Making the Case for Paid Sick Leave

Does it make economic sense for employers to offer or expand paid sick leave benefits to their employees? A new NIOSH study published in the American Journal of Public Health reported that workers with access to paid sick leave were 28% less likely overall to suffer nonfatal occupational injuries than workers without access to paid sick leave. Workers in high-risk occupations and industry sectors, such as construction, manufacturing, agriculture, and health care and social assistance, appeared to benefit most from paid sick leave. From these results we concluded that introducing or expanding employee access to paid sick leave might help businesses reduce the incidence of occupational injuries. This could, in turn, reduce costs to employers. To our knowledge, this is the first U.S. study to examine this issue empirically.

Access to paid sick leave might reduce the pressure to work while sick out of fear of losing income. Fewer people working while sick, and therefore performing at reduced functional capacity, might lead to safer operations and fewer injuries. The potential safety benefit observed in our study extends previous research demonstrating that paid sick leave is associated with shorter worker recovery times and reduced complications from minor health problems. Paid sick leave also enables workers to care for loved ones and can help prevent the spread of contagious diseases. Employers may benefit from improved productivity if paid sick leave helps reduce absenteeism, or unscheduled leave, and “presenteeism,” or the problem of  sick workers continuing to work while not fully productive. We hope that our study along with previous research that supports our findings and conclusions will encourage policy makers and employers to consider the overall wellbeing of workers when making policy or funding decisions. Such a holistic approach would lead to more integrated development of programs that both prevent occupational injury and illness and improve other aspects of worker health.

Paid sick leave is one of the non-wage benefits optionally offered by U.S. employers. Although the 1993 Family and Medical Leave Act requires public agencies and private-sector establishments to provide up to 12 weeks of leave to eligible workers, this leave can be paid or unpaid. Despite the demonstrated advantages of paid sick leave for both workers and employers, 43% of U.S. private sector workers reported having no access to paid sick leave during the study period.

The new NIOSH study addresses the second strategic goal of the NIOSH Economics Program that focuses on  improving our understanding of how economic factors, management strategies, and demographic trends affect worker safety and health. This understanding would in turn help us identify workplaces where these conditions need to be altered or their effects mitigated.

Abay Asfaw, PhD; Regina Pana-Cryan, PhD; Roger R. Rosa, PhD

Dr. Asfaw is a Senior Service Fellow in the NIOSH Office of the Director

Dr. Pana-Cryan is a Senior Scientist in the NIOSH Office of the Director and the Coordinator of the NIOSH Economics Program.

Dr. Rosa is the NIOSH Deputy Associate Director for Science.