Worker Health and Wellness Research/studies Worker health and wellness

Paid sick leave

Supporters say paid time off can prevent the spread of illness – and reduce on-the-job injuries

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Paid sick leave took a turn in the spotlight on Election Day: On Nov. 8, voters in Arizona and Washington passed measures requiring employers to provide certain workers with paid sick leave – bringing to seven the total number of states with paid sick leave laws on the books.

The passage of the proposals “is just further evidence that paid sick leave is a policy and workplace support that people want and are willing to go to ballot and vote for,” said Sarah Fleisch Fink, director of workplace policy and senior counsel for the Washington-based National Partnership for Women and Families.

Vermont and the cities of Minneapolis and Chicago were among the jurisdictions that enacted paid sick leave laws in 2016. At press time, 39 jurisdictions have or will have statutes regarding paid sick leave, according to NPWF. In addition, a Jan. 1 start date was in place for employers with federal government contracts to provide their workers with as many as seven days of paid sick leave per year. (For more on the rule, see “Federal contractors and sick leave.")

Supporters see paid sick leave – which typically allows a worker to take paid time off when he or she, or a family member, is ill – gaining momentum. They cite research showing it can help prevent the spread of disease, limit worker injury and allow workers to seek timely medical treatment.

However, critics claim providing paid sick leave can be costly – particularly to small businesses – and they worry workers will abuse it.

Supporting data

Multiple studies support the benefits of paid sick leave:

  • A 2016 study from Florida Atlantic University and Cleveland State University, published in the journal Health Affairs, found that employees without paid sick leave were more likely to work when sick or injured, and postpone or abstain from medical treatment for themselves or a relative. More work absences have been connected to shorter recovery and fewer complications, the study notes.
  • Working while sick – known as “presenteeism” – can account for as much as 60 percent of an employer’s worker health costs, surpassing the costs of work absence and medical and disability benefits, according to a 2004 report from the Cornell University Institute for Health and Productivity Studies and health information firm Medstat, published in the Journal of Occupational and Environmental Medicine.
  • Data from the Centers for Disease Control and Prevention shows sick food service workers spread 70 percent of the foodborne transmission of norovirus. And a 2013 study from the University of Pittsburgh, published in the American Journal of Public Health, determined that flu transmission in the workplace could be lowered 25 percent to 40 percent if workers stayed home one or two days.

In June, the American Medical Association approved a policy on the benefits of paid sick leave and other time off, stating that the United States is “the only industrialized nation without a federal family-leave law that guarantees workers may receive pay while taking time to care for themselves or their family.”

‘Not backed up by reality’

Critics argue that paid sick leave does not necessarily prevent employees from going to work when sick and ultimately may not benefit employers.

A 2014 review of studies by Freedom Foundation, an Olympia, WA-based conservative think tank, found that mandatory paid sick leave policies adversely affect employers, workers and consumers, as worker benefits and hours decrease, business costs increase and profits decline. In addition, no reduction in presenteeism was observed in four of five studies.

“Advocates typically make the argument that mandatory paid sick leave laws are a win-win for everybody,” said Maxford Nelsen, report author and labor policy analyst with the foundation. “Business is going to save money, consumers will be interacting with healthier employees, employees aren’t going to have to choose between going to work sick and not getting paid.

“But a hard look at the data shows that pretty rosy picture of things is not backed up by reality. Businesses in some cases have argued this is going to destroy the local economy and have very significant negative impacts. I don’t think that’s the case, either.”

Instead, the review found businesses with paid sick leave requirements endure “moderate negative consequences.”

“That cost [of paid sick leave] has to be made up somewhere,” Nelsen said. “But we’re not really seeing any decreases in turnover or workplace illness that proponents of these laws claim will happen.”

Meanwhile, half of workers interviewed for a 2014 University of Washington study on a paid sick leave requirement in Seattle said they were unable or hesitant to stay home when sick. In addition, half of workers said they feared retaliation or negative feelings from their employers about sick leave. This despite 70 percent of surveyed employers supporting the law and reporting that the costs were “modest.”

Preventing injuries?

A reduction in worker injuries is another touted benefit of paid sick leave. A 2012 study in the American Journal of Public Health concluded that providing paid sick leave to workers may help employers prevent nonfatal on-the-job injuries.

For the study, NIOSH researchers examined data about approximately 38,000 workers from the National Health Interview Survey. They found that workers with access to paid sick leave were 28 percent less likely to be injured than workers without the benefit. Employees in high-risk professions – such as construction, manufacturing, and health care and social assistance – appeared to fare better if they had paid sick leave. For example, a construction worker without paid sick leave was 21 percent more likely to experience a nonfatal occupational injury than one with paid sick leave.

“Our results show that providing paid sick leave to all employees could help reduce the incidence of nonfatal workplace injuries,” said Abay Asfaw, lead study author and senior economics fellow at NIOSH. “A lack of concentration due to fatigue, medication, et cetera, can lead to serious injuries in higher-risk industries and occupations. The higher the risk of injury, you are more likely to be injured if you show up for work while you are sick.”

Researchers also believe that if workers have paid sick leave, they may feel less pressure to work when sick due to concerns about losing money. “Safer operations and fewer injuries” could result from fewer ill employees working with a “reduced functional capacity,” they said.

Asfaw is working on research about how paid sick leave for parents can benefit children’s access to health care and how it can help employers, such as by reducing worker turnover.

“Paid sick leave can be beneficial for all – workers, employers and society. That’s the major point,” Asfaw said.

Federal contractors and paid sick leave

Under the Department of Labor’s final rule for federal contractors, published Sept. 30, employees will accumulate an hour of paid sick leave for every 30 hours they work on a covered contract. The rule will provide up to 56 hours of paid sick leave annually to about 1.15 million federal contract workers, approximately 594,000 of whom previously received no paid sick leave.

“We really see it as a further sign of progress in this movement,” said Sarah Fleisch Fink, director of workplace policy and senior counsel for the Washington-based National Partnership for Women and Families.

The rule has its detractors. In April, the Small Business Administration Office of Advocacy sent a letter requesting that DOL consider alternatives to paid sick leave and arguing that compliance with the rule would be expensive – as much as $70,000 per year – for some small businesses.

Other stakeholders have claimed the rule will be burdensome. “We absolutely cannot afford another financial burden, nor can our employees, because their wages would have to be reduced in order to accommodate the additional costs of paid illness,” one stakeholder said in the rule’s public comments. Another stated that a roofing contractor in a major metropolitan area “pays non-exempt employees $45 per hour (with benefits). If an employee accrued and used the full 56 hours of paid sick leave, that would cost the contractor $2,520 annually for one employee.”

Meanwhile, the Bureau of Labor Statistics has stated the cost of paid sick leave for an employer was 25 cents per hour per worker in private industry for 2012.

A ‘non-event’ in NYC

A 2016 report from the Center for Economic and Policy Research and the Murphy Institute at the City University of New York found that a paid sick leave law that went into effect in 2014 in New York City is a “non-event” that has not been costly to employers or misused by workers.

Workers at private-sector companies and nonprofit organizations that employ at least five people accrue one hour of sick pay for every 30 hours worked. Critics of the law have claimed it would result in job loss, worker misuse and high costs. However, researchers found that of 352 employers surveyed, 98 percent reported no abuse, 86 percent support the law and about 85 percent said it did not affect their business costs.

“Among those who did experience an increase in cost, it was those for which more than a quarter of their workforce was part time,” CEPR researcher Eileen Appelbaum said. “Even among those employers, most had a very modest increase in cost.”

Of the roughly 14 percent of employers who said their costs rose, only 2.7 percent reported an increase of 3 percent or more.

Researchers also concluded that workers considered paid sick leave “insurance” rather than “entitlement,” taking only four days on average in the past year. In addition, 97 percent of employers did not cut work hours, 94 percent did not increase prices and 91 percent did not reduce hiring.

“The momentum is huge,” Appelbaum said. “Whatever your political orientation, nearly everybody thinks people should be able to be good family members as well as good workers, and these laws make it possible to do both.”

‘A protected right’

The National Partnership for Women and Families supports laws that allow workers to accrue paid sick time – typically one hour of sick time for every 30 hours worked, according to Sarah Fleisch Fink, director of workplace policy and senior counsel for the Washington-based nonprofit.

Many of the laws call for five to nine sick days to be accrued. NPWF supports laws with “strong and inclusive definitions of family” that include grandparents, siblings and people similar to family members, and that can be used for “broad purposes” such as “safe leave” for victims of domestic violence, sexual assault or stalking, Fleisch Fink said.

“It’s important people are not penalized for using sick time. They can be given demerit points for using sick time that can accumulate and lead to disciplinary action – we don’t support that,” she added. “Paid sick time should be a protected right that people have in the workplace.”

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