What Can You Do to Combat Presenteeism in Your Workplace?

More and more employers are facing employees that are on the job but, because of illness or other non-health-related issues, are not very productive. This issue is called presenteeism. Presenteeism is a productivity and performance related issue that is receiving increased attention and concerns from employers.

Presenteeism is not always as apparent as absenteeism, because it is harder to tell how much an illness affects a person's performance than to know how often someone does not show up for work. Employees coming to work with an illness can affect both the quantity (people may work more slowly than usual) and quality of work (they might make more mistakes) of their work.¹ Presenteeism can also increase financial burden and have the negative impacts including work-related accidents, equipment breakage, absences related to family-work life balance, errors in judgment, conflicts and interpersonal problems. Studies also show that presenteeism may cost a company more substantially than they spend directly on medical treatment and medications. As of now, there is little data and sensitive measures of presenteeism in Canada. However, according to Statistics Canada, the average days absenting per employee per year is 7.5 days or 3% of salary. Studies of some chronic conditions and health risk factors found that lost productivity from presenteeism was 7.5 times greater than productivity loss from absenteeism. For some stress related health problems such as heart disease, hypertension, migraines, and neck or back pain, the ratio increased 15 times greater.² For example, if a company has 150 employees and salary costs totaled $6,240,000.³ Absenteeism would cost the employer about $187,200 while presenteeism would cost about $1,638,000.

The burning question is how to prevent and deal with presenteeism in workplace. Given the variety of causes and the different effects of presenteeism, a universal action plan which applies to all situations is unrealistic. Employers should think about the situation critically and consider the following perspectives to combat the issue.

Diagnosing and measuring presenteeism: Identifying and analyzing an issue is the starting point to solve it. A joint study conducted by the Benfield Group and the American College of Occupational and Environmental Medicine found that only 14% of companies are studying and dealing with presenteeism. It is very important for employers to know how to effectively measure presenteeism within their staff. There are several survey tools used to measure lost productive time. The most commonly used tools are the World Health Organization (WHO) Health and Work Performance Questionnaire (HPQ) and the Work Limitations Questionnaire (WLQ). The HPQ focuses on both absenteeism and presenteeism with 30 questions asking respondents to assess their overall work experience during the previous four weeks. The HPQ is more suitable for smaller employers. The WLQ consists of 25 questions and measures how an illness can impact a respondent's ability to function under job demands.⁴ This kind of tools is extremely helpful for employers to create a baseline productivity assessment in their workplaces.

Reviewing and evaluating organizational culture and policy: Company culture is another factor that affects presenteeism. For example, a company's absence management policies may encourage employees with medical conditions to come to work so they would avoid disciplinary measures. So, the fact is in trying to address absenteeism, the policies might lead to presenteeism. It is also necessary to adjust or create policies to prevent presenteeism, such as offering telecommuting options when employees have to stay home but deadlines need to be met. Employers need to ensure employees do not feel pressured to show up when they are sick.

Planning and implementing workplace wellness program: It is acknowledged by more and more employers that a comprehensive wellness program is beneficial for both employees' health and the company's financial well-being. Many employers provide health risk appraisals, health fairs, and lunch and learn seminars that include a broad range of health topics, such as physical activity, healthy eating, weight management, smoke cessation, stress management and so on. It is one of the effective and economical approaches to preventing and dealing with presenteeism.

As a complex and relatively fresh issue in the workplace, presenteeism is attracting more of the attention of employers and researchers. With relatively small efforts and by utilizing available resources appropriately, companies will be able to address and combat the issue of presenteeism. For more information or support on reducing presenteeism and creating a mentally healthy workplace, refer to the new Mental Health Promotion Info-Pack developed by the Canadian Mental Health Association, Ontario Division and the Health Communication Unit. See this resource at www.wmhp.cmhaontario.ca.

1. At Work-But out of It, 2004
2. Employers Health Coalition, Inc., 1999
3. Income in Canada, 2009
4. Benefits & Compensation Digest, Vol. 45, No. 12 December 2008