You wake up in the morning with a scratch in your throat. You can feel the blood throbbing in your temples, and a headache drums behind your eyes. You know that you’re sick. If it wasn’t a workday, you would stay in bed. Instead, you roll out of bed, take a deep breath, get dressed and go to work, even though you know you will be counting the hours until you can climb back under the blankets.
This phenomenon, called presenteeism, is as common as absenteeism, if not more so, and is affecting workers around the world. South Africa is no exception. Absenteeism costs the economy about R16-billion a year in lost productivity, according to Statistics South Africa, but presenteeism is more difficult to quantify.
“Presenteeism differs from absenteeism,” says Leon de Beer, a senior lecturer at North-West University’s WorkWell research unit. “When absent, the supervisor or employer knows that the employee is not at work and not working, but in the case of presenteeism, the employee is at work but productivity is affected and this is obviously harder to gauge by the organisation. Inevitably, this affects organisational performance and profitability.”
There are two types of presenteeism, De Beer explains. Impaired presenteeism is when the employee has health-related concerns. Motivational or disengagement presenteeism is when the employee is demotivated and disengaged from their job.
In a study published in the Journal of Occupation Health this week, researchers at the University of East Anglia focused on impaired absenteeism and found that “high job demands, stress and job insecurity are among the main reasons why people go to work when they are ill”.
The study was a meta-study that reviewed 61 previous studies on the topic involving more than 175 000 participants. “Working while ill can compound the effects of the initial illness and result in negative job attitudes and withdrawal from work,” says lead author Mariella Miraglia, a lecturer in organisational behaviour at the university’s business school.
“However, the possible negative consequences [such as disciplinary action, job insecurity, limited paid sick leave or few absence days without a medical certificate] of being absent can prompt employees to show up ill or return to work when not totally recovered.”
Another reason for coming to work when ill was that employees loved their jobs.
Health-related presenteeism also encompasses chronic conditions such as back pain and allergies.
In a paper published in the South African Journal of Human Resource Management in 2014, De Beer uses the example of hay fever. The allergy reduces employees’ productivity by up to 7%, he writes. “In terms of work time lost, employees have reported that 2.3 hours per day are spent being unproductive due to symptoms.”
But this is only one form of presenteeism.
Metropolitan Health’s executive head of wellness, Terence Govender, said in a public statement in the Mail & Guardian earlier this year: “One of the most harmful forms [of presenteeism] is disengagement presenteeism, which is when employees are demotivated or dissatisfied with their job, or certain aspects of the workplace, and do not work at their full capacity. There is also the risk that this lack of motivation and negative behaviour can spread to other employees.”
Govender suggested employee wellness solutions to address presenteeism, although he noted: “A one-size-fits-all approach never works when it comes to wellness, as each workplace has specific dynamics and unique needs.”
Miraglia agrees. “Because presenteeism is more predictable than absenteeism, it is easy to modify by management actions,” she says. “Workplace wellness and health programmes may be desirable to reduce stress and work-related illness.”
Although increasing support structures in organisations could reduce presenteeism, “controlling job demands represents a key line of defence against the behaviour”.
“Organisations may benefit from well-designed jobs that limit the level of demands to which employees are exposed every day, for example by reducing excessive workload, time pressure and overtime work, as well as making sure [employees] have the resources they need.”
This costs employers money. But De Beer says: “Spending money in order to address the risks of presenteeism within an organisation should be thoroughly considered by employers, as the investment in this area of employee work-related wellbeing should not be above that of the incurred productivity loss due to presenteeism in the first instance.
“A healthy workforce is a productive workforce and … employee wellbeing is important for organisational performance, as health and productivity are implicitly entwined.”