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Making the Case for Paid Sick Leave

Categories: Economics, Total Worker Health

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.

Public Comments

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. July 31, 2012 at 10:54 am ET  -   Martin Cassidy

    As a Nurse, Midwife and Manager it made clear sense to me that a focus should be made on presenteeism rather than punitive policies on absenteeism. Provide adequate preventative measures and robust Occi health to maximise staff health and well being and the rest should be a matter of course!

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  2. July 31, 2012 at 11:19 am ET  -   Kathy Black

    Thanks for this research/story. In Philadelphia, we have worked for several years to get a City ordinance passed that requires businesses over a certain size to provide a few paid sick days each year to all workers. Though the Philadelphia Council AFL-CIO and many individual unions have endorsed the legislation and worked for its passage, the building trades have been an obstacle. I will circulate this and hope to persuade people that paid sick leave would be beneficial for ALL workers.

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  3. July 31, 2012 at 3:51 pm ET  -   Wade

    As a person who is on sick leave right now I think that it is a fair assumption to do this. How else are we going to be able to make money? We have to have this! I’m tired of big corporations trying to take everything away!

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  4. July 31, 2012 at 7:56 pm ET  -   LawCrossing

    I agree with the fact that a worker should have the right to get paid while sick; otherwise it could translate to disaster in the workplace.

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  5. August 2, 2012 at 9:50 am ET  -   E

    “Paid sick leave is one of the non-wage benefits optionally offered by U.S. employers. ”

    ‘Optionally’… In the rest of the civilised and (comparatively) rich world we read that with genuine amazement!

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  6. August 2, 2012 at 12:41 pm ET  -   Seca

    I would be interested to examine the morale of other countries with adequate sick leave. I was examining Spain and notice while various departments with higher risk leave needs were accommodate they were also at risk for lower wages to address this expense. This is something to examine closer as healthcare professionals; administrative and allied tend to earn significant higher salaries.

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  7. August 8, 2012 at 3:05 pm ET  -   Jennifer Atkinson

    Seattle implemented mandatory, city-wide Paid Sick Leave in September of 2011, which applies to all businesses with five or more employees. So far the measures have been hugely popular; I think the following article provides some great insights on why Seattle is benefiting (socially and economically) from the new policy: New Bill Requires Seattle Employers to Provide Paid Sick Leave and Safe Time [http://www.emeryreddy.com/2011/09/638/].

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  8. August 25, 2012 at 5:56 am ET  -   bizworldusa

    The health of the Employees is very important because of the unhealth employee the work is reduce.
    I agree with the fact that a worker should have the right to get paid while sick; otherwise it could translate to disaster in the workplace.
    Thank you for sharing this.

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  9. October 3, 2012 at 3:12 pm ET  -   Mark Mayfield

    In this era of politicians from a certain party wanting to slash and burn every “entitlement” they can find (except the ones they benefit from) I think it’s important that information about the many BENEFITS of paid sick leave needs to be disseminated widely.

    I’m an attorney in California and I daily see the toll taken on “stressed out” court (goverment) employees. I absolutely agree with the benefits of paid sick leave.

    Web pages like this are totally justified in the face of a constant “anti government” stance by some. This NIOSH study published in the American Journal of Public Health proves once again the importance of benefits to workers. Clearly, paid sick leave makes for better, less stressed out and worried employees, which means more productivity and a better workplace to boot.

    Mark Mayfield

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  10. October 31, 2012 at 11:14 am ET  -   Brian Kindsvater

    Interesting study, although the question is what does one do with it? I already see comments about worker “rights” and not being anti-government, and the implicit suggestion federal law should be changed to mandate paid sick leave instead of the option for paid or unpaid leave.

    There is a vast spectrum of jobs: from high risk to no risk and the study indicates different results between the two. There are vast differences between employers, and differences between employees doing the same work. There are concerns about whether policies create permanent jobs or move more workers into agencies or temporary positions, and that impact.

    Presuming businesses are out for their bottom line, a study like this and educational efforts may move more employers to offer paid leave because it is in their self interest. This seems preferable to getting bogged down into mandates, a one-size fits all approach, or endless battles carving out “exceptions” – not to mention political issues.

    Brian Kindsvater, Esq.

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  11. January 29, 2013 at 2:28 pm ET  -   Fred Dubach

    I like this post, enjoyed this one thanks for putting up.

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