Presenteeism: taking your headache to work

Presenteeism: a new trend

A recent survey by a German health insurance company found that over a quarter of employees often work while sick, either at the workplace or from home. Even among those in leadership roles, 16% admitted to it. Working while sick has become more common in industrial societies over the last two decades, especially among those who work from home. Nearly half of people working from home say they carry on working even when feeling ill. In fact, more than one in ten say they keep working despite having a doctor’s note. And people working from home are particularly likely to use medication to stay productive despite illness.

Common among headache sufferers

Presenteeism was identified as a problem early on and investigated in scientific studies in the USA, Denmark and Sweden, with much of the research focusing on headache disorders. A study from Norköpping University, Sweden looked at employees in two very different working environments: a high-tech company (Saab Aerospace) and a public hospital. 400 employees per group were asked to complete self-report questionnaires. The extraordinarily high participation rate of over 70% is a good indication that presenteeism and headaches is a very important issue for workers.

Nearly two-thirds of the Saab employees and a whopping 78% of hospital workers reported stress-related headaches in the past three months. Half of the respondents in each group admitted to working through acute headaches.

Presenteeism in nursing: exceptionally high prevalence

Nursing professionals are particularly affected by presenteeism and its effects, as various studies have shown, including ZIES's own data. In an interim evaluation of the ZIES gGmbH prevention project "Nursing without headaches", 72% of the more than 2800 respondents reported working full-on despite pain, with 78% using over-the-counter painkillers.

The importance of this issue is well-known in the scientific community and documented in various studies. Nurses from various disciplines in a large Lisbon hospital were asked to take a survey. Questions included how they manage their workload despite feeling ill, their levels of stress, and how well they get the job done despite their symptoms. Employees who went to work despite being ill cited stress levels and anxiety as the most significant psychological burdens. Alongside back pain and respiratory issues, migraine was high on the list of self-reported physical disorders.

Mistakes often go unnoticed

An article in the Harvard Business Review highlights a concerning but often overlooked issue: when someone doesn’t show up for work because they’re sick, the work either piles up or has to be done by someone else. But you often can’t tell when – or how much – illness or a medical condition is hindering someone’s (or your own) performance. Research shows that ill employees are likely to make more – or more serious – mistakes. If these errors go unnoticed due to poor concentration or lack of focus, the consequences can be dire.

Presenteeism in care work

Work is work, whether paid or unpaid. Care work – childcare, eldercare, family support and home care – is a typical example of unpaid work. Presenteeism is a significant issue in care work in particular. Taking a sick day as a caregiver is nearly impossible. Not just because someone else would have to do it, or because the work would pile up: the simple fact is that care work often cannot be delegated or postponed. Caring for children and other relatives means doing whatever work comes up, when it comes up. The pressure may be exceptionally high because of the additional burden and heavy responsibility of another person's well-being.

Rest and recovery beats showing up for the sake of it

As far as paid work goes, a simple rule applies: sick means sick. Don’t drag yourself to work with a blinding headache. Studies show that muddling through with a headache, especially a migraine, can make the attacks more severe and last longer. People who are prone to morning migraines often feel better in the afternoon if they rest properly in the morning. Dragging yourself into work with a morning migraine risks prolonging and intensifying your symptoms. What’s more, you may be less productive during an attack. Nobody can perform at the top of their game while nursing a headache. Relying on medication to keep you functional is not advisable. Doing so increases your risk of developing medication-overuse headaches.

Many workplaces have disability officers who can help employees manage migraine-related issues at work.

Especially in caregiving professions such as nursing, the most sustainable approach to headaches is effective prevention. Knowing your headache type, identifying triggers, and adopting preventive habits helps in many cases to make your headaches less severe and less frequent.