“These workers can still take unpaid sick leave when unwell. However, since they would be foregoing income when they do so, they’re more likely to power through and engage in ‘presenteeism’ – when workers show up to work but aren’t fully functioning. Both from a productivity and a wellbeing perspective, this raises issues for employers. For instance, sick workers may be infecting their colleagues,” Dr Veen said.

“Self-employed workers face similar issues. For example, in industries like construction, which has the largest number of independent contractors in Australia, self-employed workers do not have any sick leave entitlements because they are effectively running their own businesses,” Dr Veen added.

“On-demand ‘gig’ workers – who tend to work via platforms such as Uber, Airtasker, or Fiverr as independent contractors rather than as employees – are currently in a similar position. These workers who perform services like ride-share driving or food-delivery also do not have paid leave entitlements in Australia, although this may change as a result of recent ‘employee-like’ reforms that were enacted in 2024.

“With certain groups like gig workers heavily dependent on their income, they are more likely to work when ill and when you would least like to share a vehicle with them or get them to handle your food.”

"Leaders set the tone, especially around health and wellbeing. When they role-model healthy behaviour and support time off, it gives others permission to do the same. Supportive leaders can help reduce presenteeism, while pressure from demanding leaders can make it worse," writes Dr Veen in The Conversation, with co-authors Dr Hannah Kunst and Dr Nate Zettna from the University of Sydney Business School.

"But for some workers, leave isn’t an option. Fixing this requires policy change across industries and society more broadly, not just inside the workplace."

“There are also other members of society who aren’t in paid employment but still ‘work’ in important roles providing unpaid care, for example raising young children or caring for elderly parents. For these folks, who are still disproportionately women, especially women from minority groups, taking time off often isn’t possible either.

“On top of this, we all live in a society in which health and productivity are still all too easily taken as evidence of one’s moral worth. Taking time off, even for rest and recovery, can problematically be seen as a sign of weakness and inferiority. There are economic pressures and social norms that can put pressure on people to ‘power through’ and continue to work, even when they’re unwell.

“Flexible work when unwell and access to leave entitlements without the hassle of providing medical certificates enable people to stay at home when sick.”

Dr Ashley Craig is a Professor of Rehabilitation Studies at the John Walsh Centre for Rehabilitation Research in the Kolling Institute and member of the School of Clinical Sciences

“Fatigue is more than just feeling tired after hard day’s work or feeling exhausted after intense exercise. It’s not just feeling sleepy after a poor night’s sleep. Our research shows it’s a chronic feeling of tiredness, often mixed with poor mood and even depressive symptoms, elevated anxiety about one’s personal situation, low motivation and more likely to become angry or irritated. We also know that fatigue is a prominent symptom of depression.

“Fatigue can also be associated with poor fitness, greater frequency of illness that just doesn’t go away like extended bouts of flu or COVID, and can happen as a result of medical treatments, like chemotherapy.

“Our research also shows that chronic fatigue is associated with increased risk of poor decisions and increased risk of accidents in the workplace. This is not surprising as we have shown fatigue affects neural activity, resulting in reduced frequency of alpha wave activity – similar to brain activity patterns seen in aged persons with early dementia. Also, the risk of cognitive impairment is elevated when fatigued, increasing risk of all the above symptoms.

“To properly deal with fatigue you need to address the root cause. This might look like taking time out from work if you can, seek guidance on how to effectively deal with illness, and to accept that fatigue isn’t something we should just accept as part and parcel of life: it’s a negative state requiring significant action.”