Association Between Sickness Presenteeism and Depressive Symptoms by Occupation and Employment Type During the COVID-19 Pandemic

Abstract

Background: Sickness presenteeism (SP) has gained attention in occupational health. This study aimed to analyze the relationship between SP and depressive symptoms by occupation and employment type during the COVID-19 pandemic in Korea. Methods: Community Health Survey data (August 16 to October 31, 2020-2021) were used to assess depressive symptoms and SP among workers (n = 221,241; mean age 46.0; 53.5% male). Depressive symptoms were measured using the Patient Health Questionnaire-9, and SP was defined by the ability to rest at home when exhibiting COVID-19 symptoms. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms were estimated using multiple logistic regression analyses for each sex and year stratum. The interaction between SP and occupation on depressive symptoms was assessed using relative excess risk due to interaction (RERI). Results: The prevalence of depressive symptoms was higher in individuals with SP than in those without SP (4.22% [n = 696] vs. 1.89% [n = 3861], respectively). After adjusting for demographic and occupational variables, the association between SP and depressive symptoms was significant in both sexes in 2020 and 2021 (OR [95% CI]: 2.18 [1.82-2.62], 2.41 [1.97-2.93], 2.05 [1.77-2.38], 2.47 [2.11-2.88] for male-2020, male-2021, female-2020, and female-2021, respectively). A marginally significant interaction between service workers and SP on depressive symptoms was observed among male workers in 2021 (RERI = 2.37, 95% CI = [-0.04-4.78]) but not in other strata. Conclusion: SP is significantly associated with depressive symptoms in Korean workers across employment and occupational types, with a prominent association in service workers.