Staff photo by Bill Green/ photo illustration by Melanie Bender

The laws of disease infection take over, and if you aren't lucky enough to catch the contagion, you might get stuck picking up the slack when the majority of your co-workers come down with the cold or flu.

Employers are increasingly worried about the effect of sick employees in the office, dubbed "presenteeism," according to a recent survey by CCH, a human resources and employment law information provider. Of 326 human resource executives surveyed, 56 percent said presenteeism is a problem, up from the 39 percent who cited it as an issue in a 2004 survey.

So why are people dragging themselves to work when sick? Is it fear of falling behind in duties or losing face with their boss? Or are we driven by guilt?

Working at death's door

The most common reason, according to the 2006 CCH Unscheduled Absence Survey, is a fear of falling behind on work, which 66 percent of respondents indicated. The next most common, with 56 percent, is the lack of another person to cover the sick employee's duties.

Paul Spector, a professor at the University of South Florida who holds a doctorate in industrial organizational psychology, said reasons can differ depending on where you work.

Casual working environments invite people to miss work for personal reasons, (i.e. reasons other than sickness), while employees don't believe they are as entitled in stricter environments. Depending on the position, like that of a corporate manager, some are afraid to miss work because they could be passed over for a promotion or be seen as weak.

"Some companies expect people to go to work unless you are dying," Mr. Spector said.

Forty-six percent of people surveyed by CCH cited fear of discipline as a reason why they work when ill.

Pam Wolf, a workplace analyst with Wolters-Kluwer Law & Business, which owns CCH, said employers should use the survey to examine their practices.

Ms. Wolf said 97 percent of the companies surveyed used disciplinary-based absence control programs, such as issuing warnings to employees who use too much sick time.

"Employers need to carefully assess whether any program, including incentive-based attendance programs or disciplinary programs, are having unintended effects," she said.

Mr. Spector suggested some incentive-based attendance programs can be counterproductive, as they encourage employees to show up for work even though doing so could be detrimental to coworkers.

"That's the downside to these policies ----people come to work sick and then everybody gets sick," he said. "In the long run, the companies are worse off."

In spite of the idea that employees who show up for work while sick are taking one for the team, some companies have been encouraging a different philosophy.

Ms. Wolf said "work/life programs," designed to give employees more flexibility in work schedules, are gaining popularity in helping curb absenteeism. Such programs include allowing workers alternative work arrangements, a compressed workweek (i.e. four 10-hour days), on-site childcare or elder care services.

"This is good news for employees," she said.

Thirty-six percent of respondents to the CCH survey said company loyalty brought them to the office when ill.

Mr. Spector said many people see working through illness as a measure of professionalism -- he, too, may fall into that category.

"I'm just getting over a cold and I'm in the office, but I don't have to be," Mr. Spector said. "I'm not that sick. I don't have a fever."

Sick kids

Even though working adults may ignore their body's pleas to stay home, Helen Monk, health specialist for Frederick County Public Schools, has this advice for parents when their child complains of illness:--If little Johnny has a fever, earache, sore throat, stomachache, headache or is sneezing and coughing, keep him at home.

"If they have any of those things, they really shouldn't be at school," Ms. Monk said.

Ms. Monk said the school's health specialists rely on parents' judgment on whether their child should come to school, though she's heard more than one child say their parents encouraged them to "try to make it" through the day when the child is ill.

Just as FCPS officials do not want sick children to spread illness to others, Ms. Monk said teachers are discouraged from coming to work when very ill.

"Their energy level and ability to teach creatively and to full capacity is just not going to be there," she said.

Ms. Monk said FCPS emphasizes the importance of high attendance, "but not if you're really, really sick," she said. "You have to strike a balance."