Sickness absence rates and presenteeism as work-related indicators of health

Data on sickness absence is frequently used as a health indicator of employees. Based on a cross-sectional analysis with a random sample of employees covered by the Upper Austrian Sickness Fund (n = 930), it is shown that presenteeism (attending work despite illness) is a better indicator of health states than sickness absence. Compared to sickness absence, presenteeism is more strongly associated with gastro-intestinal complaints, musculoskeletal complaints, migraine, and mental ill-health, which are likewise strong determinants of subjective health. People with health complaints in general and with migrane and mental ill-health in particular have a higher propensity to favour presenteeism over sickness absence. Especially when rates of sickness absence are low, it is recommended to complement sickness absence data with estimates of presenteeism. It is assumed that presenteeism is a better estimator of mental health in particular.