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Unhealthy Workplace or Poor Work Ethic?

Human Resources Management Association Of Barbados 6th Annual Conference & Exhibition, October 9-11, 2002





Absenteeism: Unhealthy workplace or poor work ethic? It’s an absolutely great question that is so complex that the answers cannot be put in either white or black.

Absenteeism is a workplace issue that excites the emotions. Most people who talk about absenteeism have individual points of view. Unfortunately, most of the comments and findings are based on speculation and subjectivity. Most people in management positions, to whom I have spoken, usually look at absenteeism from their perspective, that is, the position of a manager, and, in most cases, absenteeism as they see it, usually stems from poor work attitudes by workers, or, by groups of workers who are defrauding the system. The workers on the other hand, are usually self-protective in their views, and their absences are always the result of a cause; and if there is any admission other than illness, the blame is placed on obnoxious or bullying bosses or a family crisis. In other words, there is never a shade of gray in the matter.

What is absence?

Absence is defined as non-attendance at work by an employee when attendance is expected by the employer. As one organizational psychologist puts it, despite the apparent ease of the definition, absence has proved to be a complex phenomenon that resists single or straightforward explanations. The foregoing definition is not, in fact, describing a specific behaviour. In this sense absence is an administrative category rather than a behaviour.

I wish to submit very early that it’s unscientific and ridiculous to use the generalization that the main reason for absenteeism in Barbados or anywhere as malingering or dishonesty since there is much researched evidence to the contrary.

If we desire to deal objectively with absenteeism, we have to examine all of the contributing factors – including psychosocial factors at work. We have to look at root causes and we must draw up a profile of occupational illnesses and injuries, chronic illnesses, as well as social factors that impact the Barbadian worker. We are not dismissing the fact that we have to look at malingering. But we cannot use one factor and determine that is the cause.

The costs associated with absenteeism are high and while there is considerable underreporting of workplace accidents and diseases in Barbados, which, in turn, would enfeeble our attempt to paint an accurate picture of how these factors influence absenteeism, we are aware that the National Insurance Department pays out an annual average of $11.2 million in sickness and injury benefits. This, I think, gives an idea, if not a clear position of where we are in relation to how poor working environments may impact illness, injury and absences.

If we are discussing an unhealthy workplace, we have to focus not only on physical factors – extreme of temperatures, noise, vibration, the things we can see and feel - as we are wont always to do, we also have to take account of employees’ mental and spiritual health as well as their social well-being. After all, occupational health and safety is not just about the promotion and maintenance of your physical health, but your mental and social well-being, as well.

Individuals interact with their working conditions in a manner, which is determined by working conditions and by human capacities and needs. The root cause approach is an imperative because crucial job factors in this interaction include:

  1. (a)          the job task,
  2. (b)          the physical and social work environment,
  3. (c)           managerial practices and
  4. (d)          employment conditions.

Human assets and limitations, which determine the success of the interaction, are based on general psychological and biological factors, as well as individual characteristics and social contexts. When working conditions and human factors are in balance, work creates a feeling of mastery and self-confidence; increases motivation, working capacity and satisfaction; and improves health. An imbalance between environmental opportunities and demands, and between individual needs, abilities and expectations, elicits a different reaction. When needs are not being met, or when abilities are over – or under taxed, man reacts with altered cognitive, emotional, behavioral and physiological responses. The outcomes largely depend on the abilities of the individual to cope with difficult life situations and to control the early manifestations of its consequences. Thus, when exposed to the same stressful situation within reasonable limits, one individual may cope successfully and remain healthy, while another may experience health problems.1

If we are looking at absences from work, we might wish to bear in mind that, in the working environment, a number of negative, potentially health related psychosocial factors have been identified in numerous studies. These include the underutilization of abilities, work overload, lack of control, role conflict, inequity of pay, lack of job security, problems in relationships at work, shift work and physical danger.

We pay little attention to mental health problems in the workplace.  I have no information on the Barbados situation as it relates to work-related mental ill-health, but a study, undertaken by the ILO, two years ago in five North Atlantic countries, reveals that the incidence of mental ill health is increasing, with as many as one in ten workers suffering from depression, anxiety, stress or burnout, which lead, in some cases, to unemployment and hospitalization.

The ILO adds that the national statistics of several countries indicate that a lot of people drop out of work because of mental health problems. In the Netherlands, for example, for one third (1/3) of those employees who are diagnosed as disabled for work each year, the problem is related to mental health. The majority of this category, 58% is reported to be work-related. Together with musculoskeletal problems, mental health problems account for two-thirds of those who drop out for medical reasons each year.

30 to 40% of all sickness absence from work in the UK is attributable to some form of mental illness

It is difficult to be exact about the number of working days lost each year because of mental ill health. For the UK, a figure of 90 million certified days – or 30 times that lost as a result of industrial disputes is widely quoted. This compares with 8 million days lost as a result of alcoholism and drink-related diseases and 35 million days as a result of coronary heart disease and strokes.

Annually, US industry loses approximately 550 million working days due to absenteeism. It is estimated that 54% of these absences are in some way stress-related.

Tricia Day, president of Business health Systems (BHS), Santa Rosa, California states that employees suffering from job burnout or job-related stress tend to have higher absenteeism rates, produce inferior work and make costly mistakes. She estimates job stress costs US businesses as much as $200 billion annually; including a 10 percent increase in stress-related workers’ compensation claims in the past 15 years.

The ILO Encyclopedia of OSH, 4th Edition informs that anxiety disorders as well as sub clinical fear, worry and apprehension, and associated stress-related disorders such as insomnia, appeared to be pervasive and increasingly prevalent in workplaces so much so that the Wall Street Journal called the 1990s the decade of Anxiety. Corporate downsizing, threats to existing benefits, lay-offs, rumours of lay-offs, global competition, skill obsolescence, and deskilling, restructuring, reengineering, acquisitions, mergers and similar sources of organizational turmoil have all been recent trends that have eroded workers’ sense of job security and have contributed work-related anxiety.

Let’s now look at physical conditions in the workplace in Barbados. Anthony Sobers, Chief Economist, Barbados National Productivity Council, in a paper, published July 2001 and entitled, THE GROWTH OF ON-THE-JOB INJURIES IN BARBADOS AND THEIR IMPACT ON ORGANISATIONAL PERFORMANCE, states that 7% of the Barbados workforce becomes injured on the job, with the average sick leave in each case increasing from 16 days in 1995 to 29 days in 2000. The average time lost from injuries has increased by 81% over the period, which, in effect means that out of a year consisting of 220 work days, the employer is losing 9% of work time to injuries alone. Collision/stumbling/slipping represents the largest category of injuries and not tool and machinery related incidents as might be expected.

The Sobers study shows that the so-called mundane injuries – collision/stumbling/slipping were the major problem and not tool and machinery related incidents as might be expected.

I must point out that these accidents occur mainly in the service sector where the Factories Act does not provide any coverage and where there is limited regulation.

The Sobers paper states that the situation has surpassed the critical stage, given the rapid increase in the number and cost of injuries over the period. His argument is that the evidence suggests that the severity of injuries has been increasing) from 16 days to 29 days per case in 2000), and he posits that it might be related to poor environments and a low sensitivity and understanding by organizational personnel of what is required for high performance. On the other hand, he says it has been suggested that the system has loopholes that favour abuse or manipulation.

Sobers recommends that the approach to injury reduction should be people-centred with emphasis on:

•             Building high morale

•             Encouraging good communication and inter-personal relations

•             Good physical plant design and layout

•             Adherence to workers’ rights; and

•             Participation and consensus building.

He concludes that there is increasing evidence that companies with poor enabling environments experience high levels of injuries and absenteeism, with significantly low output and productivity. Moreover, poor environmental conditions can lead to illness, which eventually becomes chronic, with the resulting decline in workers’ output and reduction in the useful life of workers.

Over the period, 1993 to 1999 benefit payments increased by 148%, that is, they increased from $4.5 to $11.2 million. The number of claims also increased from a mare 639 to 4016.

The Sobers paper has indicated that injury and illness are major causes for absence, and that poor health and safety management that results in risks and hazards in the workplace may be part of the picture.

There is some corroboration.  A Survey on Work-Related Illnesses, Physical Injuries, Chemical Hazards and Other Stresses in Barbados, published in October 2001, by the Earle and Phillips Consulting Group, for the PAHO, emphasizes “…it is evident that poor workplace health and safety leads to increased liability risks, absenteeism and lost workdays which will serve to erode competitive positioning. Clearly, apart from health considerations, the improvement of working conditions is a sound economic investment”.

I wish to share with you some of themes that arose from the findings:

•             The incidence of headache amongst the Bajan workforce is high

•             A significant number of employees suffer from mental fatigue and unsafe and/or unhealthy physical conditions

•             Knowledge of the proper handling of hazardous materials is relatively modest

•             Workplace stress, the quality of home life, the extent to which the worker talent is used on the job, how workers generally feel about their work, and worker problems getting to sleep are all issues which impact worker health

•             A strong relationship exists between hours spent at the computer and the incidence of health problems associated with excessive computer use

Let’s look very briefly at the international position. The ILO reports:

•             2 million workers die annually as a result of occupational accidents and diseases;

•             250 million work-related accidents occur annually; and

•             Workplace hazards and exposures cause more than 160 workers to fall ill annually.

While the ILO does not speak absolutely to absenteeism, it gives us the costs of losses resulting from workplace injuries and illnesses. It says the annual losses resulting from work-related diseases, injuries in relation to compensation, lost workdays, interruptions of production, training and retraining and medical expenses amount to more than 4% of the total Gross National product of all countries in the world. That’s phenomenal and does indicate where poor work environments sit in relation to worker health and absenteeism.

Organisational psychologist say that many different circumstances and behaviours may trigger absence from work, and that rather than viewing absence as a single behaviour, making careful distinctions between types of absence is vital for both understanding and managing absence.

Even quite modest rates of absence can be costly for an organisation. Despite these costs, many organizations maintain surprisingly poor absence records, which mean that obtaining good evidence about absence is often difficult. Another difficulty is that, even when organisations keep good records, establishing the types and causes of absence events is problematic.

In many cases it may be impossible to verify employees’ claims about the causes of their absence. For example, it is not easy to check whether an employee really had to look after a sick relative or had a migraine or back pain. Questioning employees’ claims about absence may also damage employee relations and hence be undesirable from the organisation’s point of view.

According to industrial psychologist Rob Briner, although many of the available figures should be treated with caution, some patterns about rates of absence do emerge. First, - and he is speaking about Europe – there are considerable national variations in absence rates. For example, studies in Western Europe have found rates about twice as high as those found in Japan and the United States. Second, there are differences between occupations and sectors of industry in terms of self-reported rates of absence due to sickness and injury. There are also differences between categories of disease in the number of self reported annual days off work.

Briner stresses that it is difficult to obtain objective evidence about the causes of absence and that, intimately, we may never know the precise causes of an absence event even though employees may be willing to attribute it to a specific cause.

Correlates of absence

Although several correlations have been found, studies have produced very inconsistent results and many correlations are weak. For example, many studies have found no correlation between JOB SATISFACTION and ABSENCE, while those that have done so have found only small negative correlations, indicating that lower levels of satisfaction are only weakly associated with absence.

A key point however is that correlates of absence have been found with several different factors including:

•             Attitudes to work,

•             Biographical factors, (which are factors like older age, longer tenure, larger family size and sex),

•             Organizational features which are factors like the size of the organization and unit work size), and

•             Job content, which deal with factors like autonomy, responsibility and job level.

In most cases, therefore, absence from work is likely to be caused by several factors and some organisation psychologists have said that any single cause is unlikely to have a strong effect on rates of absence. Some factors such as age and tenure, have shown both negative and positive associations with absence indicating that these variables may be associated with both higher and lower levels of absence.

Several models of absence have been proposed in order to explain it. Given that there are different kinds of absence and different correlates of absence, no single theory is likely to account for all absence events. However, the particular model of absence that is used has implications for the way that absence is managed.

Models of absence from work

•             Medical model – suggests that the main cause of absent is injury or sickness

•             Deviance model  - views employees who are absent as somehow different from other employees: they may have particularly negative attitudes such as laziness and lack of commitment

•             Withdrawal model suggests that employees are absent as a way of withdrawing from unpleasant or unsatisfying working conditions

•             Economic model suggests that leisure and activities outside work are valued by employee; thus, not attending work in order to engage in alternatives is attractive

•             Cultural model – identifies causes of absence within social context of organization and the way shared attitudes and norms influence absence rates; thus if employees perceive their level of absence to be much lower than that of their co-workers, they may find it easier to decide not to attend work.

So we recognise that while sickness clearly can be a cause of absence, many other models are required to build up a comprehensive picture of absence.

Also without good information about patterns of absence over time, across work units and between different types of employee, accurate diagnosis and management of absence is impossible.

If we have the problem, how do we manage it?

Individual Techniques:

•             What are the negative techniques as proposed by one industrial psychologist?

These are:

-              Negative incentive (punishment) 

-              Setting expected levels of attendance

-              Investigating absence events (such as interview with superior on return)

Some experts claim that the issuing of warnings and the use of disciplinary procedures may be disincentives. Disciplinary systems are widely used, yet there is little evidence about their effectiveness. There is, however, evidence that reward systems such as attendance bonus schemes can reduce absence rates.

•             And what are the Positive (reward) Incentives?

These are:

-              Financial rewards  (such as attendance bonuses)

-              Other rewards such as free hours, recognition programmes

Work Techniques will include the following:

-              Job redesign

-              Work rotation

-              Employee participation

-              Physical working conditions

You may also influence attendance by the following:

-              Flexible working hours

-              Establishment of a company crèche

Organisational Psychologist Bob Briner concludes that techniques for managing absence may be aimed at individual employees or at changing aspects of the work or the working environment.

Individual techniques include punishments for absence and rewards for attendance. For example, (1) detailed interviews with supervisors on return to work about the causes of the absence can discourage taking time off work. Similarly, (2) issuing warnings and using disciplinary procedures may be disincentives. Disciplinary systems are widely used, yet there is very little evidence about their effectiveness. There is, however, evidence that reward systems such as attendance bonus schemes can reduce absence rates.

Changing the nature of the work in terms of job redesign may be effective, but it depends on the extent to which features of the job are actually predictive of absence. Techniques that influence the employees’ ability to attend seem to be more successful. The introduction of flexible working hours, in particular, has been shown to reduce absence.

Even with a comprehensive monitoring system, attempts to manage absence are likely to work only if they are approached systematically. In practice implementing a range of measures based on an accurate diagnosis of absence patterns is likely to be most effective. Managing absence also requires a flexible approach to employees who have long term or frequent absences. In some cases specific causes such as chronic sickness or a disability may be identified. In others, however, a range of factors both inside and outside the workplace may be important.