Joint contributions of psychological distress and body mass index to presenteeism: a register-linked follow-up study among young and early midlife municipal employees

BACKGROUND: Psychological distress and overweight are increasingly prevalent public health concerns associated with reduced work ability and sickness absence, but their combined association with presenteeism is unknown. METHODS: Survey data from the Helsinki Health Study (2017) of employees aged 19-39 (n=3,510) were linked with 12-month personnel register data. The association between psychological distress, Body Mass Index and presenteeism was assessed using negative binomial adjusted for sociodemographic and work factors. RESULTS: Presenteeism accounted for 4.4% of total working days. Psychological distress (18.2%) and overweight (41.9%) were each associated with higher presenteeism, with the strongest association for both combined (IRR 2.91, 95% CI 2.36-3.60), after adjustments. CONCLUSIONS: Psychological distress and overweight jointly increased presenteeism, highlighting the need for integrated workplace support to prevent productivity loss in this group with long work careers ahead.