Work during illness: prevalence, assessment methods and economic loss. A systematic literature review

Introduction. Due to temporary disability of employees, Russian Federation annually loses about 4% of GDP. A significant issue for the national economics and occupational health is the problem of presenteeism – attending work while being ill – which poses dangers to the employer’s financial well-being and the health of the country’s working population. However, the phenomenon of presenteeism remains largely unexplored worldwide. The significance of the issue of presenteeism is added by the varying results obtained through different assessment methods. Lack of understanding of their frequency, correlation and influence on the choice of approaches hinders both inter-research comparisons and the creation of unified strategies and recommendations to prevent and reduce economic loss associated with presenteeism. The purpose of the study is to systematize data on the prevalence, assessment methods, and economic burden of presenteeism and analyze their regional characteristics. Materials and methods. The systematic review was prepared in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The literature search was performed using PubMed, Scopus, and eLibrary databases. The review includes 84 original articles published in English and Russian between January 2020 and June 2025. Results. The undertaken systematic review has identified a number of key trends and methodological challenges in the research on presenteeism. There is a pronounced regional peculiarity, particularly in European studies, which focus on economic aspects and financial loss. The prevalence of the WPAI questionnaire in global research has been confirmed, while in Asian countries (especially Japan) the WFun scale, reflecting cultural peculiarities, is widely used. There is also a discrepancy in the approach to sampling: the focus on specific nosologies prevails in Western countries, whereas in China and Brazil, certain areas of employee activity are more frequently explored. The thematic analysis shows a focus on pain syndromes, while among the occupation groups, medical workers prevail. An extreme heterogeneity of quantitative result presentation turned out to be the major methodological challenge, significantly complicating comparisons and meta-analyses. This indicates an urgent need to develop uniform reporting standards to improve data validity and comparability. Conclusion. The literature review has identified significant methodological challenges in the research on presenteeism, requiring unification of approaches to its assessment and economic interpretation. The study has proposed the most significant areas for further research, including the development of consensus documents for standardizing assessment methods and data presentation, cross-validation of existing scales, unification of approaches to economic evaluation, expansion of the range of studied nosologies, and the creation of clinical recommendations and guidelines for practical applications to effectively manage presenteeism.

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