Leaveism and illness-related behaviour.

Background: Recent studies have suggested that leaveism may be a link between sickness absence and sickness presence (attending work despite illness). This paper examines one of the three components of leaveism (utilization of annual leave entitlements or flexi hours instead of sick leave).

Aims: To study whether leaveism provides additional information about employees' well-being not already predicted by sickness absence and sickness presence and to test previously suggested reasons for this behaviour.

Methods: Data from a heterogeneous sample of employees from a study on presenteeism was used to analyse the association between leaveism and self-rated health and to further investigate previously hypo thesized links with sickness absence and sickness presence.

Results: Data from 930 employees (response rate 31%) were analysed. Although the use of leave entitlements when unwell is less prevalent (mean = 1.5 days per year) than sickness absence (6.2 days) and sickness presence (7.4 days), this component of leaveism is significantly related to subjective health adjusted for sickness absence, sickness presence and other control variables. The results suggest that this component of leaveism is associated with fear of job loss, promotion prospects, more restrictive attendance policies and work overload. Contrary to expectations it is associated with lower, rather than higher, job enjoyment.

Conclusions: Leaveism provides additional information about employees' illness-related behaviour and well-being and should be further considered in future research. Among those employees who try to avoid sick leave, high workload seems to be a stronger predictor of sickness presence, whereas fear of job loss seems to promote leaveism.