Publication

What do we know about workplace presenteeism?

Published: 18 March 2026

ERC SOTA Review No 68

Associated Themes

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  Management and Leadership
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  Mental Health
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  Productivity and performance

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Presenteeism, the act of working while unwell, has become a growing concern for employers, policymakers, and occupational health researchers. It has been traditionally viewed as a uniformly negative behaviour which results in productivity loss and impaired health. However, recent theoretical developments challenge this unidimensional framing. This review presents the current literature on presenteeism, including definitional concerns, its prevalence and effects, and undertakes a systems-level approach to understanding its determinants.

We discuss a ‘dual-pathway’ framework for understanding presenteeism as a dynamic decision-making process. One pathway reflects maladaptive presenteeism, which is ultimately driven by the avoidance of absenteeism. This form of presenteeism is often associated with job insecurity, workload pressure, and organisational norms that discourage time off. The second pathway represents adaptive presenteeism, where attendance decisions are guided by personal values, a sense of identity, or perceived therapeutic benefits of work. Both pathways are shaped by interacting individual, job-level, and organisational determinants.

We outline possible targeted recommendations across these levels to reduce harmful forms of presenteeism, while also enabling supportive, context-sensitive responses. These include improving job design and work environments that balance productivity with well-being.

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