Employees coming to work during sickness could be costing more than sickness absence, research has suggested.
Sickness "presence" of employees might match the cost of £13bn companies are known to suffer when workers stay at home during illness, the Work Foundation has said.
This was because of the hidden costs and underestimated employee ill-health that could lead to greater problems in the future.
A study of 510 workers by the research group said that around 50% came to work even when they were unwell.
Employees under stress or with monetary problems would also drag themselves to the workplace without giving themselves enough time to recover.
Katherine Ashby, of the Work Foundation, said: "In the current economic climate, with high job insecurity making employees more wary of taking time off, understanding the causes and effects of sickness presence is crucial.
"In addition to sickness absence, measuring sickness presence may provide a more reliable picture of an organisation's health-related productivity losses.
"Organisations need to be aware that low levels of sickness absence may not tell the whole story. Successfully tackling the underlying causes of sickness presenteeism could improve employee wellbeing and so reduce both sickness presence and sickness absence."
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"The pressure of work (not of my employer) is such that I rarely give myself enough time to fully recover as I know that the stress involved in dealing with the piles of 'must do stuff' sent down from the PCT along with running the practice will just get out of hand!" – Paula Elliott, Chesterfield
"Anyone coming to work when they are ill risks taking more time to recover, not performing at their best and also of sharing their ailments eg, viruses, with everyone else, including patients. As a caring organisation the NHS should make sure that it looks after its staff. It's not too diffiuclt to identify those swinging the lead and there are plenty of management techniques for dealing with those" – Name and address withheld