December 26, 2006     The Consumer

Sniffling, Sneezing and Turning Cubicles Into Sick Bays

By MICHAEL MASON

She knew she shouldn’t do it. But there were 25 eager students waiting in the lecture hall, and not much time left in the semester to tell them everything about statistics and medical research.

So Dr. Cheryl Koopman, an associate professor of psychiatry at Stanford University, popped in another throat lozenge and marched to the podium to begin a three-hour lecture — sick as a dog.

“It was the worst cold,” Dr. Koopman recalled. “I was coughing and apologizing and drinking water until I just about lost my voice. But I just felt this obligation to do it.”

She is hardly the only one. Ailing employees are dragging themselves to work in increasing numbers, according to several studies. So widespread is the phenomenon that experts have invented a name, calling it presenteeism, the opposite of absenteeism.

Dr. Koopman is among the first scientists to try to measure presenteeism in the workplace, and her research shows that it is often motivated by altruism. But that does not fully explain the tide of sniffling, hacking workers who choose to struggle on at the office instead of staying home, turning cubicles into recovery rooms and exasperating their co-workers.

Now officials at the local and federal levels are taking aim at what they believe to be a major cause: the refusal of many companies to provide paid sick leave to employees.

“Presenteeism is part of our culture of work,” said Vicky Lovell, director of employment and work/life programs at the Institute for Women’s Policy Research, a nonprofit group. “Some workers think the company is going to fall apart without them. But many simply fear being suspended or fired if they don’t show up.”

In a telephone survey of nearly 1,000 adults conducted by the National Foundation for Infectious Diseases, more than one-third of workers said they felt pressured to go to work when sick. About the same number reported that they had picked up the flu from a colleague in the workplace.

In a recent survey of 326 human resources executives by the research firm Wolters Kluwer, 56 percent said presenteeism had become a problem in their companies, up from 39 percent two years ago.

“We work in a Dilbert environment these days,” said Brett Gorovsky, an analyst at Wolters Kluwer. “We’re in closed office spaces, where germs are a bigger concern. And there’s downsizing. There are fewer people to backfill now, so workers more often feel they have to show up.”

Because of lost productivity, ill workers on the job account for as much as 60 percent of corporate health costs, according to researchers at Cornell University — more than absentee workers, and far more than companies pay in direct medical and disability costs.

Many companies are scrambling to respond with free flu vaccinations, expanded telecommuting options and educational programs. But many researchers say workplace policies are responsible for putting employees at risk in the first place.

Only half of workers in the United States earn paid sick days, and only one-third receive paid time to care for sick children, according to a recent report by the Institute for Women’s Policy Research. 
The situation for low-wage and part-time workers is particularly acute. Only 23 percent of the lowest paid workers have paid sick days, the institute found; among restaurant workers, the figure is closer to 14 percent. Many risk losing their jobs should they take any sick time at all.

“These are often workers with a lot of public contact,” said Dr. Lovell, who wrote the report. “They are the retail clerks who ring up your purchase and people serving food at restaurants.”

In one case, more than 1,000 people were sickened with a gastrointestinal virus at a casino in Reno, Nev., in an outbreak that began with a few sick employees who said their supervisors had pressured them to go to work. The employees, mostly low wage earners, had little or no paid sick leave.

In November 2006, voters in San Francisco approved a measure requiring employers in the city to provide paid sick leave, the first law of its kind in the nation. Several other cities are poised to follow suit.

In Congress, Senator Edward M. Kennedy, Democrat of Massachusetts, and Representative Rosa DeLauro, Democrat of Connecticut, have announced plans to reintroduce the Healthy Families Act, which would require employers with 15 or more workers to offer at least seven days of paid sick leave each year. “It will make a major difference in the lives of working families,” Ms. DeLauro said.

That should help keep ill co-workers at home in bed. Until then, infectious disease experts are encouraging workers to wash their hands, cover their mouths and use disinfectants on their work surfaces.

Or there is Dr. Lovell’s approach. When she hears co-workers coughing and sneezing, she pointedly suggests that they go home, saying, “You’re not doing anyone a favor by making them sick.”