ObjectivesThe aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the ‘healthy’ workers.DesignPopulation-based cross-sectional study.SettingSalaried population in Spain.ParticipantsData were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615.Main outcome measuresSelf-reported episodes of SP and their reasons.Results23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker’s wage to the total household income and downsizing; factors among the ‘unhealthy’ workers are working more than 48 hours and not having a contract. The most common reason for SP is ‘did not want to burden my colleagues’, 45.7% (95% CI 37.3 to 54.4), whereas ‘I could not afford it for economic reasons’ ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report ‘worried about being laid off’ as a reason for going to work despite being ill.ConclusionsThe estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding ‘healthy’ workers). The reason ‘I was worried about being laid off’ was much more common than the estimates for Sweden or Norway.

Background: There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed.Methods: A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016). Results:Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous.Conclusions: Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.Since the 1980s, the economic impact of the loss of productivity among presenteeist workers, that is those who report for work despite being ill, has been a topic of interest in disciplines such as social sciences or management. 1,2 It has been observed, for example, that in certain circumstances the cost associated with performance-based work loss could exceed the costs of absenteeism and medical treatment combined. 3 A second approach focuses on the act of attending work while ill and its effects on worker's health. 1,4 In this approach, presenteeism is defined as the fact of working despite being ill 5 and it should be considered an important issue due to its association with several health problems. [6][7][8][9][10][11] In recent meta-analytic research, McGregor et al 12 explore the effect of these two operationalizations of presenteeism on previous Am J Ind Med. 2019;62:580-589. wileyonlinelibrary.com/journal/ajim 580 |

Toll station workers are occupationally exposed to vehicle engine exhaust, a complex mixture of different chemical substances, including carcinogenic compounds. Therefore, a study was carried out on attendants of two highway toll stations to describe their occupational exposure to vehicle engine exhaust, based on a worst-case scenario approach. Personal sampling was conducted during the day shift for all attendants, testing for three groups of chemical substances: polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs) and aldehydes (formaldehyde and acrolein). Concentrations of total PAH, BTEX (benzene, toluene, ethylbenzene, and xylenes) and formaldehyde content varied between 97.60-336.08 ng/m3, 5.01-40.52 μg/m3, and 0.06-19.13 μg/m3, respectively. No clear relationships could be established between exposure levels and the number of vehicles. Furthermore, no differences were found between truck versus car lanes, or inside versus outside the tollbooth. Not all the detected VOCs were related to vehicle exhaust; some were consistent with the use of cleaning products. The measured concentrations were far below the established occupational exposure limits, but tended to be higher than values reported for outdoor urban environments. There are very few international studies assessing occupational exposures among toll station workers, and this is the first such study to be conducted in Spain. The results suggest that further, more detailed studies are necessary to characterize exposure properly, and ones which include other airborne pollutants, such as ultrafine particles. The comparison of the results to other similar studies was difficult, since no data related to some important exposure determinants have been provided. Therefore, it is recommended that these determinants be considered in future studies.

This study could be useful in order to begin planning interventions on specific psychosocial exposures to protect mental health in the workplace.