Strong Coworker Bonds Cut Sick-Day Stress but Fuel Working While Ill

Strong friendships among coworkers can protect employees’ health by lowering stress, but the same close bonds can also push people to keep working while sick, according to a new study published in BMC Public Health.

Researchers Sara Ravnkilde Nielsen, Vera Winter and Signe Pihl-Thingvad examined how bonding workplace social capital — the tight-knit relationships employees form with colleagues — influences presenteeism, the tendency to show up at work despite illness.

The team used a time-lagged survey design drawing on responses from 1,914 employees nested within 300 organizational units of a large Danish municipality. Because the surveys were collected at different points in time, the design allowed the researchers to test how earlier relationship quality related to later attitudes and behavior.

The study tested a dual-path model using structural equation modeling. In this framework, strong coworker relationships were expected to affect presenteeism through two opposing psychological routes: one running through stress and the other through work engagement.

The results confirmed both routes. Bonding workplace social capital reduced presenteeism by lowering employees’ stress, consistent with the idea that supportive colleagues buffer the strains that might otherwise force or encourage sick leave.

At the same time, the same strong relationships increased presenteeism through higher work engagement. Employees who felt closely connected to their coworkers were more engaged in their work, and that engagement was linked to a greater propensity to attend while ill.

The authors conclude that these opposing pathways underscore the complexity of social dynamics at work. Close coworker ties are neither simply beneficial nor simply harmful for attendance behavior; they operate through two mechanisms pulling in opposite directions simultaneously.

For public managers, the findings suggest a need to recognize both the protective and the unintended effects of strong coworker relationships. The researchers note that managers should ensure that high work engagement does not inadvertently promote unhealthy attendance behavior among staff.

The study’s scope is limited to employees within a single large Danish municipality, and it relies on survey data and a mediation model rather than a randomized design. Even so, it offers rare evidence on the underlying mechanisms connecting workplace social relationships to presenteeism, an area where explanations of how relationships shape sick-day behavior have remained scarce.

Subject of Research: How bonding workplace social capital affects presenteeism through stress and work engagement

Article Title: Opposing effects of strong coworker relationships in times of sickness: a dual path between bonding workplace social capital and presenteeism propensity

Article References: Nielsen, S. R., Winter, V., & Pihl-Thingvad, S. (2026). Opposing effects of strong coworker relationships in times of sickness: a dual path between bonding workplace social capital and presenteeism propensity. BMC Public Health. https://doi.org/10.1186/s12889-026-29492-6

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29492-6

Keywords: presenteeism, workplace social capital, coworker relationships, work engagement, occupational stress, dual-path model, structural equation modeling, public health, Denmark, employee wellbeing, Opposing, effects