Ill at home, still at work? Working from home practices and sickness presenteeism.

Working from home has increased globally during the COVID-19 pandemic. Yet, its implications for sickness presenteeism (i.e., working while ill) remain insufficiently understood. We examine formal and informal working from home practices and their associations with sickness presenteeism, considering segmentation preferences and pre-pandemic working from home experience. Using two representative German workforce survey waves (2019: N = 5,363; 2021: N = 10,049), we find that informal working from home was associated with higher sickness presenteeism propensity and more sickness presenteeism days, especially when employees often engaged in supplemental (i.e., informal) work from home. Compared to employees whose job never required supplemental work from home, those who often did so had a 0.12 higher probability of choosing to work while ill across both waves and reported 1.93 and 1.57 additional sickness presenteeism days per year in the 2019 and 2021 waves, respectively. Thus, informal working from home may represent a double risk factor regarding decision- and health-related aspects of sickness presenteeism. In contrast, formal working from home was unrelated to sickness presenteeism propensity but associated with 0.71 and 0.76 fewer sickness presenteeism days per year in the 2019 and 2021 waves, respectively, possibly reflecting modest health-related benefits or pre-existing differences among employees. Exploratory findings highlight that for employees working from home for the first time, the interaction between working from home practices and segmentation preferences was associated with sickness presenteeism propensity. Overall, our results suggest that working from home agreements should clarify sickness-related expectations as part of occupational health efforts.