Employers have long worried about workers who call in sick so they can surf or watch TV. Now some experts say companies should pay attention to the flip side of that problem: employees who show up feverish and sneezing.

They even have a word for this behavior, which can hurt productivity just as absenteeism does: “presenteeism.”

Though the worry isn’t new, it has gained momentum with fears of a bird-flu pandemic. Should the disease mutate into a strain that passes from person to person, public health officials say, it could thrive in offices.

“I wish employers would make it possible for sick employees to stay home,” said Dr. Jonathan Fielding, public health director for Los Angeles County. “Certainly from a public health standpoint that makes sense.”


Yeah, right, many workers say. In the real world, calling in sick is often not an option.

“We’re in an environment where they just need the bodies to keep things going,” said Candace Greene, 35, who oversees substitute teachers for the Los Angeles Unified School District. And if you do take a sick day, “you pay for it in attitude when you come back the next day.”

Even highly paid employees may not get any slack, precisely because they are highly paid, said Dana Cephas, a Los Angeles labor and employment lawyer.

“A partner can’t call a client and say, ‘I can’t get what you want today, because my key attorney is sick,’ ” he said. “Employers say, ‘We’re paying you $100,000 or $200,000 -- you don’t get sick.’ ”


But many workers cannot afford to call in sick. The federal Bureau of Labor Statistics reports that 42% of all workers in private industry are not entitled to sick time.

Even if they do have paid leave, low-wage workers may not want to take it. Cephas said his father, a janitor, never took a sick day -- because he was paid for his unused leave at the end of the year and “we needed the money.”

Recent surveys suggest many employees feel the same. Ninety percent of workers polled last year by LifeCare, a Connecticut firm that provides counseling and information services to employees, said they had come to work sick.

Most said they showed up because they felt it was “too risky to be absent” or worried they would fall behind in their job, according to the study.


Another recent survey found that employers are increasingly aware of the problem. CCH Inc., the Illinois-based human resources information firm that conducted the poll, said 48% of employers last summer said presenteeism was a problem in their companies -- up from 39% in 2004.

But some employers fear that workers will slack off if it’s too easy to stay home.

“We don’t want you to come to work when you’re sick,” said Carol Dyer, human resources director of West Los Angeles-based Public Communications Services, an 80-person company that installs and maintains telephones in prisons.

“But, on the other hand, we expect you to come to work. If it’s a mild cold -- well, it’s like, tough it out.”


Employers may be encouraging presenteeism by cutting back on sick pay.

Although exact figures are unavailable, some human resources experts believe companies are reducing the number of sick days they provide, with five a year becoming more common. Moreover, a growing number of employers block workers from accumulating unused sick days from one year to the next.

This may explain rising presenteeism rates because a bad cold combined with a child’s bout of bronchitis can quickly drain an employee’s sick-leave account, said CCH analyst Tulay Turan.

“If you have five days of sick leave and on the sixth day disciplinary action is taken, people don’t want to take that chance,” she said.


But many employers are beginning to recognize that they must find ways to make sure workers not only come to work when they’re well but also stay home when they’re sick.

“There are two different kinds of employees -- some people take advantage every time they’re sick. There are others who come in and infect the whole place,” said Marilyn Sherman, human resources director for Otis College of Art and Design in Los Angeles.

“We encourage people to get the flu shot -- and to stay home if they get it,” she said.

One answer to the problem of presenteeism may be improving office morale -- so workers are happy to show up when they’re well, but not afraid to stay home if they’re not.


Turan said that companies CCH surveyed where employees rated the workplace morale as “poor” or “fair” have experienced more problems with both presenteeism and absenteeism.

Another may be to encourage telecommuting for workers who must be on the job even if they’re contagious.

The threat of bird flu could even trigger “a sea change” in employer attitudes toward the practice, said John Challenger, chief executive of outplacement firm Challenger, Gray & Christmas.

“I could see myself choosing that option,” Challenger said. “It would be wrong to infect my co-workers, but I can get work done at home.”


UCLA business school professor David Lewin thinks cutting presenteeism will depend on the example that employers themselves set by staying home when they are sick.

“Eventually employers have to ask: Do I want people here who are sick?” he said. “If they think it through, the answer is going to be more no than yes.”