Working conditions’ contribution to employer costs of presenteeism and sickness absence in Finland
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Working conditions are associated with sickness absence (SA), but less is known about their contribution to presenteeism and more specially, direct cost of presenteeism and SA. We examined how working conditions contribute to these. Methods We prospectively linked the Helsinki Health Study survey on workplace atmosphere, bullying, social support, organizational justice, work-family conflict, and physical working conditions with employer’s personnel register data on individual level annual salary and SA days during a one-year follow-up among 2,520 women and 691 men (aged 19–39 in 2017, 78% women). We estimated presenteeism days using the Work Ability Score (WAS, work ability 1–10) and WAS-related discount factors. Employer costs of presenteeism and SA were estimated using a two-part model, with SA costs differentiated for days 1–10 (100% employer cost) and 11–60 (30% cost). Results Mean annual employer costs of presenteeism, 1–10 and 11–60 days SA were €2172, €1896, and €383 for women, and €2198, €1420, and €289 for men, respectively. Overall, presenteeism costs were up to twice as high among participants reporting psychosocially demanding work, but smaller for physical working conditions. Especially those with high work-family conflicts (women: €2852, 95% CI €2522–3181; men €2704, 95% CI €2078–3622) and poor workplace atmosphere (women: €2202, 95% CI €1443–2962; men €3136, 95% CI €1219–5052) had higher annual presenteeism costs compared to those without. The differences in the costs of the 10 first SA days were similar but smaller than those for presenteeism, while differences in 11–60 days costs were mainly non-significant. Adjusting for education and marital status marginally contributed to the findings. Conclusions Working conditions were associated with higher employer costs, particularly due to presenteeism. Improving these conditions could reduce costs while supporting productivity, work ability, and broader public health and economic benefits. Key messages • Work–family conflict, poor workplace atmosphere, bullying, low social support, and organizational injustice are associated with higher employers’ costs of presenteeism and sickness absence. • Displaying costs of early declines in work ability encourages improvements in working conditions and timely, targeted preventive actions, benefiting employees, companies, and society.
Authors: AC Svärd, M-L Kalima, K Vänni, E Roos, R Luoto, T Lallukka
Institutions: University of Helsinki, Häme University of Applied Sciences
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7223650628