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Sickness absence associated with shared and open-plan offices (2011) (nih.gov)
317 points by villaaston1 on Sept 27, 2017 | hide | past | web | favorite | 194 comments

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.

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

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.

Be that as it may, federal law does not require sick leave [0], so expecting people to act against their own interests is not the clear solution.

The dilemma between

- your livelihood & potential (costly) treatment

- absence without sick pay

goes beyond kindergarten-level because kindergarteners really don't have much to lose.

Staying at home when you are sick, from the employer's perspective, should be vastly preferable. Even if the employer were totally heartless about people's health and only cared about money, it's a risk avoidance strategy that pays for itself many times over by reducing the chance the business collapses. They lose a negligible amount of productivity to reduce the risk they lose a significant amount of productivity. And yet, there are many employers who will hold you in contempt for asking they institute sick leave -- even if it's the only reasonable way to deal with the reality that people transfer sickness but also need to eat.

Sick people act rationally when looking out for their own livelihood's continued existence. I agree it's definitely good to hope to gain recognition for your displays of respect towards your employer/coworkers. But if your employer/coworkers do not respect that you have jeopardized your livelihood for their benefit, the continued and self-inflicted cost is pretty much a total refutation of "good breeding", cultural learnings, or understanding what manners are for.

And then, beyond the 1st-order consequences, there are 2nd-order (immunity/interpersonal/office politics) consequences of the decision to prevent people from coming into contact with all pathogens, if the primary aim is only to reduce the risk of extremely harmful pathogens (but those aren't particularly relevant to the discussion of individual decision-making).

[0] https://www.dol.gov/general/topic/benefits-leave/sickleave

Arguably it is kindergarten where a lot of Americans learn the wrong lessons. Kindergartens for most of us were the first open plan offices with terrible inhumane absence policies that most of us experienced.

Current childcare policies are causing public health problems by keeping children away when not needed, or requiring courses of not needed antibiotics before the child is allowed back.

> 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!

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

Where do you get your numbers from? Allergies are a pretty common thing. And the symptoms mimic a cold. Numbers seem to differ, but I'm getting anything from 10% to 30% of adults. [1] I'm pretty sure that makes your numbers bad.

And want folks to stay home? How the heck are they supposed to afford it when they can be contagious for 2 weeks? Heck, folks are contagious before their symptoms even start. How can one allow for that? [2] Most jobs aren't going to allow for that sort of time off, nor are schools. Most that do will require a doctor's note - and it hardly seems reasonable to go to a doctor for a simple cold virus.

[1] http://www.aaaai.org/about-aaaai/newsroom/allergy-statistics [2] https://www.healthline.com/health/cold-flu/contagious#overvi...

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.

>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.

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).

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.

The CDC says 12.1% of the adult US population has sinusitis[1].

[1] https://www.cdc.gov/nchs/fastats/sinuses.htm

So what? Transpeople are rather low as a percentage of the population, yet we extend or argue to extend massive courtesies to them. If you are going to make a policy, expect to include a small population.


There are a lot of definitions of "trans" going about these days. Just search on Youtube of Reddit. Many of them are in my opinion attention seekers (not saying that genuine transgenderism doesn't exist, but a lot of people are making some very silly sounding claims lacking any scientific backing).

I agree. There is also anecdotal evidence that within the trans community (MtF) that take hormones, the commuity is split into people wanting to trans-ition and to as a third way that spans the genders. My point in the original post is that we have policies for such a small group of people, that the OP should look into sneezing policies to take into account small groups.

Here's a policy: Regardless of what's in your underpants -- don't sneeze in the air, don't cough on people and keep thy cooties to thyself. Pretty simple really.

Not everything is about sexual identity. This SJW nonsense has gone over the top. Please don't try to convince me we need a non-binary-trans-sneeze policy because of white cis privilege because you'd be wasting your time. If so, we have reached cultural peak absurdity.

Nope, not convincing you that you need a non-binary sneeze policy. I'm using that as an example of having policies that make sense when dealing with a minor population. The original example was people with sinititius and being able to comply with the policy. Also, another goal was to make people think do we even need such a draconian sneeze policy to begin with? What about the science that says that the more things you are exposed to the more resilient your system?

way more people that that have allergies

That's unfortunate. I used to suffer from occasional random sneezing until I got far enough down the list of suggested hayfever treatments to find one that worked (avamys). There are a lot of different causes of this kind of thing and some are very easily treated and some aren't.

this used to be me. constantly sick with sinus infection (like out of action for ~10 days every 2 months). I started dating someone who ate a vegan diet, and after adopting that diet I've been sick twice in 4 years and both times were very light and ran for only 2-3 days.

I have no idea why it had that effect for me, and everyone is different, but if she's suffering enough that she's at the point where she'll try anything you might pass along my anecdote. I wish I had chanced into it earlier.

As someone else mentioned, sick leave is not guaranteed. There are millions of people who have jobs where if you call in sick, you are risking your job.

For years, my dad had 4 days off a year. That was both vacation and sick time. Any other time missed was time he wasn't getting paid for.

People who read HN probably don't know what that's like for the most part, especially if you offer opinions like yours. You might have learned that in kindergarten but sometimes you gotta eat, too. Especially when others are depending on you.

Im not telling people not to cover their mouth. That's a reasonable expectation. I'm saying don't expect people to hold in sneezes.

Screw that, I would prefer to take the risk of a cold than have to make up the work for lazy bastards who take a day of for a bit of a runny nose. There is a good chance I am going to get it anywhere else I go anyway (shops, public transport, anywhere public basically).

Genuine sickness yes, but a bit of a cold where half of the office can manage to soldier on? I reckon I ought to get some sort of bonus for the fact I stay in shape, eat well and haven't had a sick day in a few years.

Some people can't even avoid it because of their work, doctors receptionists for example.

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

Yes, fine, but none of these involve suppressing a sneeze. The goalpost has shifted.

> Cover your sneeze. Cover your cough.

Face masks FTW! Then you can creep out anybody.

When I see people in airports with those on, I make a point of coughing as loudly as possible when up close to them

Really? It seems like pretty much the most justified cultural norm I can imagine. Stopping/slowing the spread of disease is one of the only good reasons to even have cultural norms.

And what about saying "bless you?" People sure have superstitious hangups about sneezing. And I don't mind, it doesn't hurt anything, until I get a sarcastic "you're welcome" from people for not thanking them for blessing me. I seriously don't get that. When did saying "bless you" require an official display of gratitude? I didn't ask for anything and would just like to sneeze in peace, please.

I've never personally seen it as something religious, just being nice and in my country it's considered being well-mannered. That being said in my country we don't say "bless you", a literal translation to what we say would be "health".

When I visit other countries it feels weird that nobody says anything when people sneeze. But I realize that's a cultural thing and try to avoid saying "Bless you".

Thank the sneezer instead. If they wonder why you thanked them you can thank them for the aerosol of bacteria and crud they sent your way.

In east Asia it's customary for sick people to wear masks to avoid spreading disease via coughing or sneezing. A practice that ought to be adopted everywhere.

I know I'm promoting a passive-aggressive strategy which is also social corrosive, but it's a way of spreading (!) the meme. And don't say "Gesundheit" because you think "bless you" is religious -- saying Gesundheit is simply non-denominationally superstitious.

"In east Asia it's customary for sick people to wear masks to avoid spreading disease via coughing or sneezing. A practice that ought to be adopted everywhere."

Toughen up people!

We don't eat food off the floor because it would probably give us a bad stomach. Eating "hygienically" is a practice that we have adopted.

Dogs eat stuff off the floor all the time. Have they evolved a more advanced immune system than ours? Or just kept it well trained?

Dogs adopt the strategy of "eat first, ask questions later" (as pack animals that eat garbage, carrion etc). So they are quick to vomit up something that causes trouble. Also they are more likely than humans to eat stuff that will kill them.

As for their immune system, inbreeding of dogs has caused all sorts of susceptibilities, though overall humans are a better vector for disease (density, widespread distribution, gregariousness, etc). Also humans worry about disease symptoms that dogs and other animals stoically ignore and thus the disease can go unnoticed by the human. (e.g. a bit of diarrhoea dribbling uncontrollably out your backside will probably concern you but a dog will just put up with it -- though an owner will likely object!) .

"Gesundheit" means "health". Sneezing is an indicator of health risk.

It's a tradition, not a superstition.

I think you are too comfortable casually dismissing a cultural behavior that has existed across different forms for millenia. Perhaps there are interpersonal, cultural, body-language, psychological, and other ways that this behavior is important to us, and your certainty at its unimportance seems out-of-proportion to its continued prevalence and an over-estimation of the quality of the possible completeness of your analysis.

>And what about saying "bless you?"

correct answer to that is "not in your lifetime" (from the joke about a very old very rich grandpa who sneezes and his relatives :)

I frequently sneeze with so much force that I pop a little vein in my eyes. I even bruised a rib sneezing once. Anything that can help mitigate this is great in my book.

I disagree, vehemently in fact. It's not a hard thing to do.

What culture are you thinking of?

Is this sarcasm?

This is the first time it's occurred to me that other people cannot control their sneezes.

I've had the occasional "where the hell did that come from?" sneeze, but they're a rare exception, maybe a few times a year. I cannot fathom not being able to control something like a sneeze; to me, it would feel like not being able to control farting, coughing or talking.

When my alergies strike (hello, Spring!) I often cannot control my sneezes. I can control not sneezing in people's faces, though. I also sometimes cannot control my coughs. Farting, fortunately, I can control :)

> like not being able to control farting, coughing or talking

Did you know? Plenty of people cannot control these actions 100%. Please don't assume others are like you.


Are you honestly suggesting that not being able to control semi-autonomous bodily functions is a matter of personality traits?

One of these things is not like the others. People should be able to control talking (assuming they know it bothers the people around them).

I struggled to come up with things that, to me, would be very strange to not be able to control anymore.

I know there are medical conditions that prevent you from controlling all three - I've had coughs bad enough that I couldn't help it, and there are definitely bowel conditions that mean your sphincter isn't 100% reliable, and there is Tourette's and assorted mental conditions that basically make it difficult to impossible to control your speech.

People should be able to control all of them, at least for timespans of a few seconds.

Unless they've got medical conditions, which some people do.

Counter PSA: Did you know that your body is sneezing for a reason and taking all the air out of it may be counter productive and actually lead to more sneezing?

Your body is often sneezing because it has been hijacked by a virus that triggers the sneeze in order to spread infection.

Sneezes were evolved before the invention of the handkerchief and tissue.

Unless I inhaled pepper that never happens. I've watched others learn this technique too even large men. It can take years of practice though, just like learning any good habit/manner.

I think the question is if you've considered that not sneezing completely may encourage a situation where you sneeze more often. If the sneezing is actually a helpful thing, it might be a problem to inhibit it.

As someone with severe seasonal allergies, it certainly does happen to others. Its not about manners or habits for everyone.

Oh wow, that sounds like great advice. I’m a regular 3-times sneezer for no obvious reasons, often in office building. I figured it may be related to an allergic reaction to those office floor carpets (that or I’m allergic to working as such).

Since my sneezing is super loud I am looking forward to trying this technique soon! Thanks for sharing

I can sneeze without exhaling at all.

Of course, I am afraid of what this does to my blood pressure, and whenever I do it, I start thinking that one day I'm going to burst a blood vessel while sneezing like that.

Comes in handy if you have a photic sneeze reflex, though.

I definitely am not recommending holding in your sneeze. Exhale what air you can. When the sneeze comes, open your throat wide so to minimize the air velocity. It takes practice.

Just sneeze into the crook of your arm. It stops the spray and muffles the noise.

If I have to sneeze I usually just bend over and sneeze at the ground a foot away. Is that any good?

But I prevent sneezes by controlled in-out breathing and gently pinching/rubbing my nose.

Something better; pinch your nose when you're about to sneeze. This kills the sneeze immediately.

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.)

I was just reading about a "Mars study" where 6 people were in close quarters for 8 months to examine the behavioral effects of a long-term space mission. https://www.apnews.com/bafab7eaf7be45d388f11ef81e7f15d8/Mars...

The article didn't say much about the results, other than:

> We’ve learned, for one thing, that conflict, even in the best of teams, is going to arise

I immediately though of my experience with open office plans.

I never worked in an open office (not for long, we had an open area) but worked in a 4 person office and agree with you. The stress of being constantly interrupted and not able to finish the work, can reasonably be assumed to lower the immune system and make people sick.

So have I. I wouldn't.

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

And higher stress levels from working in open offices.

Especially the noise is wearing me down.

How is it like in the US? I've mostly had positive experiences in open offices (except for an annoying co-worker or two), but then again, I've never had my own office, only worked from home a few times.

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.

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.

It's definitely not just introverts either—me and a number of friends are not introverts per se but definitely take advantage of WFH whenever possible just to have some privacy and a break from the chaos.

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

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.

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.

Note that they don’t report a confidence interval for the one-person office because it is the baseline for the other rate ratios. (This is generally how the baseline group is identified when reporting ratios in journal articles.)

Assuming social conflict as well as physical health is a driver, the local peak at 2 makes perfect sense.

You've quoted rates not absolute values.

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.

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.

I agree completely. Maybe the tools we're using at my current job are just shitty, or maybe we as a team aren't very good at communicating, or maybe a combination of all three things - but I definitely feel like we accomplish more when we're physically present on most days.

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.

Nothings beats a white board for explaining something

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

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

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.

I don't think you can really undersell the cult-building aspect, in addition to the psychological factors, which are heavily intertwined.

Co-working spaces have actually been rather successful in outsourcing these factors - both the cultism and the necessity for human interaction. Not every company needs its own brand of Kool-aid, especially when the cultural attraction of many tech companies is indistinguishable from the industry as a whole. It may be beneficial to have core values that are shared among a cluster of companies, and reap some advantages of scale that brings with it.

corporate told us to call it TEAM-building.

You can be a knowledge worker and have a job that involves working on physical product / working with equipment you can't take home with you.

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.

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.

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.

That is very US specific. In Europe, in a lot of office-based work if you get sick you take some days off and it doesn't impact your normal yearly 20-30 day vacation allowance. If you need more than X days (in my case 5), you need a paper from your doctor, otherwise you self declare as sick. At my workplace, people tend to work from home if they are just feeling a bit sick.

It's mostly a fairly recent trend even in the US. For most of my career, I had separate vacation and sick days (as well as, possibly, personal/floating holidays). I'm not sure when the shift occurred but apparently a combined pool is pretty much the norm these days.

The new trend is 'unlimited' vacation days, where nothing can impact you vacation time, because you have to fight with your manager for it.

Fortunately, it's a trend that seems to have had fairly limited pickup. It really does seem like a bad system in practice. I have always, other than the odd day lost when I've hit a cap or whatever, used every day of vacation I've been allotted. In past roles, I've even taken month long vacations where I was totally out of touch.

I would not want to be in a situation where my vacation time depended on some prevailing sense among coworkers of the appropriate number of days to take off.

> Fortunately, it's a trend that seems to have had fairly limited pickup

It's been the case at the last four places I worked: large corporations who knew their H1B workforce wouldn't ask for time off, and startups where I wouldn't get any spare moments to meet with my managers to ask for vacation.

(Fwiw, the vacation time at the start ups was perfectly decent, given the situation. I think I took ~3 weeks off each year. At the big company, it was a total fiddle.)

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.

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.

Okay I am not understanding, would help enlighten me please?

I read this and go '52 weeks a year for sick leave? Aren't there 52 weeks in a year total?'

Here in the Netherlands you can get back your vacation days if you get sick during your vacation. Might not earn as much in the US, but some benefits...

It's like that in Germany too. Days you are sick during a vacation are counted as sick days, not vacation days. (Why not, you're sick aren't you?)

Some uptight employers require a doctor's note but most just roll with it.

That always stuck me as a profoundly civilized attitude.

That's not the case everywhere. My sick days aren't bundled into my PTO, and it's still a problem getting people to stay home when they're sick.

My employer has taken it to the next step and even all the holidays are floating and part of my combined PTO.

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.

Dealing with illness and work is something that's important for everybody but I think it's something contractors (or other non-salary workers) need to be especially cognizant of.

I've been contracting for the last 13 years. I've had a few occasions where I feel I "worked through" a period of illness too enthusiastically and ended up making myself feel worse and lengthening the illness. Knowing that you need to bill, and therefore need to work, is tough to balance against stopping work to get better. It's been a tough lesson for me, but I try very hard to slow down or even stop work when I'm sick.

On the last occasion I really tried to "power through" an illness (with a persistent bad cough and even more persistent sore throat) I started thinking about Jim Henson's death. That made me slow down. Nothing is worth that.

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

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.

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.

The latter is how I understood it.

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.

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.

British English would use "Sick leave". But I also speak Norwegian so perhaps that explains why it seemed unremarkable until I saw the comment above.

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

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.

Why on earth are sick days included in your paid time off? If you're sick, you're sick? I assume you're in the USA, given that barbaric policy?

It's especially barbaric considering this policy leads to more sickness in the workplace by encouraging contagious people to come in and infect everyone else.

Now you must spend your own time recovering from illness that your employer was the primary cause of. That's brilliant right there. U-freakin-S-A.

Common barbaric policy here in the States, I am afraid.

The root problem I think is that the US has too few vacation days. This resulted in many people abusing sick day policies by taking sick days off for things that really should be "vacation" days. But management fought the symptom, not the cause, by just pooling vacation and sick days.

Although it's mostly worked to my personal advantage, I generally loathe the combined PTO plan that's the current style. It's somewhat understandable from an employer's perspective--time you're not working is time you're not working and they don't need to potentially police abuses of sick time--but I still don't like it. "Sorry kids. We can't take that family vacation this year because daddy caught that bad flu last Spring."

But a non-trivial number of people have historically abused dedicated sick time; there are even people cheerfully admitting to it on this thread.

I find combined PTO is great as long as you have enough of it. I get 35 days PTO and I don't have a problem taking a day off when I'm sick.

Now if I only had 15 days PTO....

Yeah, if I had that much I'd be much less conservative for sure. You work for a European company or do you just have clout to ask for that much?

Compounding this is the fact that I can only carry over 5 days per year, so at most I can only use 20 days in a calendar year). In a few years my PTO gets a bump to 20 days a year.

That is indeed a nice chunk of time. I wouldn't have any issue in that case either. I can't really complain too much about mine but 15 days is basically just middling vacation time for a mid-career US professional with no sick/personal time on top of it.

Perhaps the next time you get sick, you should avoid the cough suppressants and decongestants, and have a few excuses to stop by the boss's office, and the HR offices, just to chat and incidentally spray infections fluids everywhere.

"Sorry, I'm out of sick days - but as long as I'm here, let's have that lengthy meeting about X. Here, I even brought you a cup of coffee!"

I'd say it's time to look for another job. There are better places to work at.

The place (federal government) is great, but my current contract employer has some puzzling policies. I've never had a better work/life balance than this place.

In a few years, the contract will be rebid and I'll roll the dice with my next employer. I rarely get sick, so it's not that big of a deal, but I was highlighting how poor policy can induce sub-optimal choices by the employee.

What is PTO?

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.

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.

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.

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.

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.

"Personal time off" or "paid time off". It is an informal term that is usually synonymous to a more formal term such as "casual leave" in many companies.

Paid Time Off, so vacation time

Paid time off

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

Could also be politeness. Maybe I feel okay about sneezing a lot in my own cube, but not on other people. So I take sick days I might not have if I were more isolated.

Indeed this may even help understand why the case of exactly 2 people in an office results in higher absences (50%) than the 3-6 case (36%): You develop a more personal relation with that other person and they're usually not too much of an annoyance, so out of respect for them you stay home when sick.

When you are in a more crowded office this mechanism doesn't kick in because, frankly, you likely hate them at least a bit, and that would explain the lower %.

Finally when packed in a chicken farm scenario, all these mechanisms go out of the window and the sheer amount of germs, noise, distraction and stress you're exposed to trumps every other factor, hence the highest reported (62%) value.

> Do they determine that people just take more sick days because they need some level of privacy

Yeah, I too think this could explain it better. Say a work day is 8 hours, ideally, you cannot work on the same thing for 8 hours. But an open-plan office forces you to do this, or pretend to, because you are being "watched"...and this can be exhausting.

A cellular office plan, gives you the privacy to relax, and maybe do something else, then say when you feel refreshed, you get back to working.

An open-office plan encourages collaboration, but that's based on the assumption that we all work the same way.

"An open-office plan encourages collaboration"

They always say that but from my observation this is simply not true.

An open plan office encourages lying to the employees about why you have an open plan office.

It's cheaper, and more of a panopticon for the floor-walky managers. It encourages the creation of a projected isolation shell, like some kind of psychic box turtle. Noise-cancelling headphones are essential to that effort.

When I actually collaborate, I am far more likely to do it if I can do it privately with a specific person, rather than with everyone who may be listening.

I suspect a lot of people involved in these decisions have actually convinced themselves that they're good for collaboration/innovation/etc. At the same time, if open floor plans actually cost more per employee than private offices I'm pretty sure that any arguments espousing the benefits of the open plan would fall on deaf ears in a big hurry.

2nd day in our new open office and I'm trying to work while 2 guys are having a catch with a football over my head.

Do you think if you shared a 3 person office with those 2 guys that problem would go away?

I think it would be better. Open layouts encourage antisocial behavior.

Pretty sure it would go away if they were in one person offices. And one person offices are cheap to provide.

Office design's impact on sick leave rates (2014) 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.

Long sick leaves are usually for serious stuff that's non-transmissible, whereas short sick leave is usually for exactly the kind of stuff that's easier to transmit in an open office.

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.

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".

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?

Most infections clear themselves up after a couple of days.

> 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?

That's not an either-or question. It could very plausibly be both. More people in a room means more potential for infections.

I know it's a stretch, but the former could be analyzed in terms of sickness.

The paper actually refers to analysis of how background noise raises stress levels (with the resulting effect on absence) so it’s not so big a stretch.

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.

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.

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.

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.

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.

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.

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.

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.

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

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

That's anecdotes for ya.

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

But are you working in an open office at home? Probably not, and that's why you didn't get sick!

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?

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".

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.

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.

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.

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.

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

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.

You don't build immunity to a virus that constantly mutates, e.g. the flu virus.

Seems like an intuitive result.

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

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.

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

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

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

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

you mean like classrooms in schools?

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

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

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.

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.

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

The findings were that open-plan offices lead to more sick days (62% compared to cellular offices)

Apparently I should not read when I first wake up if I want to avoid down voting :)

I clearly read it backwards and thought it was an odd result so I jotted down a few reasons why I thought the strange result could occur.

More obviously, if you are closer to other sick people, your odds of getting sick are higher.

The finding is that open/shared offices increase, not decrease, sickness absences.


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.


> 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?

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