• Welcome!

    Occ Psy Dot Com was set up in December 2010, and aims to present current occupational psychology research and perspectives in an accessible way.

  • Suggestions

    Would you like to see a certain article or topic represented on Occ Psy Dot Com? ) When will one of you guys state specific policy differences between Cialis sample Party daily cialis cost and the Republican Party?There are none. J. E. how much does cialis cost Its what Carly Fiorina would do. But if you have cable TV, youre paying for Fox News, Generic tadalafil online, and possibly MSNBC. whatever youve got in your lineup.

  • Follow us on Twitter!

    We tweet about everything that is psychology and business. Join our followers now to keep up to date!

    Follow laurakrikhaar on Twitter

Presenteeism in the workplace, reviewed

Sick at work: Consequences may include productivity loss

Absenteeism, i. e. not showing up for work, has been the subject of much research to date. In contrast, presenteeism (defined as showing up for work when one is ill), has only received interest in recent years, with research suggesting that it might cause more aggregate productivity loss than absenteeism. Consequences of chronic presenteeism or absenteeism may include effects on downstream health status, job attendance dynamics, and organizational membership.

The present review by Gary Johns touches on the subject of defining presenteeism appropriately for organizational practice and research, attempts to summarise the two main streams of research in presenteeism, and proposes a theoretical framework which could guide future research.

Reviewing theory and research

Presenteeism has been defined in various ways, and the author emphasises that a definition should neither ascribe motives, nor consequences to presenteeism. In particular, productivity loss resulting from presenteeism should not be labeled “presenteeism” (as has sometimes been the case), firstly, because it is unhelpful to refer to cause (presenteeism) and effect (productivity loss) as one and the same, and secondly, because this implies that presenteeism is seen as a negative event by the organisation, although presentees will likely be more productive than absentees, which may – in some situations – render presenteeism an act of organisational citizenship.

Presenteeism has been researched from two main perspectives: A British/European view with a focus on the precursors of presenteeism, and an American view, which – rather than asking why people show up to work when they are feeling ill – has concentrated on the productivity loss resulting from presenteeism.

Precursors of presenteeism

Research indicates that certain factors, such as earning relatively high wages, working in a firm that is in the process of downsizing, working as a non-permanent employee, and knowing that work is piling up when one is ill, are associated with less absenteeism, thus suggesting that these factors may influence an individual’s inclination to attend their job even when they are feeling unhealthy. A growing body of evidence supports the notion that norm-based “absence cultures”, operating at a collective level, may account for variance in individual job attendance.

Different medical conditions, and whether they generate absenteeism or presenteeism, have also been the subject of research. In particular, it has been suggested that certain conditions may figure more heavily in presenteeism than others, in part because they are not generally seen as legitimate reasons to be absent.

Productivity loss attributed to presenteeism

There is widespread agreement that presenteeism accounts for more aggregate productivity loss than absenteeism: “On the face of it, this suggests an iceberg effect in which the more visible portion of work loss (absenteeism) is dwarfed by that portion beneath the surface (presenteeism)” (p. 530). This does not mean that productivity could be enhanced if people were advised not to show up for work when they are ill, but rather indicates that while productivity loss from absenteeism may be high, productivity loss from presenteeism is probably even higher, because it is more prevalent then absenteeism, but much less accounted for.

A theoretical model

The author suggests a model which “assumes that fully productive regular attendance is interrupted by a ‘‘health event’’ that is either acute (e.g., the flu), episodic (e.g., migraine), or chronic (e.g., the onset of diabetes)”, and that “to some extent, the nature of the health event will dictate whether absenteeism or presenteeism ensues” (p. 532).

Among other notions, it is identified that a theory of presenteeism should recognize the subjectivity of health, account for the relationship between absenteeism and presenteeism, give special attention to job insecurity as a precursor of presenteeism, incorporate work attitudes and experiences, as well as personality, and attend to presenteeism’s social dynamics.


How can a deeper knowledge of presenteeism be useful? The author proposes that scholars in organizational behavior, human resources, organizational psychology, and health psychology should apply their distinct skills to add to “our understanding of how absence episodes start and how decisions to return to work are effected”, and to probe “the loosely coupled but important connections among having a medical condition, defining oneself as ill, and engaging in work behaviors associated with assuming a sick role” (p. 522).

Such knowledge could contribute to more accurate estimates of employee health costs, and is required if organisations are to take informed decisions about how to manage presenteeism.

Image courtesy of Orphan Jones.


ResearchBlogging.orgJohns, G. (2009). Presenteeism in the workplace: A review and research agenda Journal of Organizational Behavior, 31 (4), 519-542 DOI: 10.1002/job.630

This entry was posted in Reviews (Peer-Reviewed) and tagged , , , , . Author: . Journal: . Bookmark the permalink. Both comments and trackbacks are currently closed.
Rebecca Quereshi is the founder of Occ Psy Dot Com, an occupational psychology professional holding an MSc in Occupational Psychology from Birkbeck College, University of London. ••• You can read more about her on our editor's page, follow her on Twitter at @occupationalpsy, connect with her on LinkedIn, or see a list of all her articles at Occ Psy Dot Com.


  1. Francesca Meijer
    Posted 20 January, 2011 at 5:42 PM | Permalink

    Presenteeism is a really interesting topic, and the article highlights that old chestnut of the importance of clearly defined terms and specificity – particularly in the realm of research. Johns highlights the influencing nature of the type of illness (i.e. that different medical conditions influence a person’s presenteeism / absenteeism behaviour) on behaviour, and we might also want to consider the influence of individual differences, such as job role and job commitment, as well as local culture.

    In my last consultancy, it was the client-facing folk, particularly those at higher levels, who would crawl in to work with red noses, whereas the clerical staff – who perhaps had work that could more easily be taken on by others – would be much less inclined to face work if feeling rubbish. The attitude one has to one’s job and employer could also be assumed to influence whether or not we turn up and feelings of fear, loyalty or determination must too play a role. In terms of local culture, I would expect some groups (particularly those used to high density urban living, and those who have already experienced large scale virus outbreaks – think face masks associated with some Asian cities) to be more sensitive to passing on / being the recipient of contagious germs.

    So while research and theory development frequently requires a narrowness of focus, perhaps the above suggests practice needs a broader scope, one that considers influencing how employees do behave when they become ‘ill’. For example, perhaps organizations need specific dialogue with employees with regard to expectations, and in this case, it would be essential for leaders to role model the policy, rather than ‘pressing on’ regardless. The use of mobile technologies might also play greater importance in the case of communicable illness, where poorly employees are actively discouraged to share the space of their well colleagues.

    Finally, the question of how responsible an organization is for their employee wellbeing extends out of the subject of presenteeism: can we do anything to prevent certain types of illness? What efforts should an organization go to avoid presenteeism (or absenteeism) and ensure a present and healthy workforce? Boosting, rather than diminishing, employees’ immune systems by initiatives like promoting ‘healthy’ job design, working hours, even policies and practices supporting with diet and exercise seem like good starters. I would argue that these are not just ethical issues, but part of an organizational culture that keeps an eye on both its employees and the bottom line.

    • Posted 21 January, 2011 at 10:09 AM | Permalink

      Great thoughts and examples! I like your idea of a more specific dialogue regarding expectations, and for leaders to role model policies. Unfortunately, it is the nature of many jobs – especially professional/specialist/managerial – that many tasks cannot simply be taken over by another person. I am wondering whether a new approach to job-design may be underway (also, as part-time work is becoming more of a subject of interest for this working population)?