Abstract
BackgroundEarlier studies have suggested that sickness presenteeism (SP) may be a risk factor for future health problems. The purpose of the present study was to test this in a nationally representative prospective study of Swedish workers.MethodsProspective cohort with a representative sample of the Swedish working population surveyed in 2008 and 2010. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using logistic regression.ResultsThose who reported more than 7 days of SP had higher risk of suboptimal SRH compared to those who reported no SP (OR = 5.95; 95% CI 4.98–7.12), also after adjustment for confounders (OR = 1.64; 95% CI 1.30–2.06). Those who reported 1–7 days of SP also had an increased risk before and after adjustments. Inclusion of self-rated physical and psychological work capacity did not attenuate the associations, whereas of emotional exhaustion attenuated the ORs to non-significance for both outcomes, indicating that the health consequences associated with SP are largely related to mental health.ConclusionThe results strengthen earlier findings suggesting that SP can be a risk factor for future suboptimal general health and sickness absence, particularly through mental health problems. This indicates that asking about SP could yield important information for employers, occupational health practitioners and GPs, possibly leading to more timely intervention that could decrease the risk of future sickness absence and more serious health problems, especially in the mental domain. Further studies of the possible causal pathways between SP and future health development are also warranted, especially since going to work is often seen as desirable also for those with poor health.
Highlights
The basis for sickness absence is reduced work capacity due to illness
In follow-up analysis after three years, with control for known risk factors for cardiovascular disease the researcher found that the risk of heart attacks had doubled in the sickness presenteeism (SP) group compared with the second group who had had low or moderate Sickness absence (SA)
Odds ratio of suboptimal self-rated health in 2010 was substantially increased for those who had reported more than 7 days of SP in 2008 compared to those reporting no SP (OR = 5.96; 95% confidence intervals (CI) 4.98 to 7.12) after adjustment for age, sex, and income, and Odds ratios (OR) = 1.46 in the fully adjusted model (Table 4, left)
Summary
The basis for sickness absence is reduced work capacity due to illness. The individual must decide how he or she will act in relation to the illness or loss of work capacity. Sickness absence and sickness presence (SP) may be said to be mutually exclusive courses of action in case of sickness entailing loss of work capacity. The North American perspective is focused on productivity loss at work related to illness [2], while the Scandinavian and European literature defines SP as attending work despite illness which would have motivated sickness absence, i.e. a person goes to work despite the feeling that he/she should have stayed at home because of his/her subjectively poor health condition [3,4]. The purpose of the present study was to test this in a nationally representative prospective study of Swedish workers
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