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Study links working while sick to higher risk of future absence
Laine Bergeson
Today at 4:40 p.m.
Public Health Workers who report going to work while sick, a phenomenon known as presenteeism, may be more likely to miss work due to illness in the future, according to a longitudinal study of South Korean employees published today in BMC Public Health.
Using nationally representative survey data from the Korean Health Panel Study, researchers analyzed responses from 4,180 wage workers aged 20 years or older from 2019 to 2022 to examine whether working while ill predicted later absenteeism.
The team found that, throughout the study period, presenteeism was consistently more common than absenteeism. From 12.7% to 25.0% of workers reported going to work while ill in a given year, compared with 8.6% to 12.3% who reported missing work because of illness.
Workers who had previously taken sick leave were nearly 3.5 times as likely to be absent again in the next survey wave
Further analysis showed that workers who reported presenteeism earlier in the study period had significantly higher odds of being absent due to illness later in the study period. Employees who worked while sick had a roughly 30% higher likelihood of later absenteeism compared with those who did not report presenteeism (odds ratio [OR], 1.30).
Prior absenteeism was an even stronger predictor of future absence. Workers who had previously taken sick leave were nearly 3.5 times as likely to be absent again in the next survey wave (OR, 3.45).
Presenteeism may signal declining health
To better understand the direction of the relationship between presenteeism and absenteeism, the researchers used a bidirectional model to examine whether the two behaviors predicted each other over time. The analysis showed that presenteeism significantly predicted later absenteeism, while absenteeism did not predict future presenteeism.
The findings suggest that working while ill may serve as an early signal of declining health or worsening work capacity. “Our findings support a temporally ordered association in which prior presenteeism is followed by higher odds of subsequent absenteeism,” write the authors. “Presenteeism continues to serve as a reliable longitudinal signal of future absence.”
The study highlights structural and cultural factors that may influence work attendance patterns in South Korea. The country is one of only a few nations without a statutory paid sick-leave system, and workplace norms often discourage taking time off when ill.
The authors caution that the association between presenteeism and absenteeism should not be interpreted as evidence of causation. The relationship between the two may reflect underlying differences between workers, such as mental health status and workplace culture, rather than a direct effect of working while sick.
Even so, the researchers say monitoring presenteeism could help employers identify workers at elevated risk for future absence and guide interventions.
“From a public health perspective, even a 30% increase in risk, when applied to a large workforce, may translate into substantial cumulative costs related to productivity loss, healthcare utilization, and workforce sustainability,” write the authors.
“Importantly, unlike chronic disease status or a prior history of absenteeism—both of which are less amenable to short-term intervention—presenteeism can be targeted through organizational-level policies such as paid sick leave, workload management, and cultural change, making it a practical entry point for preventive action,” they conclude.
Study links working while sick to higher risk of future absence
Laine Bergeson
Today at 4:40 p.m.
Public Health Workers who report going to work while sick, a phenomenon known as presenteeism, may be more likely to miss work due to illness in the future, according to a longitudinal study of South Korean employees published today in BMC Public Health.
Using nationally representative survey data from the Korean Health Panel Study, researchers analyzed responses from 4,180 wage workers aged 20 years or older from 2019 to 2022 to examine whether working while ill predicted later absenteeism.
The team found that, throughout the study period, presenteeism was consistently more common than absenteeism. From 12.7% to 25.0% of workers reported going to work while ill in a given year, compared with 8.6% to 12.3% who reported missing work because of illness.
Workers who had previously taken sick leave were nearly 3.5 times as likely to be absent again in the next survey wave
Further analysis showed that workers who reported presenteeism earlier in the study period had significantly higher odds of being absent due to illness later in the study period. Employees who worked while sick had a roughly 30% higher likelihood of later absenteeism compared with those who did not report presenteeism (odds ratio [OR], 1.30).
Prior absenteeism was an even stronger predictor of future absence. Workers who had previously taken sick leave were nearly 3.5 times as likely to be absent again in the next survey wave (OR, 3.45).
Presenteeism may signal declining health
To better understand the direction of the relationship between presenteeism and absenteeism, the researchers used a bidirectional model to examine whether the two behaviors predicted each other over time. The analysis showed that presenteeism significantly predicted later absenteeism, while absenteeism did not predict future presenteeism.
The findings suggest that working while ill may serve as an early signal of declining health or worsening work capacity. “Our findings support a temporally ordered association in which prior presenteeism is followed by higher odds of subsequent absenteeism,” write the authors. “Presenteeism continues to serve as a reliable longitudinal signal of future absence.”
The study highlights structural and cultural factors that may influence work attendance patterns in South Korea. The country is one of only a few nations without a statutory paid sick-leave system, and workplace norms often discourage taking time off when ill.
The authors caution that the association between presenteeism and absenteeism should not be interpreted as evidence of causation. The relationship between the two may reflect underlying differences between workers, such as mental health status and workplace culture, rather than a direct effect of working while sick.
Even so, the researchers say monitoring presenteeism could help employers identify workers at elevated risk for future absence and guide interventions.
“From a public health perspective, even a 30% increase in risk, when applied to a large workforce, may translate into substantial cumulative costs related to productivity loss, healthcare utilization, and workforce sustainability,” write the authors.
“Importantly, unlike chronic disease status or a prior history of absenteeism—both of which are less amenable to short-term intervention—presenteeism can be targeted through organizational-level policies such as paid sick leave, workload management, and cultural change, making it a practical entry point for preventive action,” they conclude.