Candidate prognostic factors of presenteeism among French workers: an exploratory longitudinal study

TL;DR

This study explores factors linked to presenteeism, or working while unwell, among French workers over a year, identifying potential predictors like job type and mental health.

Contribution

The study identifies candidate prognostic factors for presenteeism using a longitudinal design and the PROGRESS framework.

Findings

Health care workers and blue-collar workers had higher odds of high presenteeism.

Low decision latitude, job strain, depression, and poor sleep quality were associated with increased presenteeism.

Nonlinear effects were observed for sleep disturbances and musculoskeletal pain.

Abstract

Presenteeism, defined as working despite health problems, represents a major economic and public health burden. While many determinants have been proposed, robust prognostic evidence remains limited. According to the PROGRESS framework, exploratory studies are essential to identify candidate factors before confirmation. This study aimed to explore potential prognostic factors of presenteeism among a sample of French workers.

A 12-month prospective longitudinal study was conducted in three companies. Adult employees completed baseline sociodemographic characteristics, physical activity, sedentary time, psychosocial work factors, mental health, and musculoskeletal symptom questionnaires. Presenteeism was measured at a follow-up (FU) using the Stanford Presenteeism Scale-6 (SPS-6). High presenteeism was defined as a score of 16 or higher. Logistic regression analyses, adjusted for age, sex, and compliance with physical activity guidelines, were used to identify possible associated factors. Restricted cubic spline analyses were tested for potential nonlinear relationships.

Among the 224 included participants at the baseline, 139 (62.1%) completed the follow-up. The mean age was 42.9 years (± 10.8) and 60.7% were women. Twenty-nine participants (20.9%) presented high presenteeism at a follow-up. Possible associated factors included health care work sector (OR = 13.96, CI 95% 1.73–112.99), blue-collar occupation (OR = 3.91, CI 95% 1.39–11.01), extended workday (10 h or more) (OR = 0.17, CI 95% 0.05–0.60), low sedentary time (OR = 3.93, CI 95% (1.41–10.96), low decision latitude (OR = 5.71, CI 95% 2.23–14.58), job strain (OR = 5.00, CI 95% 1.25–20.08), depression (OR = 3.56, CI 95% 1.30–9.60), poor sleep quality (OR = 1.14, CI 95% 1.01–1.27), and a greater number of painful sites (OR = 1.34, CI 95% 1.05–1.70). Nonlinear effects were observed for sleep disturbances and multisite musculoskeletal pain.

This exploratory study highlights a clustered pattern of psychosocial work, working, and clinical factors associated with presenteeism. In line with PROGRESS recommendations, these findings should be interpreted as hypothesis-generating and require replication/confirmation in larger, independent cohorts. Such work may inform future prognostic models and guide occupational health interventions.

The online version contains supplementary material available at 10.1186/s12889-025-26020-w.

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