
Sickness absence associated with shared and open-plan offices (2011) - villaaston1
https://www.ncbi.nlm.nih.gov/pubmed/21528171
======
louprado
PSA of the day: With practice you can learn to delay your sneeze by a second
or two. That gives you time exhale all the air from your lungs so the sneeze
has minimal power[1].

Tilt your head down too and with further practice you can learn to open your
throat in order to minimize air velocity.

[1] Source: me, a former obnoxiously loud sneezer that always dismissed it as
an unavoidable and comical physiological quirk because I am too big and manly
to sneeze quietly. It isn't, it wasn't, and I'm not.

edit: added a step.

~~~
tcfunk
Expecting that people should control their sneezes is a ridiculous cultural
norm.

~~~
jackhack
Expecting sick people to not fill a room with hundreds of millions of
aerosolized particles when that could be clearly avoided is a result of simple
respect for those around you and evidence of manners and good breeding.

Cover your sneeze. Cover your cough. Stay home when sick. These are
kindergarten-level cultural learnings.

~~~
whoru007
> Cover your sneeze. Cover your cough. Stay home when sick. These are
> kindergarten-level cultural learnings.

A friend/colleague of mine is suffering from Chronic sinusitis and she usually
sneezes every morning for around 20-30 times (random number, I know!) over
period of few hours. The 'sneezing fit' is 100% of the time non-contagious yet
loud and 'full with watery substance', She covers her sneezing most of the
time however it is not always possible to react in time.

Also, she's a single working mother raising two well mannered and cute
children. Would you expect her to _always_ stay home when she's always 'sick'?

These kindergarten-level cultural learnings you are talking about are societal
pressure, we inhale pollutants, pollens and smoke from cigarettes all the
time!

~~~
d23
Be realistic. We're talking about the 99.9% of other people who don't have
that condition.

~~~
mattrices
The point is not all sneezes are due to colds. There are other causes that
account for much more than .1%. Don't reinfoce societal pressure with biased
probability analysis.

~~~
MSM
>Don't reinfoce societal pressure with biased probability analysis.

They aren't saying don't sneeze, they're saying cover your sneeze. It doesn't
matter _why_ you are sneezing, covering it is the standard.

~~~
debaserab2
Agreed, but I think what is ridiculous is training your lungs to minimize the
effectiveness of your sneeze. That is absolutely ridiculous: your body is
sneezing for a reason, let it do its thing (and cover it).

~~~
Djvacto
I think his tips were meant as an option. To be quite honest I'll be trying
some of these, because it's not a huge amount of effort at all.

------
nils-m-holm
Noise, permanent distraction, regular interruption, no privacy, and people
spreading germs all over the place. No wonder that people get sick! I would
rather be poor than work in a shared office one more time. (I have experienced
both, so I know what I'm talking about.)

~~~
throwanem
So have I. I wouldn't.

~~~
loup-vaillant
I bet it depends on how poor you were, and how noisy the open plan was.
Tolerances also vary.

------
mattrices
This makes me wonder how many of those additional absences in open plan
offices are due to depression / introverts recoiling in horror rather than
increased biological pathogen transmission.

~~~
ams6110
That was my thought. When I worked in large open "bullpen" office I certainly
did "take a sick day" from time to time just because I could not stand the
thought of spending 8 hours in that environment on that day. I was never
actually sick any more often than normal during that time.

------
bretpiatt
Too many variables to isolate on this study to provide proof that correlation
equals causation. Even with the isolating they've tried to do with the 95% CI
the range is:

1 Person Office: 1 (They didn't report a range here)

2 Person Office: 1.13-1.98 sick days

3-6 Person Office: 1.08-1.73 sick days (LOWER than 2)

6+ Person Office: 1.30-2.02 sick days

Great item to study further. This isn't scientific proof of anything. As a
solo worker you may come in to the office when sick as well since you don't
have to worry about getting anyone else sick and so many other variables they
didn't control for make this interesting but far from proof.

Direct PDF link to full study:
[http://www.sjweh.fi/download.php?abstract_id=3167&file_nro=1](http://www.sjweh.fi/download.php?abstract_id=3167&file_nro=1)

~~~
wott
There is a perfect _positive_ correlation between smoking + alcohol
consumption and health!

1 person: heavy smokers 15%, drinkers 16%

3-6 pers: heavy smokers 13%, drinkers 16%, sick leave +36%

2 pers: heavy smokers 10%, drinkers 15%, sick leave +50%

> 6 pers: heavy smokers 9%, drinkers 13%, sick leave +62%

Please drink and smoke more to fight sickness.

~~~
loup-vaillant
They said they controlled for those confounding variables. I bet the raw data
used in this study also says smokers and drinkers are more often sick than the
others.

------
brightfog
I don't think it's about open-offices or not: Work environments just don't
reflect work anymore.

There isn't any rational reason for knowledge workers to go to an office every
day. Socializing and building a cult around a company might be the only
reasons. But IDK if these are enough to justify an office.

There must be another solution we aren't aware of yet.

~~~
aedron
No remote working solution comes close to in-person collaboration, in my
opinion. I can explain someone something in probably less than half the time
in person than over some electronic link-up.

I'm not sure what it is (lack of body language? Lack of shared physical
presence and tools?) or if it can be remedied by better technical solutions
(it's possible), but it's the reality right now.

~~~
brightfog
Yes and no. You can build great working relationships in the office but also
remotely. You can have really bad conflicts in the office but also remotely.

I think the difference is that once you got attached to some people from your
work that the motivation to see and talk to them is one key driver to work for
the company every day. This attachemnt might develop faster in an office
environment.

~~~
gourou
Nothings beats a white board for explaining something

~~~
brightfog
Yes true but a missing whiteboard often leads to well executed specs and
mockups.

~~~
gourou
What interactive online tool are you using to explain/come up with a solution
to an issue?

~~~
brightfog
There isn't any dedicated interactive online tool for explaining I am aware
of.

The most powerful tool for collaboration and communication though is screen-
sharing + your mouse cursor + your voice available in any video calling
software.

------
geff82
Just a personal observation: when I first moved into a giant-open plan office
in 2015 in a big German company, I got significantly more sick. It was horror.
Also, bathrooms were unusually crowded, probably helping spread diseases.
Since then, it seems my body got a bit used to it and I am sick less often.
But is is still more than the times before.

What might also increase days that people are not there: at least in our
office we actively encourage people not to come back from sickness soon. We
urge them to stay at home to avoid spreading disease further. While I
personally might come back to a single office after 2-3 days, as I can't that
easily infect other people in my private office, I stay away for a week more
often now.

~~~
zebraflask
This fits with my experience. My department has some cubicle farms and some
shared but much more private office suites. The cube farm people are always
getting sick. Somebody comes in with a cough and promptly spreads it. It then
can take weeks before there's a week without somebody sick.

Getting people to stay home when they are sick has been harder to implement
than you'd think. I've tried with my work team. A number of the developers are
from cultures that have what I would call a very stubborn "must work at all
costs" mentality. It can take some persuasion (berating?) to get some of them
to see that taking a sick day doesn't make them a "bad worker," but showing up
sick, getting other people sick, and pushing buggy code because they're sick
does.

~~~
logfromblammo
Ever since companies ditched vacation and sick leave in favor of combined PTO,
I work while sick. When I had sick leave, I used it.

It may well be that they don't want to cut their July vacation short by a day
because they caught a cold in January. And to compound the issue, it was
probably a cold they caught at work, because the company leave policy
reinforces the behavior. People who stay home when sick are punished with
shorter vacations.

~~~
hvindin
It's smallish things like this which make me realise how lucky I am not to
live in America.

In this particular case though, possibly just how lucky I am to live in
Australia. Here it's either just common practice at most companies, or
possibly required by law, but everywhere I've seen the leave policies provides
52 weeks a year of sick/carers leave.

Usually this is broken up into ~20 days of leave where one isn't really
required to provide any justification beyond "I felt bad that day" and beyond
that a doctors certificate may be required.

But that's always entirely separate to annual leave.

~~~
logfromblammo
Yeah, well, the biggest spiders I ever typically see are wolf spiders smaller
than my thumbnail, so there is that.

Very, very tiny consolation. I'd live with a dog-sized spider if it would mean
that corporate management wasn't filled with cold-blooded monsters.

------
sjcsjc
It would be interesting, but perhaps not terribly useful, to see how sickness
absence varies between contract and permanent staff. In the past, when
contracting, I have dragged myself to work when feeling dreadful.

~~~
make3
that's funny, at work (a large, well known & appreciated software company)
contract workers take pride in coming to work at 11h+ or just not coming in
unless really required

~~~
katastic
That sounds a lot more like people who are trying super hard to become full-
time workers.

That the situation one of my college buddies (and all his fellow contractors)
endured for a couple years. They did everything the normal workers did, but
since they were technically "contractors" in title, everyone treated them like
second-class citizens. (Caveat: Major japanese company--but still in the USA.)

If that's not the case with yours, I'm glad they're not in the same situation.
My friend eventually moved up to one of the top contracters and still couldn't
get into the company proper so he had to seek employment elsewhere.

------
skj
The title makes it seem (to me) like they're finding that open plan offices
reduce sickness.

But they're not reporting on the absence of sickness, but rather absence due
to sickness, which they found occurred at a higher rate in open offices.

~~~
scbrg
Where are you from? I'm guessing that how you interpret the title might depend
on your native language/dialect.

Judging by the names of the authors, I'm guessing they're mostly Danish, or at
least Scandinavian. As a native speaker of another Scandinavian language
(Swedish), I understood the title as it was intended, but I'm not sure if the
phrase "sickness absence" is the best way of expressing "absence due to
sickness" to a native English speaker.

~~~
vvesperr
I'm American and I understood "sickness absence" as the intended "sick leave"
or "absence DUE TO sickness" but it did take me a second.

------
kross
Root cause: bad sickness/time off/work from home policies.

~~~
fizgig
I think this is a big part of it. I currently have 15 PTO days per year, which
includes sick leave. If I'm feeling off, I'll ask if I can work from home,
which I always get denied (which is odd, since I do after-hours maintenance
and on-call incidents remotely).

So rather than piss away PTO, I dose up on drugs and drag my ass to the
office. If I had dedicated sick leave, I'd just take the day off. But this
miserly PTO policy results in me hoarding it.

~~~
kwhitefoot
What is PTO?

~~~
moron4hire
A bastardization of leave policies that lumps pleasure and rest time in with
convalescence such that people new to an office often don't get to take real
vacations after having spent all of their PTO on gaining immunity to a new
germ pool.

~~~
logfromblammo
Vacation leave and sick leave are mentioned in law, and companies are required
to keep funds in reserve to pay for those balances. PTO was invented to stop
people from using sick leave when they weren't sick, and to avoid having to
keep the cash liability for leave balances on the books.

Usually, the combination results in fewer days of available leave, and since
vacations are often planned months in advance, people are forced to come in to
the office while sick or spoil their entire vacation by screwing up the
itinerary.

~~~
ghaff
PTO balances are typically still liabilities because they're owed to employees
when they leave modulo accumulation caps or use it/lose it policies.

It's pretty much inevitable that pooling sick time and vacation time results
in a lower total. People aren't really expected to use all their sick time in
a given year if ever. But for those who do plan to maximize their use of
vacation, it means there's not a lot of margin when they do get sick and it
encourages behaviors that aren't good for anyone.

~~~
moron4hire
Even worse: so-called "unlimited" leave policies. It's basically "no
obligation for leave at all". Hence why it's very popular with the startup
crowd these days.

~~~
ghaff
From an accounting perspective, there's also no (or very limited) liability
associated with accrued vacation time. (There may be some associated with
required sick days.) If someone leaves the company, there's no accrued time to
pay off.

------
nautilus12
Do they determine that people just take more sick days because they need some
level of privacy while they work or because they are actually are getting sick
more often? I would think its the former, tbh

~~~
sanxiyn
Office design's impact on sick leave rates (2014)
[https://www.ncbi.nlm.nih.gov/pubmed/24460745](https://www.ncbi.nlm.nih.gov/pubmed/24460745)
investigated this question.

"Sick leaves were self-reported ... as number of short and long (medically
certified) sick leaves... A significant excess risk for sickness absence was
found only in terms of short sick leaves." Which supports your hypothesis.

~~~
sidlls
How does that support the hypothesis? One might conclude that the non-open
plans mitigate the spread of short term sickness (e.g. colds) instead.

~~~
sanxiyn
Support, not definite evidence. It could be that both short and long sick
leaves are affected. Compared to that, it supports "not actually getting sick
more often".

~~~
sidlls
It isn't clear to me how that is supported. Are you saying rates of short-term
and long-term sickness ought to have the same correlation with office layout?
Why?

------
arjie
Table 2: median days of sickness in single person offices in last year: 1.0.
Median days of sickness in 6+ person offices: 2.0. Respective means are 4.9
and 8.1.

~~~
DangerousPie
What's your point? Simply comparing the median is not really going to tell you
much, especially since you need to adjust for confounding factors.

~~~
arjie
When evaluating risk, I like knowing the absolute consequences, not relative
consequences. The abstract has the relative consequences. My comment has the
absolute consequences.

Since there are maybe a fixed 230 working days in a year, a thing that takes
me from 10 absences to 12 absences is worse for me than a thing that takes me
from 1 absence to 2 absences. I'd rather not compare the two as 20% up vs 100%
up.

If anyone else felt the same, my comment would help.

~~~
DangerousPie
That's fair enough, but the numbers you give are neither the absolute nor the
relative consequences.

You can't draw any conclusions from simply comparing the medians. On one hand
that completely ignores any confounding variables which could lead to either
over- or underestimation of the true difference. And on the other hand the
medians may not be particularly meaningful. For example, if the effect only
occurred in the top 25%ile of employees, the median would stay the same even
if all of the ones in open plan offices were sick for the entire year.

If you took the mean instead of the median the difference would already be 8.1
- 4.9 = 3.2 days.

~~~
arjie
I've edited the comment to include the mean values from the paper.

I'm comfortable with the two measures as a better summary of the results than
the RR in the abstract.

------
quantumhobbit
Let’s not forget that it often makes sense to call in sick just to be able to
complete work that requires concentration in a quiet environment.

~~~
overcast
I never get sick, so my sick time is just personal time for when I don't feel
like coming in work. But mainly I just use it for working on my own personal
projects. Silent environment at home is amazing compared to a busy office. I
wish our open office space, was converted to sound proof cubes.

------
ivanjovanovic
I am curious if sickness increase is caused by mental aspects of sharing the
office or the transmittable diseases factor. Authors didn't get into these
details the from what I see by briefly looking at the whole paper.

------
fairview14
I'm working full remote. My sickness absence is almost 0%, only a few days
last year due to a flu.

~~~
icebraining
I'm working in an open plan office. My sickness absence last year was zero.

That's anecdotes for ya.

~~~
consp
With N=2 and testing all variables we conclude that working does not make you
sick and keeps you healthy.

------
imglorp
Recognizing the ongoing discussion we keep having here about office planning,
what other meaningful open plan research is laying around? Re productivity,
roi, job satisfaction, creativity, etc?

------
tpudlik
Please note that the study defines any office space shared by more than 6
people as "open plan". Also, although there's a (statistically) significant
difference between 1 person offices and "open plan", there is no significant
difference between 2 person offices and"open plan".

~~~
rdtsc
Not a bad metric. After about 4 people or so, it might as well be "open
office". That is the chance of each one of those people being distracted by
someone from outside the office, or a phone, or two of them talking about
something is pretty high.

(Worked in a cubicle farm, 4 person office, 3 person office, 2 person, then my
own office, now at home in my own office).

Top choice is work at home. Then own office. Then 2 person office. Once it
gets to 3 person office, I'd pick a cubicle with high sound insulated walls.

Open office would be a nightmare for me. I'd get set just from stress of not
being able concentrate and get my work done.

------
hedonistbot
62% more days of sick leave is an acceptable trade off for most employers. If
the alternative is a separate office for everyone, the rent expenses will be
more than the paid leave loss. And the only thing upper management cares about
is the bottom line. So in a sense, increased productivity in the economy is
partially paid by our degrading health. That's not something often mentioned
in the Economics text books.

------
SAI_Peregrinus
When I get sick, I wear a surgical mask. You can buy them at any drugstore.
You might get weird looks, but explaining that I'm sick and don't want to
spread it usually turns those into thanks. It's apparently common/expected to
do this in Japan, it would likely help if the practice spread elsewhere.

------
TaylorGood
My two years in corporate america was open floor; side by side plus in front
of you. When someone was sick, it usually took down the people sitting within
the quadrant. Since there wasn't sick days, everything was under PTO and
Vacation > Recovering at home. Just not a good system.

------
NicoJuicy
Getting more sick ==> More resistance against diseases? That's always
something i'm wondering.

~~~
DanBC
People being off for stress related illness doesn't necessarily protect them
from future stress (unless their treatment includes resilience). It also
increases pressure on colleagues, increasing their risk of stress related
illness.

------
emodendroket
Seems like an intuitive result.

------
davidgerard
(2011) - have there been any further studies or attempts at replication?

------
ijafri
as an HR manager, we had to adopt open plan, for our own reasons, however
before we did so, we have made our hygienic rules 10x stricter, But I guess
solely chalking up sickness to open plan is bit too far-fetched, there are
still too many public places, commute, public washrooms etc that one can't
avoid ... having said, this also depends higher than usual standards for
hygienic at work.

~~~
loup-vaillant
May I ask what were those reasons? I always hear why open plans are horrible,
never why they're awesome —or needed.

------
noonespecial
Sounds like an OSHA issue. Open office plans plus stingy or non-existent sick
leave policies now provably cause hazardous work places.

------
jasonmaydie
Isn't this common knowledge? Kids who go to daycare get more sick in the
beginning, less sick in general.

------
parasight
I would have bet on it. Greater exposure to germs, probably worse hygiene and
higher levels of stress.

------
sharemywin
you mean like classrooms in schools?

------
aanastasov
Has anyone been able to find the data used in the study?

~~~
traxmaxx
Maybe in the PDF?
[http://www.sjweh.fi/download.php?abstract_id=3167&file_nro=1](http://www.sjweh.fi/download.php?abstract_id=3167&file_nro=1)

~~~
aanastasov
I've read (mostly skimmed through) the entire paper and didn't see any mention
of the data being public.

------
gcb0
in open floor offices you are elbow to elbow to somebody else all day long.

sick days are just a way to cope with that and get away from those people.
especially with engineers. or take some time at home to do things online like
buying tickets for a concert that you don't want to talk about in the office.
its stressful to be watched every second. sick days and "have a cold, will
work from home" are just a way to escape. doubt anyone was really sick.

------
sethammons
Three plausible reasons off the top of my head on why open offices would
experience less reported sick days.

One: the same reason as experienced by garbage men or sewer guys; greater
exposure causing improved immune systems.

Two: being in an open office increases the top-down butts-in-seat
observability, causing employees to come into the office even while sick to
keep up a better work image.

Three: (what happens at my work) perhaps the work places that can support an
open office can also support working from home and so instead of sick days
being days off, employees just work from home with minor ailments, reducing
the number of reported sick days. At least for me, if I have a slight cold,
I'm still up for a mostly productive day, but I don't want to spread a cold to
others in the office. So I work from home.

~~~
arjie
Mate, the results are the opposite. More sick days in open offices.

------
edw519
<rant>

I call B.S.

1\. "associated" means nothing. "Anything" can be "associated" with "anything
else". "significantly related" is almost as worthless. Correlation is better
than association. Causation is better than correlation. Where's any of that?
This is just a hypothesis, not a conclusion.

2\. I've been working in corporate offices for 38 years in every possible
environment imaginable: private office, war room, open office, basement,
hallway, double office, even a closet. One place someone came in and yelled,
"Get out of here now! There's mold everywhere!" Sure enough, hazmat had to
clean the office.

3\. I have NEVER missed a day of work. EVER. Some people say I'm lucky. That's
probably a little bit true. But not really. Read on...

4\. Here's a list of things that I believe (without any supporting data or
government research) have "significantly more impact" on sickness absence that
open-plan offices: diet, lifestyle, movement of any kind, drug use, tobacco,
alcohol, stress from work, stress from non-work, medical history, genetics,
donut consumption.

5\. I loathe open offices for many reasons (mainly because those deciding
these things have no idea how to achieve, but that's another rant). But cut me
a break, blaming open offices for sickness absence is really a reach. Without
proper controls, the statistical evidence presented by OP can be caused by
many other co-factors. (See #4 above.)

6\. Never get health info from the internet.

</rant>

~~~
dkersten
> stress from work,

Open offices cause me significant amounts of stress (for varous reasons),
so... does that means that open offices are in your list, under the _“stress
from work”_ category?

