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Presenteeism, Health and Performance

April 13 2022 - Research reported in the Journal of Occupational Health Psychology has highlighted the tremendous costs of presenteeism on employees and organizations alike.

The study of 126 employees asked to log their daily productivity provided 995 daily work observations. On days when employees were ill, they only engaged in presenteeism - continuing to work despite experiencing health symptoms - when they had not met their daily work goals.

But it emerged that engaging in presenteeism compromised their productivity on the next day as it depleted their mental energy which that could not be recharged overnight.

Professor Wlad Rivkin, lead researcher from Trinity Business School, said:

"It is crucial to tackle daily presenteeism, especially for remote workers. For example, managers should openly discourage presenteeism by reassuring team members that if they feel unwell it is acceptable to reduce their daily work goals and instead tend to their health. In light of the energy-depleting nature of presenteeism if employees engage in presenteeism they should work on tasks that are inherently pleasant rather than tedious tasks that further drain their energy.

"So, while it may seem as a good idea to work despite ill health to deliver on work goals our research shows that this has a knock-on effect for (remote) workers’ performance on the next day as presenteeism drains employees’ psychological energy, which cannot be fully recovered after work."

Overworking Worsens Performance

Employees afraid of losing their jobs because of the Covid-19 pandemic may overwork in the belief that this might save them from being made redundant. But this may lead to the opposite result as it can have negative impact on wellbeing, making them less productive according to Professor Argyro Avgoustaki from ESCP Business School.

According to Argyro Avgoustaki: "Individuals who work extensively or intensively experience negative well-being outcomes such as stress, fatigue, burnout, exhaustion, illness, and reduced satisfaction."

Managers need to be aware of a number of factors that can have a negative effect on employee well-being. For example:

  • Working overtime reduces the time vailable to an employee to rest and recover, and
  • Working intensly reduces opportunities for recovery during the working day

Argyro Avgoustaki adds: "Lack of recovery accumulates over time and ultimately decreases an employee’s ability to perform at adequate levels and deliver quality work. Tired employees are less alert and more prone to making mistakes."

Avgoustaki points out that despite the somewhat obvious damaging effects of overworking, people keep doing it. Why? People often work excessively in order to:

  • Have better chances at career advancement
  • Gain social recognition and praise, and
  • avoid losing their jobs

Avgoustaki argues that managers should lead by example, encouraging environments where excessive work is not the norm but only required exceptionally in very busy periods.

Argyro Avgoustaki concludes: "Managers need to provide some discretion over how and when work should be done as well as creating meaningful work experiences will help employee well-being. This way, at times when employees have to work harder, their well-being, and in turn productivity, will be better preserved."

If employees need to work constantly under pressure then their well-being will deteriorate, and an unhappy employee is a less productive employee. Essentially if we can understand employee well-being, we will also understand how employees can become more productive.

Previous article - Long Hours Bad For The Heart

Research led by University College, London and published in the European Heart Journal in 2010 found that working overtime is bad for the heart. The study forms part of the long-term follow-up of more than 10 000 London office-based civil servants (the Whitehall II study). Researchers compared people working a normal seven-hour day with those working a minimum of three hours extra. They found that this level of overtime is associated with a 60 per cent increased risk of heart-related problems (including death due to heart disease, non-fatal heart attacks and angina).

Dr Marianna Virtanen, epidemiologist at the Finnish Institute of Occupational Health said:

"The association between long hours and coronary heart disease was independent of a range of risk factors that we measured at the start of the study, such as smoking, being overweight, or having high cholesterol.

"Our findings suggest a link between working long hours and increased CHD [coronary heart disease] risk, but more research is needed before we can be confident that overtime work would cause CHD. In addition, we need more research on other health outcomes, such as depression and type 2 diabetes."

The Whitehall II study recruited 10 308 volunteers aged 35-55 from twenty civil service departments in 1985. The third phase (1991-1994) introduced a question on working hours. Based on an average of 11.2 years follow-up, the current research analyses results from 4262 men and 1752 women aged between 39 and 61, up to the most recent period for which clinical data are available (2002-2004). Researchers caution that while the cohort includes several occupational grades it inevitably has no blue-collar or private sector workers.

Researchers identified 369 cases of fatal CHD, non-fatal heart attacks (myocardial infarctions) or angina. After adjusting for socio-demographic characteristics (such as age, sex, marital status and occupational grade) and 21 risk factors they found that working three to four hours overtime (but not one to two hours) was associated with a 60 per cent higher rate of CHD compared with no overtime.

Considering possible explanations, results indicate that working overtime is associated with type A behaviour pattern (a tendency towards aggressive, competitive, tense, time-conscious and hostile behaviour), psychological distress (depression and anxiety) and poor sleep patterns. In addition, researchers highlight undiagnosed high blood pressure associated with work-related stress; and "sickness presenteeism" (employees who habitually work overtime also tend to work when ill, may ignore symptoms and not seek medical advice). Researchers also suggest that people working overtime, but in jobs where they have more freedom over work-related decisions, may have a lower risk of CHD. However, the current findings were independent of all of these factors.

Marianna Virtanen explained:

"We did not measure whether subsequent changes in these factors during the follow-up period altered the association. One plausible explanation for the increased risk could be that adverse lifestyle or risk factor changes are more common among those who work excessive hours compared with those working normal hours. Another possibility is that the chronic experience of stress (often associated with working long hours) adversely affects metabolic processes. It is important that these hypotheses should be examined in detail in the future."

Lead author Mika Kivimäki, professor of social epidemiology, concluded:

"At the moment there is no research on whether reduction in overtime work reduces CHD risk. Further research on this topic is therefore needed. Our own future research will include analysing data over periods of time to examine whether working long hours predicts changes in life style, mental health and traditional risk factors, such as blood pressure, blood glucose and cholesterol. We hope that this research will increase understanding of the mechanisms underlying the association between long working hours and coronary heart disease. We will also examine whether overtime work increases the risk of depression, as recent research suggests that depression increases the risk of coronary heart disease."

An accompanying editorial is provided by Gordon McInnes, professor of clinical pharmacology at the Western Infirmary, University of Glasgow. While echoing researchers' caution about the specific characteristics of the study's subjects, he nevertheless concludes that the findings may have far-reaching implications for cardiovascular risk assessment.

Gordon McInnes said:

"These data from a large occupational cohort reinforce the notion that work stress attributable to overtime is associated, apparently independently, with an increased risk of coronary heart disease. A trend for risk to be related to hours of overtime worked supports this conclusion. If the effect is truly causal, the importance is much greater than commonly recognized. Overtime-induced work stress might contribute to a substantial proportion of cardiovascular disease. Physicians should be aware of the risks of overtime and take seriously symptoms such as chest pain, monitor and treat recognized cardiovascular risk factors, particularly blood pressure, and advise an appropriate lifestyle modification."

Quoting British philosopher Bertrand Russell, Gordon McInnes concluded:

" 'If I were a medical man, I should prescribe a holiday to any patient who considers work important'."



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