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Updated Apr 11, 2024

The Problem of Presenteeism: Employees Coming to Work Sick Costs Businesses

When employees come to work sick, it puts the whole team at risk and costs businesses money. In the wake of the COVID-19 pandemic, stopping presenteeism is more important than ever.

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Adam Uzialko, Business Strategy Insider and Senior Editor
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Everybody gets sick now and then, but many employees are tempted to show up to work even when they’re feeling unwell, whether to preserve paid time off (PTO), avoid work piling up, or save team members from picking up the slack. This trend of coming to work sick is known as “presenteeism.” It carries significant risks to public health and costs businesses money.

Discouraging presenteeism can be more challenging than it sounds. It’s the responsibility of company leadership and managers to ensure employees are encouraged to take time off when they’re feeling ill, especially in the wake of the COVID-19 pandemic. 

Part of discouraging presenteeism means ensuring workers have the tools that let them stay home, including adequate time off and the ability to do their jobs from home when needed.

FYIDid you know
As a small business leader, you need to know and understand federal and local sick leave laws.

How big of a problem is presenteeism?

Presenteeism might not sound like a significant problem. After all, most people like to rest when they’re not feeling well. However, presenteeism is more common than it might seem. According to The Shift Project, a Harvard-run survey of 6,600 workers analyzing paid sick leave found that 65% of employees surveyed worked even when they were ill.

Employees come to work sick for various reasons:

  • They don’t want to fall behind.
  • They don’t want to add to another team member’s workload.
  • They don’t want to use up their paid sick time.
  • They lack access to sick leave.

Regardless of the reason, presenteeism poses a risk to other workers, customers, and the business itself.

“When employees come to work sick, they jeopardize the rest of the team and put them at risk of also getting sick, which then means that each employee will soon face the same amount of lost productivity and the business now has to shoulder [multiple] sick employees rather than just the one,” said Stephanie Troiano, executive recruiter at talent search firm Wimbush & Associates.

However noble an employee’s intentions, coming to work sick is reckless and costly. Research from the University of Arizona found that when one worker spends just two to four hours in the workplace, they spread germs to more than 50% of commonly touched surfaces in the area. Illness spreads quickly, especially in a confined space like an office.

“When sick employees feel compelled to physically go to work, they risk exposing the entire office staff and their clients to disease,” said Ilana Jacqueline, patient advocate and author of Surviving and Thriving with an Invisible Chronic Illness. “For an otherwise healthy employee, it may cost them several days of a bad cold. For more at-risk populations, it could result in hospitalizations, the need of intravenous antibiotics, and weeks of grueling recovery.”

Presenteeism isn’t just a risk to colleagues and their families; it also represents a substantial economic cost. The American Productivity Audit estimates that presenteeism costs the U.S. economy $150 billion in lost productivity every year, as reported in Harvard Business Review. 

For small businesses, runaway costs associated with presenteeism could seriously threaten operational continuity. Businesses need to be proactive in their approach to preventing presenteeism before it becomes a problem.

Key TakeawayKey takeaway
Even one half-day at work sick can spread germs to more than 50% of the most commonly touched surfaces in an office. Presenteeism costs the U.S. economy an estimated $150 billion in lost productivity every year.

How to prevent presenteeism

By combining policies that allow workers to take time off without sacrificing vacation days and remote work capabilities, employers can significantly reduce instances of presenteeism. 

It also helps to create a workplace culture that prioritizes a healthy work-life balance. You want your employees to understand they can and should take time off when appropriate, absolving highly motivated workers of any guilt they may feel for taking sick days. 

Take these concrete steps to prevent presenteeism. 

1. Offer a paid sick leave policy.

Paid sick leave could alleviate the main reason employees come to work ill. Many employees don’t want sick time to cut into their paid time off. (After all, who wants to burn a day for a bad cold in February that could be spent soaking up the sun in July?) 

With paid time off set aside specifically for sick leave, employees can feel empowered to take the recovery time they need without feeling like they’re sacrificing their recreational time off work.

“Employees should provide generous PTO and sick days,” said Shemifhar Freytes, engagement and corporate culture strategist at Enlivity. “A lot of employees show up to work sick because they don’t want to use their vacation time. Giving them flexibility and generous PTO will help them take the time they need to recover.” 

Did You Know?Did you know
A generous PTO policy shows employee appreciation, which can also boost engagement, employee retention and company morale.

2. Staff adequately to support workload when sick workers stay home.

Some employees feel the need to come in even when they’re sick because they have a lot of work to do. Faced with the option of letting work pile up or passing work to another team member, many choose to forgo the day off and come in anyway. While this work ethic might be commendable, presenteeism is not. 

One way to combat the fear of work not getting done is to staff adequately so that ample team members can pick up the slack if any employee calls out sick. Some businesses choose to run with a skeleton crew to save on labor costs, but the trade-off is when one team member is out, the team may have difficulty functioning.

Make sure you have adequate staff at all times, including part-time employees on call. This reduces the pressure on employees to show up sick.

3. Allow employees to work remotely.

When employees feel sick but still want to work, there’s often no reason for them to come into the office and risk spreading germs. Today’s employees have the tools to work from home when needed, including remote working tools like Zoom and Microsoft Teams.

“With the rise of video conference software and online workspace organizational tools, employees are better equipped than ever before to do their jobs from the comfort of their own homes,” Jacqueline said. “Whether their illnesses are chronic or acute, if companies implement the use of these tools, not only will they minimize the cost of absenteeism due to illness, but also due to inclement weather, traffic and parental leave.”

During the COVID-19 pandemic, many companies switched to a fully remote work model, in which employees worked for extended periods from their homes. If your business or specific departments and teams can work entirely remotely, consider allowing employees to stay home when they feel ill but want to put in a full day’s work. [Related content: Guide to Managing a Remote Workforce]

Offer employees a stipend to purchase approved equipment as part of a work-from-home incentive. They can set up their home workspaces to be as comfortable and productive as their station at work.

4. Encourage taking time off for illness in your workplace culture.

If you make it clear that management supports and encourages employees to take time off until their health recovers, that goes a long way in preventing presenteeism. Many workers are worried about what their managers and leadership teams might think, so reassuring them regularly and cementing time off into workplace culture is a big help.

“It’s incredibly important that the ‘sick policy’ comes from the top,” Troiano said. “It should be an employer-sponsored policy, because if it’s an initiative carried out by the team … and not management, it sends the message that the expectation is to work when sick … [and] your health isn’t an excuse to stop being productive.” 

Taking responsibility for workers

While an employee might have the best intentions, they’ll end up being counterproductive and potentially hazardous if they come to work sick. Give workers the space and resources to recover at home, whether they’re on the clock or resting and recovering. Especially in the wake of the COVID-19 pandemic, employers should take greater responsibility for the health and wellness of employees and customers. 

Protect your workplace by discouraging presenteeism and supporting your employees when they’re taking time away to recover.

Source interviews were conducted for a previous version of this article.

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Adam Uzialko, Business Strategy Insider and Senior Editor
Adam Uzialko, senior editor of Business News Daily, is not just a professional writer and editor — he’s also an entrepreneur who knows firsthand what it’s like building a business from scratch. His experience as co-founder and managing editor of a digital marketing company imbues his work at Business News Daily with a perspective grounded in the realities of running a small business. Since 2015, Adam has reviewed hundreds of small business products and services, including contact center solutions, email marketing software and text message marketing software. Adam uses the products, interviews users and talks directly to the companies that make the products and services he covers. He specializes in digital marketing topics, with a focus on content marketing, editorial strategy and managing a team.
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