QUESTION: Some of our staff recently had the flu and attended work when they were clearly not well. We were concerned that they could be spreading their illness to other employees. Should we have told them to go home?

 In a utopian world, employees would all be competent, conscientious, effective, fit for work on the day and highly productive for the full shift. They would not procrastinate, make mistakes or overlook anything. No-one would be tired, upset, alienated, or busy with non-work matters, and no-one would be the worse for wear, either due to overindulgence the night before, or due to illness. And there would definitely be no-one who came into work with a cold or the flu – coughing and sneezing and breathing contagion, spreading whatever they’ve got among the other staff.

Being present at work but not fully functioning is referred to as ‘presenteeism’, and it is a major cost to business in terms of diminished productivity. ‘Sickness presenteeism’ is a very common variant of this corporate malaise, and it is especially unwelcome, given the risk of illness spreading to other staff.
The sensible thing would be to stay home when you’re unwell but, in many workplaces, turning up at work despite illness is expected, or even understood as a badge of commitment and diligence, according to the unwritten rules of the organisation’s ‘culture’ – its norms, values and practices. Taking a sick day is often informally frowned upon, and seen as evidence of ‘slacking off’.

Ironically, work performance and productivity can be greatly undermined by those who are working ill. The adverse effects are generally threefold. In the first place, the sick individual’s capacity for effective work is impaired, with less output, and work of lower quality. Research has indicated that by working unwell, employees raise their risk of on-the-job accidents. In addition, their illness can be prolonged by their refusal to rest and recuperate; and in the case of an infectious disease, other staff – or even clients, customers or members of the public – can contract it. Co-workers with chronic health conditions or other vulnerabilities, such as pregnancy, age or particular susceptibilities, can be especially badly affected. 

The undesirable consequences are compounded if the unwell employee is working with food, where germs can be transferred to food preparation surfaces, the food itself or other surfaces such as taps and door handles, which are then touched by other staff.

It is useful to consider the reasons for sickness presenteeism, as different causes call for different remedies.

Reasons for presenteeism

Job insecurity is commonly the main prompt for people to come to work when they’re ill. If they believe sickness absence will be interpreted as lack of commitment, they are more likely to adopt the stoic stance and doggedly drag themselves in to work. This is particularly likely if the organisation is restructuring or downsizing, or the business is not thriving, or if their supervisor or line manager has been disparaging about their work performance.

Work pressure in terms of deadlines, volume of work or lack of suitable back-up personnel is another key driver of working when ill. People may recognise their absence will cause losses for the business, or inconvenience and delays for others, or they may have subconscious reasons for believing their presence is indispensable. 

Industrial conditions can also play a part in determining sickness behaviour, as staff without paid sick leave are much more likely to soldier on through illness. A study by the (US) National Institute for Occupational Health and Safety found that employees with paid sick leave were 28 per cent less likely to suffer non-fatal workplace injuries.

The view that ‘I’m probably no longer infectious’ can also be cited as the reason they are at work, not at home, resting. This is not always justified, however, as some viruses can continue to be passed to others for several days after the symptoms subside.

What can you do?

As with other aspects of ‘workplace culture’, management sets the tone. 

Workers can be told – in staff meetings, with notices, through on-the-job direction of line managers and supervisors, and in a wide variety of other ways: ‘Do not come to work if you are suffering an illness’. Clear, practical guidance as to what conditions should trigger a sick day can help, and management also needs to model this behaviour by complying with this restriction themselves.

Management may also deal with the issue by making arrangements for temporary assistance to back up absent staff, where feasible, or agreeing that the person can work from home, or make up the hours when they are well. Flexible work systems can also help with the situation where an employee saves up sick days for when they are needed to care for a sick child or elderly parent.

Allowing employees short periods of sickness absence without requiring a doctor’s certificate reportedly decreases sickness presenteeism, and companies may also choose to offer vaccinations for certain conditions, or provide in-house wellness or health promotion programs, including advice on effective handwashing. 

If employers can discourage staff from coming to work when they’re ill – and even by directing them to go home, if need be – the business is likely to benefit.
By Gaby Grammeno on 31 May 2018