Employees Who Work From Home at Higher Risk of Presenteeism

Employees who started working from home early in the COVID-19 pandemic were more likely to develop impaired work functioning as an aspect of presenteeism over the next few years, reports a study in the July Journal of Occupational and Environmental Medicine.

Atsushi Takayama, MD, PhD, MPH, of Kyoto University Graduate School of Medicine and Public Health designed a study to assess the impact of working from home on the development of presenteeism. Presenteeism, which has been defined as "going to work despite feeling unhealthy," has been linked to increased costs, reduced productivity, and future health problems.

The study included initial and follow-up surveys from 3,522 desk workers from a Japanese nationwide study evaluating the life impact of COVID-19. All employees included in the analysis had never worked from home before the pandemic. About 30% started working from home in or after April 2020.

In follow-up surveys, 15.3% of employees developed presenteeism—defined as impaired work functioning, reduced work participation, or both—up to 2021. In 2022, rate of new-onset presenteeism rose to 21.4%.
After adjustment for other factors, employees who worked from home at least once a month were 22% more likely to develop presenteeism, compared to those who never worked from home. The association was statistically significant for the outcome of impaired work functioning, with a 30% increase in incidence, but not for reduced work participation.

In subgroup analyses, the link between working from home and impaired work functioning was stronger for workers in higher positions, such as managers or board members. The authors suggest that this could reflect the previously reported "autonomy paradox," reflecting the increased work demands associated with higher levels of responsibility.

As working from home becomes increasingly common in the post-pandemic world, the study provides new evidence that it may increase the risk of presenteeism—particularly impaired work functioning. The researchers note that these effects must be balanced against  some of the reported positive effects of working from home, including reduced psychological and physical stress.

"Workers and policy makers should be aware of the potential risks of presenteeism that working from home may generate," Dr. Takayama and coauthors conclude. "Further research is required to understand how to properly manage this new option of working from home."
About the Author
Dr. Takayama may be contacted for interviews at takayama.atsushi.6k@kyoto-u.ac.jp
ACOEM (www.acoem.org), an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Takayama A, et al. Longitudinal Association of Working From Home on Work Functioning Impairment in Desk Workers During COVID-19 Pandemic: A Nationwide Cohort Study. J Occup Environmental Med. 2023;65(7):553-560.