Remote work has made it possible for employees to remain on the job while sick without entering the workplace. New research suggests the risks depend less on location than on whether home working is formally arranged or simply becomes an expectation that people will always be available.
The practice of working while ill is known as presenteeism. It has traditionally been associated with an employee arriving at work despite needing time to recover.
Email, video calls and workplace messaging have complicated that picture. An employee can now stay home, call in sick and still spend part of the day dealing with urgent requests.
A peer-reviewed review published in Health Psychology Research argues that existing definitions do not adequately capture these different situations. The authors, Luo Lu, Cary Cooper and Shu-Fang Kao, describe presenteeism according to three questions: What kind of illness does the employee have, where are they working and how much work are they doing?
Eight ways of working while ill
The researchers divide each question into two possibilities. The illness may be physical or mental. The employee may work on-site or remotely. Their participation may be full or reduced.
Those three divisions produce eight possible forms of presenteeism.
The distinction matters. Completing a normal eight-hour day from home with influenza is not the same as answering one urgent email while recovering. Both count as work during illness, but their effect on recovery and productivity may be very different.
The framework is conceptual rather than an experiment measuring employee outcomes. Its purpose is to give researchers and employers a more accurate way to describe behavior that may otherwise disappear from sickness records.
It also includes mental health. Someone experiencing anxiety or depression may continue working remotely at full capacity, reduce their hours or travel to the workplace as normal. A narrow measure based only on physical attendance could miss all three.
Formal remote work produced a different pattern
A separate study in Social Science & Medicine helps explain why the terms of a remote-work arrangement may matter.
The researchers examined representative German workforce surveys from 2019 and 2021, covering 5,363 and 10,049 employees respectively. They distinguished formal working from home from supplemental home working, in which employees performed additional work outside their normal workplace.
Employees who frequently did supplemental work from home were 12 percentage points more likely to work while sick than those whose jobs never required it. They also reported 1.93 additional presenteeism days in 2019 and 1.57 additional days in 2021.
Formal home working showed a different pattern. It was not associated with a greater likelihood of choosing to work while ill and was associated with about three-quarters of a day less presenteeism per year in both survey waves.
These are associations, not proof that either arrangement caused the difference. Workers with formal home-working agreements may differ from other employees in job type, autonomy or circumstances that the analysis could not completely capture.
Even so, the contrast points to a useful business distinction. Scheduled remote work can give employees control over how they work. Informal home working may instead extend the working day and make it harder to decide when work has actually stopped.
Sick leave still needs clear boundaries
Many companies are reconsidering where employees should work. As MBN recently reported, concerns about collaboration, supervision and productivity have led some employers to reduce remote-work opportunities.
The new research adds a different question. When somebody is ill, does working from home offer genuine flexibility, or does it create an unspoken obligation to remain reachable?
Employers can make that distinction clearer by stating that remote work is not an automatic substitute for sick leave. Employees may also need options to reduce their hours or workload temporarily, rather than choosing between a full working day and complete absence.
Access is uneven as well. Office employees can often move work home, while people in factories, stores, hospitals and transport jobs usually cannot. Remote presenteeism may therefore make sickness behavior less visible in some occupations without changing it in others.
An employee answering messages from the sofa may be absent from the office but still present at work. Unless companies record that distinction, sickness figures may look better while employees quietly lose the time they need to recover.
