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Absenteeism, Presenteeism, and Keeping the Workplace – and Workers – Healthy

By Julie Athey

After a brief respite offered by the warm summer months, the swine flu is back in action just in time for the beginning of the school year and all the germ-spreading opportunities that offers. The resurgence of the H1N1 virus coincides with the regular flu season, one result of which is that employers are facing a double-whammy this year as employees are more likely than ever to be exposed to one or the other type of virus, or even both.

Employers should think now about the resulting challenges they may face in regard to absenteeism and presenteeism, how they can affect the company’s bottom line, and what steps they can take to minimize related costs and other problems associated with both.

What’s your HR IQ on swine flu? * What’s your HR IQ on the regular flu season?

Employees working while sick
For years, many companies have looked for ways to encourage their employees to take fewer sick days. Considering the drag absenteeism puts on productivity and the added work it creates for other employees, it’s an understandable concern.

But studies show that employees who show up at work when they’re sick can be even more costly. In response to the 2007 CCH Unscheduled Absence Survey, 87 percent of employers reported that sick employees who showed up to work were suffering from such easily spread illnesses such as the cold or flu. 38 percent reported that such so-called “presenteeism” was a problem in their companies.

In addition, a 2004 Harvard Business Review survey suggested that sick employees going to work may cost more than absenteeism, disability payments, and direct and indirect medical costs combined.

It’s a perfect Catch-22 situation. On one hand, when employees are absent from work, it creates more work for other employees and reduces productivity. On the other hand, sick employees are less productive when they’re at work and are likely to infect healthy employees, which can create an even greater drain on productivity.

While there’s no perfect solution, employers have some options to consider in addressing this tricky situation. In order to do so, however, you need to get a good grasp of the scope of the problem and its possible causes.

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Costs of presenteeism
According to the 2007 CCH Survey, 65 percent of the survey’s respondents said that employees came to work sick because they had too much work/deadlines. In addition:

  • 56 percent said there was no one available to cover their workload;
  • 55 percent didn’t want to use vacation time;
  • 49 percent wanted to save their sick leave for later in the year; and
  • 49 percent feared they would be disciplined.

Yet clearly such presenteeism has an economic price. Sick employees aren’t going to be as productive as they would be if they were healthy, and they risk passing their illness to other employees who will, in turn, be less productive (and so on, and so on, and so on).

In addition, employers should be concerned about workplace safety when an employee reports to work sick. An employee who’s ill may not be able to concentrate as well as when he’s healthy. That lack of concentration can lead to accidents that could affect the employee and other workers.

Causes of presenteeism
For some companies, presenteeism is a result of their efforts to develop policies to combat absenteeism that make it more difficult to take sick leave. In some cases, employees may face discipline for missing more than a certain number of days of work, even if the absences were for illness or to receive medical treatment.

Another factor that can create presenteeism is poor health care plans or no health care plan at all. If employees can’t afford medical care to manage chronic illnesses or prevent possible health care issues, there’s a good chance they won’t be able to function as fully as possible on the job. The same employees may be at risk of getting very sick because they haven’t been able to take proper care of their health.

In short, employers need to take a close look at their policies to make sure they aren’t inadvertently encouraging employees to report to work in situations that are ultimately counter-productive.

One recommended change would be to allow employees to carry over a certain amount of unused sick leave from one year to the next. It is obviously impossible for employees to predict how much sick leave they may need from one year to the next. Allowing them to carry over unused leave can give them the flexibility to manage the inevitable ups and downs. Yet only 42 percent of employers that responded to the 2007 CCH Survey allowed employees to carry over sick time from one year to the next.

Another option is to allow employees to telecommute if they have had the flu but are well enough to work or need to stay home to care for a sick family member.

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An ounce of prevention
According to the CCH survey, 66 percent of respondents offered free or low-cost flu shots at work. In the alternative, many employers include them in their health care coverage plans as part of preventive health care. Although that may seem like a huge expense, experience shows that the end savings to employers in reduced absenteeism and presenteeism far outweigh the initial expenditure.

Fortunately, a vaccine for the H1N1 virus is expected to become available within the next few months. In the meantime, the CDC recommends being vaccinated for the seasonal flu rather than waiting for the H1N1 flu to become available. Employers should consider whether to cover the cost of the H1N1 vaccination in addition to the regular seasonal flu shot. They may even need to set up two separate flu clinics, one now and one when the H1N1 shot becomes available.

In addition, there are other disease-prevention measures employers can take to promote good health, including providing employees with antibacterial hand sanitizer to help cut down on the spread of germs and posting information to educate employees on how to avoid getting sick.

Common sense tips to avoid spreading germs in the workplace
Sometimes a person can be contagious before he even feels sick. For example, most healthy adults may be able to infect others beginning one day before symptoms develop and up to several days after becoming sick. So it’s important for employers to encourage employees to use some basic precautions every day to prevent the spread of illness in the workplace.

The CDC recommends the following simple actions to help decrease the spread of respiratory illnesses in the workplace.

  • Avoid close contact with people who are sick.
  • When you’re sick, keep your distance from others to protect them from getting sick.
  • Stay home when you’re sick or have flu-like symptoms. Get plenty of rest, and check with a health care provider as needed.
  • Cover your nose and mouth with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
  • Clean your hands often to help prevent the spread of germs. When soap and water aren’t available, alcohol-based disposable hand wipes or gel sanitizers may be used.
  • Avoid touching your eyes, nose, or mouth to prevent spreading germs picked up from contaminated objects.
  • Stay home for at least 24 hours after a fever has ended (unmedicated).

Additional information can be found at http://www.cdc.gov/h1n1flu/.