association between self-rated health and mortality: additional studies, 1995 to 1999. Res Aging 21(3):392–401

    Article  Google Scholar 

  • Bergstrom G, Bodin L, Hagberg J, Aronsson G, Josephson M (2009a) Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 51(6):629–638

    Article  Google Scholar 

  • Bergstrom 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(10):1179–1190

    Article  Google Scholar 

  • Bockerman P, Laukkanen E (2010) Predictors of sickness absence and presenteeism: does the pattern differ by a respondent’s health? J Occup Environ Med 52(3):332–335

    Article  Google Scholar 

  • Burdorf A, Post W, Bruggeling T (1996) Reliability of a questionnaire on sickness absence with specific attention to absence due to back pain and respiratory complaints. Occup Environ Med 53(1):58–62

    Article  CAS  Google Scholar 

  • Caverley N, Cunningham JB, MacGregor JN (2007) Sickness presenteeism, sickness absenteeism, and health following restructuring in a public service organization. J Manag Stud 44(2):304–319. doi:10.1111/j.1467-6486.2007.00690.x

    Article  Google Scholar 

  • Conway JM, Lance CE (2010) What reviewers should expect from authors regarding common method bias in organizational research. J Bus Psychol 25:325–334. doi:10.1007/s10869-010-9181-6

    Article  Google Scholar 

  • Elstad JI, Vabo M (2008) Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scand J Public Health 36(5):467–474

    Article  Google Scholar 

  • Ferrie JE, Kivimaki M, Head J, Shipley MJ, Vahtera J, Marmot MG (2005) A comparison of self-reported sickness absence with absences recorded in employers’ registers: evidence from the Whitehall II study. Occup Environ Med 62(2):74–79

    Article  CAS  Google Scholar 

  • Fredriksson K, Toomingas A, Torgen M, Thorbjornsson CB, Kilbom A (1998) Validity and reliability of self-reported retrospectively collected data on sick leave related to musculoskeletal diseases. Scand J Work Environ Health 24(5):425–431

    Article  CAS  Google Scholar 

  • Hallberg UE, Sverke M (2004) Construct validity of the Maslach burnout inventory: two Swedish health care samples. Eur J Psychol Assess 20(4):320–338

    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(6):956–964

    Article  Google Scholar 

  • Hanson LL, Akerstedt T, Naswall K, Leineweber C, Theorell T, Westerlund H (2011) Cross-lagged relationships between workplace demands, control, support, and sleep problems. Sleep 34(10):1403–1410. doi:10.5665/SLEEP.1288

    Google Scholar 

  • Hensing G (2004) Swedish Council on Technology Assessment in Health Care (SBU). Chapter 4. Methodological aspects in sickness-absence research. Scand J Public Health Suppl 63:44–48. doi:10.1080/14034950410021844

    Article  Google Scholar 

  • Heponiemi T, Elovainio M, Pentti J, Virtanen M, Westerlund H, Virtanen P, Oksanen T, Kivimaki M, Vahtera J (2010) Association of contractual and subjective job insecurity with sickness presenteeism among public sector employees. J Occup Environ Med 52(8):830–835

    Article  Google Scholar 

  • Hultin H, Hallqvist J, Alexanderson K, Johansson G, Lindholm C, Lundberg I, Moller J (2010) Low level of adjustment latitude–a risk factor for sickness absence. Eur J Pub Health 20(6):682–688. doi:10.1093/eurpub/ckp240

    Article  Google Scholar 

  • Karasek R, Baker D, Marxer F, Ahlbom A, Theorell T (1981) Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health 71(7):694–705

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  • Koopmanschap M, Burdorf A, Jacob K, Meerding WJ, Brouwer W, Severens H (2005) Measuring productivity changes in economic evaluation: setting the research agenda. Pharmacoeconomics 23(1):47–54

    Article  Google Scholar 

  • Lipmann R (1986) Depression scales derived from Hopkins symptom checklist. In: Sartorius N, Bann T (eds) Assessment of depression. Springer, Berlin, pp 232–248

    Chapter  Google Scholar 

  • Magnusson Hanson LL, Theorell T, Bech P, Rugulies R, Burr H, Hyde M, Oxenstierna G, Westerlund H (2009) Psychosocial working conditions and depressive symptoms among Swedish employees. Int Arch Occup Environ Health 82(8):951–960

    Article  Google Scholar 

  • Maslach C, Jackson SE, Leiter MP (1996) Maslach burnout inventory manual, 3rd edn. Consulting Psychologists Press, Inc., Palo Alto

    Google Scholar 

  • Meade AW, Watson AM, Kroustalis CM (2007) Assessing common methods bias in organizational research. Paper presented at the paper presented at the 22nd Annual Meeting of the Society for Industrial and Organizational Psychology, New York

  • Nyberg A, Westerlund H, Magnusson Hanson L, 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 

  • Oyeflaten I, Hysing M, Eriksen HR (2008) Prognostic factors associated with return to work following multidisciplinary vocational rehabilitation. J Rehabil Med 40(7):548–554. doi:10.2340/16501977-0202

    Article  Google Scholar 

  • Schultz AB, Edington DW (2007) Employee health and presenteeism: a systematic review. J Occup Rehabil 17:547–579

    Article  Google Scholar 

  • Svedberg P, Ropponen A, Lichtenstein P, Alexanderson K (2010) Are self-report of disability pension and long-term sickness absence accurate? Comparisons of self-reported interview data with national register data in a Swedish twin cohort. BMC Public Health 10:763. doi:10.1186/1471-2458-10-763

    Article  Google Scholar 

  • Theorell T, Perski A, Akerstedt T, Sigala F, Ahlberg-Hultén G, Svensson J, Eneroth P (1988) Changes in job strain in relation to changes in physiological state. A longitudinal study. Scand J Work Environ Health 14(3):189–196

    Article  CAS  Google Scholar 

  • Theorell T, Oxenstierna G, Westerlund H, Ferrie J, Hagberg J, Alfredsson L (2003) Downsizing of staff is associated with lowered medically certified sick leave in female employees. Occup Environ Med 60(9):E9

    Article  CAS  Google Scholar 

  • van Poppel MN, de Vet HC, Koes BW, Smid T, Bouter LM (2002) Measuring sick leave: a comparison of self-reported data on sick leave and data from company records. Occup Med (Lond) 52(8):485–490

    Article  Google Scholar 

  • Vingard E, Alexanderson K, Norlund A (2004) Swedish council on technology assessment in health care (SBU). Chapter 9. Consequences of being on sick leave. Scand J Public Health Suppl 63:207–215

    Article  Google Scholar 

  • Wallman T, Wedel H, Johansson S, Rosengren A, Eriksson H, Welin L et al (2006) The prognosis for individuals on disability retirement. An 18-year mortality follow-up study of 6887 men and women sampled from the general population. BMC Public Health 6:103

    Article  Google Scholar 

  • Wikman A, Marklund S, Alexanderson K (2005) Illness, disease, and sickness absence: an empirical test of differences between concepts of ill health. J Epidemiol Commun Health 59(6):450–454

    Article  Google Scholar 

  • Wolke D, Waylen A, Samara M, Steer C, Goodman R, Ford T, Lamberts K (2009) Selective drop-out in longitudinal studies and non-biased prediction of behaviour disorders. Br J Psychiatry 195(3):249–256. doi:10.1192/bjp.bp.108.053751

    Article  Google Scholar 

Download references

Acknowledgments

CL, HW, JH, and KA were financed by a research programme grant from the Swedish Council for Working Life and Social Research (FAS, grant #2007-1143). PS is financed by a postdoctoral grant from the Centre for Health Care Science (#2179/08-607 and #2675/09-607). The SLOSH study (wave I and II) was funded by FAS (grant #2005-0734 and #2008-0958). The project was carried out within the framework of Stockholm Stress Centre, a FAS centre of excellence (grant #2009-1758). All authors are independent from their funders.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Stress Research Institute, Stockholm University, 106 91, Stockholm, Sweden

    Constanze Leineweber & Hugo Westerlund

  2. The Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden

    Jan Hagberg

  3. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

    Hugo Westerlund, Pia Svedberg & Kristina Alexanderson

Authors
  1. Constanze Leineweber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hugo Westerlund
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan Hagberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pia Svedberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kristina Alexanderson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Constanze Leineweber.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 187 kb)

Supplementary material 2 (PDF 77 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leineweber, C., Westerlund, H., Hagberg, J. et al. 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 (2012). https://doi.org/10.1007/s00420-012-0735-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-012-0735-y

Keywords

Search

Navigation