Home-Based Telework and Presenteeism: New Lessons Learned From the Covid-19 Pandemic

Reasons behind sickness presenteeism: insights from four national surveys in Latvia

Introduction

Sickness presenteeism-working despite being ill-is influenced by work demands, personal circumstances, and socio-demographic factors. This study investigates the prevalence of sickness presenteeism and its self-reported reasons across socio-demographic groups in Latvia.

Methods

Data were pooled from four consecutive cross-sectional surveys conducted from 2006 to 2018, representing a sample of 6,368 hired workers. Logistic regression was used to assess associations between presenteeism and socio-demographic variables (gender, age, education, income, and job position), while chi-squared tests examined differences in reasons for presenteeism.

Results

Overall, 11% of respondents reported working while ill in the past year. The most common reasons were a lack of replacement possibilities (27.7%), financial considerations (25.5%), specific work-related aspects (17.4%), and mild illness (14.0%). Significant socio-demographic differences were observed, with gender, income level, and job position influencing the reasons for presenteeism.

Discussion

These findings underscore the need for targeted workplace policies, including strategies to address replacement gaps, financial insecurity, and job-related pressures. Future research should explore cross-national comparisons and the impact of evolving work patterns, such as telework, on presenteeism trends.

Remote work - the new normal needs more research

One of the recent global crises has been the COVID-19 pandemic, drastically changing how we work in expert positions or otherwise do work that can be performed using mobile devices. This change has been seen in many studies since the onset of the pandemic. In the Scandinavian Journal of Work, Environment & Health, papers about remote work (alternative search terms telework, hybrid work) have increased from zero, before 2021, to four [see eg,(1–4)]. However, the increase is even more clear in PubMed-indexed papers, where the number of articles was 1–10 per year from 1990 to 2019, 134 in 2020, and 346–470 per year in 2021–2023. However, despite this urgent interest in this topic (5, 6), we still have some knowledge gaps. The sweet child has many names Although remote work has existed for decades (7), it has many names. As indicated above, terminology that has been used in the literature varies, such as telework, work from home, and hybrid work, where people work both remotely and at their employer’s premises. The European Foundation for the Improvement of Living and Working Conditions (Eurofound) has used the term telework, defining it as “a work arrangement in which work is performed outside a default place of work, normally the employer’s premises, by means of information and communication technologies (ICT). The characteristic features of telework are the use of computers and telecommunications to change the usual location of work, the frequency with which the worker is working outside the employer’s premises, and the number of places where workers work remotely (mobility)” (8). Thus, these terms capture a variety of definitions while measures have mainly relied on survey items. Although surveys can specify the timing, ie, “Have you worked remotely in the past week?” or the average of the past month, they are self-reported and thus prone to recall and reporting biases. On the other hand, earlier research indicates that sometimes workers work a part of a specific day from home and the other part from their employer’s premises, thus the same day can be both an on-site and a remote workday (9, 10). How are these differences reflected in the survey items or should they be monitored differently? Since the last decade, the use of employer-owned register data for studies of working hours has increased [eg, (11-13)] and such data could enable investigation of place for work (ie, where) in addition to timing (when) (14, 15). Thus, longitudinal studies using employer’s register data for working hours and places for working are needed to deepen the knowledge about the various ways of combining remote work and work at the employer premises and the subsequent effects on employee health, well-being, and work performance.

The COVID-19 pandemic time dominates research on remote work, but we do not know much about the post-pandemic worklife Besides the measures of remote work, another aspect hampering the current knowledge is the fact that studies of remote work among knowledge workers have been focused on the preceding or early years of the pandemic (16–19) or used cross-sectional design and/or survey data (18, 20–21) mainly focused on the psychosocial aspects of the work environment. Thus, studies combining a longitudinal design with register data are needed (14, 19). Various factors influenced remote work during the COVID-19 pandemic. Regulations and guidelines at global, national, and regional levels dictated remote work practices, particularly concerning infectious disease symptoms. Logistical factors—such as the availability of public transportation and workspace capacity at employer premises—also impacted whether employees intended to work remotely, had the opportunity to do so, or were even allowed to by their employers (22, 23). Furthermore, infrastructure issues, such as fast internet connectivity and affordability of housing with a workspace (ie, enablers for working from home remotely) influence the possibility and attractiveness of remote work (24–26). These infrastructure issues related to nations and their cities, and employers might play a role that has not yet been elaborated for the future of work.

Regulations and monitoring are needed Remote work challenges employee well-being as we have become aware via national legislation to restrict connectivity after work (27). However, such restrictions are rather few; in Europe only nine countries (Belgium, Croatia, France, Greece, Italy, Luxembourg, Portugal, Slovakia, and Spain) have legislation providing a right to disconnect. Although interest in disconnecting after work has existed for decades, the research seems to be characterized by similar weaknesses as studies of remote work in general: vague terminology, cross-sectional designs, and self-reported data as indicated by a recent mapping review (28). Still, the evidence is rather clear on the mental and physical health benefits of allowing employees to disconnect and recover (29). This might suggest that along with the high prevalence of remote work, studies and efforts should be invested in national and local regulations and longitudinal, high-quality studies using daily register data on working when and where to address the link to employee well-being, health, and productivity (30). Daily register data could be targeted to monitor working hours (14, 31) and computer use (32) and access control to premises or other intelligent workplace systems (33) that enable the monitoring of employees or wearable technology such as smartwatches or access tags (34) for research purposes. Thus, by deepening our understanding of remote work and detachment from work, we might improve workplace productivity and human resources.

From the responsibility of the employers to the freedom of employees Remote work is often done from home or a place owned by the employee (ie, vacation home). Sociodemographic factors such as income and educational attainment strongly determine home sizes and their locations (ie, whether they are in cities or more rural) (25). Given the fact that a home is a private place where individuals live alone or with others, employers do not have a say on the living or working conditions. This is a challenge from the occupational safety and health (OSH) perspective. Most of the OSH legislation dictates the role of the employer in safeguarding their employees from risks and hazards. In remote work, employees set their working conditions and work, some with state-of-the-art workstations with wide screens and separate keyboards and electronic tables, while others might not have any dedicated workspaces but work sitting on the sofa or at the kitchen table. In the short-term or occasionally, this might be fun. However, the long-term effects of poor physical working conditions or positions may negatively impact musculoskeletal organs, eye ergonomics, or cognitive functions (35, 36). This is especially concerning since young employees or those with lower socioeconomic status might be more vulnerable to these working conditions in their homes and have less economic incentives or knowledge of possibilities to adjust them. This aspect related to office ergonomics in remote work has been acknowledged in the literature (37), but further research and emphasis should be placed on avoiding any new pandemic of musculoskeletal or other health complaints due to working from home.

The rise and shine of remote work One may speculate if the increased rates of remote work will remain. If we think about the employer perspective, working both remotely and on-site has been, and will continue to be, challenged, and potentially adds costs as the use of premises varies a lot. Even though there are a lot of positive aspects of remote work from the employee perspective, some negative aspects have also been highlighted such as social isolation, lack of peer or supervisor support, and spillover of work to leisure time, all of which have increased due to remote work (5, 6, 18). These do not account for the fact that, in general, the possibility of employees having control over their work is an important factor that is strongly linked with well-being and health (38, 39). Therefore, even in the discussion about remote work, an important reminder is needed. Remote work is a form of flexible working that can be defined as having employment agreements that promote employees’ control over when, where, for how long, and how continuously the employee works (40–42). This form of employee-oriented flexibility refers to the employee’s entitlement to influence when and where they work and according to their individual needs and wishes. This contrasts with arrangements in which the employer determines the employees’ working times and location according to the company’s needs (company-based flexibility). Another important fact that has been missed in the current remote work discussion is the fact that flexibility helps people align their work commitments with their private lives. Besides, flexibility allows employees better opportunities to recover from the strain and effort associated with work, both during and outside work. In these mechanisms, the immediate impact of flexibility leads to a reduction in stress, thereby promoting better health (43, 44). Thus, I dare to claim that soon, within 1–5 years, we will not discuss remote work but rather flexibility. The discussion will lead to legislation and regulations enabling flexibility in a way that promotes the health and employee well-being while at the same time ensuring a safe and healthy work environment. Such legislation and regulations will exist locally, nationally, and internationally as such flexibility will also enable working across country borders.

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Work Disability and Musculoskeletal Disorders Among Teleworkers: A Scoping Review

PURPOSE

This project aimed to examine the existing evidence on work disability or musculoskeletal disorders (MSDs) among teleworkers.

METHOD

A scoping review was conducted in eight bibliographic databases (MEDLINE, CINAHL, Embase, PsycINFO, ABI/Inform Global, EBM Reviews, Web of Science, Dissertations & Theses Global) from inception to June 2022.

RESULTS

Out of 9192 records identified, a total of 79 selected articles representing 77 studies were retained. Most studies were published after 2019, aligning with the COVID-19 pandemic's telework surge. Among the included papers, 51 addressed MSDs among teleworkers, 17 were on work disability, and 11 addressed both concepts. The studies were predominantly cross-sectional. Some trends are emerging, although study results are contradictory. Several papers reported increased musculoskeletal discomfort among teleworkers. Factors associated with MSDs among teleworkers include poor workstation setup, extended workdays, sedentary lifestyle, excessive devices use, and psychological factors. Regarding work disability, studies found that telework is associated with reduced absenteeism but increased presenteeism, with employees more likely to work while unwell from home than when on-site. Mixed results were found regarding teleworkers' work ability and functioning.

CONCLUSION

This paper provides an overview of the literature on work disability and MSDs among teleworkers. It identifies literature gaps, underlining the need for ergonomic improvements, long-term impact studies, a better conceptualization of presenteeism in the context of telework, and tailored interventions to enhance the telework experience.

Impact of Teleworking Practices on Presenteeism: Insights from a Cross-Sectional Study of Japanese Teleworkers During COVID-19

Few studies have examined the relationship between teleworking practices and presenteeism. This study determined the association between teleworking practices and presenteeism among teleworkers in Japan. A cross-sectional online survey was administered to 2687 teleworkers from five companies in Japan, collecting data on demographic variables, teleworking practices, frequency and duration of teleworking, presenteeism, and various lifestyle- and health-related factors. A logistic regression analysis was performed. Teleworkers with full-time employment and less teleworking experience exhibited higher presenteeism rates. Key practices negatively associated with presenteeism included creating a dedicated workspace, chatting with colleagues, and setting daily work goals. Gender differences were significant: for men, additional practices, such as determining their work hours, were beneficial; while for women, chatting with colleagues was particularly important. A sensitivity analysis indicated that specific teleworking practices can mitigate presenteeism. Certain teleworking practices, such as creating a workspace, chatting with colleagues, and setting work goals, were associated with lower presenteeism among teleworkers. These findings highlight the need for organizations to support telework ergonomics, promote social interaction, and encourage goal setting to enhance teleworker productivity and health. Training for employees and supervisors to raise awareness of their own and their subordinates' health while teleworking is advised.

Do worksite health promotion programs (WHPP) influence presenteeism among employees? A systematic review1

BACKGROUND

Worksite health promotion programs (WHPP) aiming to reduce presenteeism are rapidly increasing. However, program-efficacy seems impaired by lack of conceptual understanding and theoretical frameworks related to presenteeism.

OBJECTIVES

To study (1) the concept of presenteeism, (2) the causes of the phenomenon and (3) which WHPP affect presenteeism.

METHODS

We followed the PRISMA 2020 guidelines for mapping relevant literature in seven databases. The main search-terms were "worksite", "WHPP", "presenteeism", "employee productivity" and "interventions". Reviews and review of reviews were included and analysed according to research questions and ecological theory.

RESULTS

Of 2196 studies identified, 14 reviews were included, comprising 1390 single studies. Conceptually, presenteeism was poorly defined, mostly related to productivity/performance limitations due to ill health. Factors causing presenteeism addressed individual health or lifestyle (78%), and, to a lesser extent work and organisational factors (management/job stress) (22%). Forty-five highly diverse WHPP were identified, about 90% focusing health outcomes. 22/45 WHPP affected presenteeism/productivity positively. Multi-component WHPP implemented at multi levels accounted for 55%. Single-component programs, implemented at individual level, were mostly targeting health-risk subgroups. No specific WHPP seems preferable. Methodological quality seems highly associated with worksite intervention-efficacy.

CONCLUSION

Increased telework opportunities due to COVID-19 experiences has affected working conditions worldwide, for better and worse, requiring adaptions at employee, management, organisational and socio-cultural levels. Our results showed high program diversity, several adaptable to future needs (e.g., digital solutions), however hampered by narrow focus on individual health. Future research should focus on theory-based high quality multilevel WHPP comprising contextual, work, and organisational factors.

Working Anytime and Anywhere -Even When Feeling Ill? A Cross-sectional Study on Presenteeism in Remote Work

Background

Working despite feeling ill - presenteeism - is a widespread behavioral phenomenon. Previous research has shown that presenteeism is influenced by various work-related and personal factors. It's an illness behavior leading to a range of negative but also positive consequences. Due to coronavirus disease 2019 (COVID-19) pandemic, remote work has become the "new normal" for many employees. But so far, little is known about presenteeism in remote work. This study aims to investigate presenteeism in remote work by looking at the extent of remote presenteeism, differences to presenteeism in on-site work, and associated factors.

Methods

A nationwide cross-sectional online survey was conducted in Germany with N = 233 participants. Data were analyzed using descriptive statistics, t-tests, and correlation analysis.

Results

The results reveal that presenteeism is prevalent in remote work x̅ = 4.13 days (Md = 3; D = 2; s = 4.95). A low ability to detach from work (r = -.17; p = .005) and low supervisor support (r = -.14; p = .02) is associated with more remote presenteeism days. Remote working conditions seem to facilitate presenteeism.

Conclusion

This study provides empirical insights into a subject area of great societal relevance. The results show that awareness should be raised for presenteeism in remote work. It should be regarded as a behavior that can be functional or dysfunctional, depending on the individual situation. Supervisor support and detachment should be fostered to help reduce dysfunctional presenteeism. Promotion of health literacy might help remote workers to decide on a health-oriented illness behavior. Further research is vital to analyze to what extent and under which circumstances presenteeism in remote work is (dys)functional and to derive clear recommendations.

Prepared for Home-Based Telework? The Relation between Telework Experience and Successful Workplace Arrangements for Home-Based Telework During the COVID-19 Pandemic

OBJECTIVE

This article focuses on the perceived effects of home-based telework during the COVID-19 pandemic with respect to five outcomes (job satisfaction, burnout, work-family conflicts, technostress, and social isolation) and how these are affected by workplace arrangements and telework experience.

METHODS

Cross-sectional survey data from employees in the IT, finance, and insurance sector collected during the COVID-19 crisis ( N = 808) were used for the study.

RESULTS

Outcomes are most negatively affected by feelings of surveillance and most positively affected by suitably equipped offices. Organizational teleworker support is most strongly related to job satisfaction. Experienced teleworkers report better outcomes, because of improved support, less perceived surveillance, and better equipped home stations.

CONCLUSIONS

Adaptation of management strategies avoiding surveillance and suitable setups of home offices to reconcile work and private spheres are key to well-being of teleworkers.

Longitudinal Association of Working From Home on Work Functioning Impairment in Desk Workers During COVID-19 Pandemic: A Nationwide Cohort Study

OBJECTIVE

This study clarifies the longitudinal association between working from home and work functioning impairment among desk workers.

METHODS

Nationwide surveys were conducted from 2020 to 2022, analyzing 3532 desk workers who never worked from home before the COVID-19 pandemic.

RESULTS

The adjusted hazard ratio (95% confidence intervals) of working from home at least once a month or more with the composite result (incidence of work functioning or reduced work participation) was 1.22 (1.04-1.43). The cause-specific hazard ratios of work functioning impairment and reduced work participation were 1.30 (1.04-1.61) and 1.13 (0.86-1.47).

CONCLUSIONS

Working from home could be longitudinally associated with work functioning impairment, especially for workers who are in higher positions. Workers and policy makers should be aware of the potential risk of working from home regarding presenteeism.

Digital Stress. Effects of Different Intensities of Working From Home on Workers' Health

OBJECTIVE

Because hybrid and remote work models have exponentially expanded with digitalization and the COVID-19 pandemic, this study examines how different intensities of WFH impact workers' health.

METHODS

Drawing on the job demands-resources model, we applied two-way analysis of variance and regression models to the sixth European Working Conditions Survey to examine how the type and magnitude of WFH effects on health depend on its intensity.

RESULTS

A key aspect in relation to remote work is the frequency with which the worker carries out this type of work, with best results among those WFH only several times a month, for women, and several times a week, for men.

CONCLUSIONS

Reasonable intensity of WFH may have beneficial effects on health, but these positive effects are reduced when working fully home-based.

Escape or activate? Pathways of work stress on substance use

BACKGROUND

Research on the spillover effects of work stress on substance use have mainly focused on the concept of escapist substance.

OBJECTIVE

Building on the concept of self-endangering work behavior, we expand this stress-theoretic view with a presenteeism path of work-induced substance use. Contrary to emotion-based disengaging coping strategies associated with escapist use, we argue that high job demands may also promote problem-focused engagement coping, where substances are used for activation.

METHODS

A structural equation model was used to analyze both assumed pathways of stress-induced substance use with survey data from a random sample of n = 411 employees.

RESULTS

We confirmed that high job demands are directly related to escapist substance use, but indirectly related to activating substance use, mediated by presenteeism behavior. Both types of substance use are reduced in organizations with high psychosocial safety climate, but increase with higher competitive climate. Social support is related to reduced activating substance use. Males show a stronger tendency for the escapist path, whereas the presenteeism path is more prevalent in women.

CONCLUSION

Work stress may not only induce substance use as a disengaging emotional coping strategy, but also as an active problem-focused coping strategy, where employees engage in substance use to continue their efforts necessary for work-related goal attainment. A psychosocial safety climate may provide opportunities for intervening on the "cause of causes" of substance use. Moreover, due to the higher prevalence for activating substance use in female workers, previous research may have underestimated women's risks for work-induced substance use.

Working From Home During the COVID-19 Pandemic: The Association With Work Productivity Loss Among Patients and Caregivers

OBJECTIVE

The aim of this study was to measure the association of working from home (WFH) with work productivity loss due to caregiving responsibilities or health problems during the COVID-19 pandemic.

METHODS

We conducted an online survey of family/friend caregivers (n = 150 WFH/75 non-WFH) and patients (n = 95/91) who worked during the past 7 days in May and July 2020, respectively. Absenteeism and presenteeism were measured using the Valuation of Lost Productivity questionnaire.

RESULTS

Working from home was associated with higher odds of absenteeism (odds ratio, 2.53; 95% confidence interval, 1.11 to 5.77) and presenteeism (2.79; 1.26 to 6.18) among caregivers and higher odds of presenteeism among patients (2.78; 1.13 to 6.84). However, among caregivers with absenteeism more than 0 days, WFH was significantly associated with fewer absent workdays.

CONCLUSIONS

Working from home was not associated with overall absenteeism and presenteeism in caregivers or patients. Working from home allows a more flexible and inclusive workplace without impacting productivity, although further research is needed.