Inaccurate and misogynistic: why we need to make the term ‘hysterectomy’ history
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Have you had a tonsillectomy (your tonsils taken out), appendectomy (your appendix removed) or lumpectomy (removal of a lump from your breast)? The suffix “ectomy” denotes surgical removal of the named body part, so these terms give us a clear idea of what the procedure entails.
So why is the removal of the uterus called a hysterectomy and not a uterectomy?
The name hysterectomy is rooted in a mental health condition – “hysteria” – that was once believed to affect women. But we now know this condition doesn’t exist.
Continuing to call this significant operation a hysterectomy both perpetuates misogyny and hampers people’s understanding of what it is.
From the defunct condition ‘hysteria’
Hysteria was a psychiatric condition first formally defined in the 5th century BCE. It had many symptoms, including excessive emotion, irritability, anxiety, breathlessness and fainting.
But hysteria was only diagnosed in women. Male physicians at the time claimed these symptoms were caused by a “wandering womb”. They believed the womb (uterus) moved around the body looking for sperm and disrupted other organs.
Because the uterus was blamed for hysteria, the treatment was to remove it. This procedure was called a hysterectomy. Sadly, many women had their healthy uterus unnecessarily removed and most died.
The word “hysteria” did originally came from the ancient Greek word for uterus, “hystera”. But the modern Greek word for uterus is “mitra”, which is where words such as “endometrium” come from.
Hysteria was only removed as an official medical diagnosis in 1980. It was finally recognised it does not exist and is sexist.
“Hysterectomy” should also be removed from medical terminology because it continues to link the uterus to hysteria.
Common but confusing
About one in three Australian women will have their uterus removed. A hysterectomy is one of the most common surgeries worldwide. It’s used to treat conditions including:
- abnormal uterine bleeding (heavy bleeding)
- uterine fibroids (benign tumours)
- uterine prolapse (when the uterus protrudes down into the vagina)
- adenomyosis (when the inner layer of the uterus grows into the muscle layer)
- cancer.
However, in a survey colleagues and I did of almost 500 Australian adults, which is yet to be published in a peer-reviewed journal, one in five people thought hysterectomy meant removal of the ovaries, not the uterus.
It’s true some hysterectomies for cancer do also remove the ovaries. A hysterectomy or partial hysterectomy is the removal of only the uterus, a total hysterectomy removes the uterus and cervix, while a radical hysterectomy usually removes the uterus, cervix, uterine tubes and ovaries.
There are important differences between these hysterectomies, so they should be named to clearly indicate the nature of the surgery.
Research has shown ambiguous terminology such as “hysterectomy” is associated with low patient understanding of the procedure and the female anatomy involved.
Uterectomy should be used for removal of the uterus, in combination with the medical terms for removal of the cervix, uterine tubes and ovaries as needed. For example, a uterectomy plus cervicectomy would refer to the removal of the uterus and the cervix.
This could help patients understand what is (and isn’t) being removed from their bodies and increase clarity for the wider public.
Other female body parts and procedures have male names
There are many eponyms (something named after a person) in anatomy and medicine, such as the Achilles tendon and Parkinson’s disease. They are almost exclusively the names of white men.
Eponyms for female anatomy and procedures include the Fallopian tubes, Pouch of Douglas, and Pap smear.
The anatomical term for Fallopian tubes is uterine tubes. “Uterine” indicates these are attached to the uterus, which reinforces their important role in fertility.
The Pouch of Douglas is the space between the rectum and uterus. Using the anatomical name (rectouterine pouch) is important, because this a common site for endometriosis and can explain any associated bowel symptoms.
Pap smear gives no indication of its location or function. The new cervical screening test is named exactly that, which clarifies it samples cells of the cervix. This helps people understand this tests for risk of cervical cancer.
Language matters in medicine and health care
Language in medicine impacts patient care and health. It needs to be accurate and clear, not include words associated with bias or discrimination, and not disempower a person.
For these reasons, the International Federation of Associations of Anatomists recommends removing eponyms from scientific and medical communication.
Meanwhile, experts have rightly argued it’s time to rename the hysterectomy to uterectomy.
A hysterectomy is an emotional procedure with not only physical but also psychological effects. Not directly referring to the uterus perpetuates the historical disregard of female reproductive anatomy and functions. Removing the link to hysteria and renaming hysterectomy to uterectomy would be a simple but symbolic change.
Educators, medical doctors and science communicators will play an important role in using the term uterectomy instead of hysterectomy. Ultimately, the World Health Organization should make official changes in the International Classification of Health Interventions.
In line with increasing awareness and discussions around female reproductive health and medical misogyny, now is the time to improve terminology. We must ensure the names of body parts and medical procedures reflect the relevant anatomy.
Theresa Larkin, Associate Professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Children can be more vulnerable in the heat. Here’s how to protect them this summer
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Extreme heat is increasingly common in Australia and around the world and besides making us uncomfortable, it can harm our health. For example, exposure to extreme heat can exacerbate existing medical conditions, or cause problems such as heat stroke.
Due to a combination of physiology and behaviour, children are potentially more vulnerable to severe heat-related illness such as heat stroke or heat exhaustion.
But these are not the only heat-related health issues children might experience on a very hot day. In a new study, we looked at emergency department (ED) visits and unplanned hospital admissions among children in New South Wales on heatwave days.
We found a significant increase in children attending hospital compared to milder days – with a range of health issues.
maxim ibragimov/Shutterstock Why are children more vulnerable in the heat?
Sweating is the main way we lose heat from our bodies and cool down.
Children have a greater skin surface area to body mass ratio, which can be an advantage for sweating – they can lose more heat through evaporation for a given body mass. But this also means children can lose fluids and electrolytes faster through sweating, theoretically making them more susceptible to dehydration.
Meanwhile, younger children, particularly babies, can’t sweat as much as older children and adults. This means they can’t cool down as effectively.
Children in general also tend to engage in more outdoor physical activity, which might see them more exposed to very hot temperatures.
Further, children may be less in-tune to the signals their body is giving them that they’re overheating, such as excessive sweating or red skin. So they might not stop and cool down when they need to. Young children especially may not recognise the early signs of heat stress or be able to express discomfort.
Children may not easily be able to communicate that they’re hot and bothered. christinarosepix/Shutterstock Our study
We wanted to examine children’s exposure to extreme heat stress and the associated risks to their health.
We measured extreme heat as “heatwave days”, at least two consecutive days with a daily maximum temperature above the 95th percentile for the relevant area on a universal thermal climate index. This ranged from 27°C to 45°C depending on the area.
We assessed health outcomes by looking at ED visits and unplanned hospital admissions among children aged 0–18 years from NSW between 2000 and 2020. This totalled around 8.2 million ED visits and 1.4 million hospital admissions.
We found hospital admissions for heat-related illness were 104% more likely on heatwave days compared to non-heatwave days, and ED visits were 78% more likely. Heat-related illness includes a spectrum of disorders from minor conditions such as dehydration to life-threatening conditions such as heat stroke.
But heat-related illness wasn’t the only condition that increased on heatwave days. There was also an increase in childhood infections, particularly infectious enteritis possibly related to food poisoning (up 6% for ED visits and 17% for hospital admissions), ear infections (up 30% for ED visits and 3% for hospital admissions), and skin and soft tissue infections (up 6% for ED visits and 4% for hospital admissions).
Kids can be more vulnerable in the heat because of their behaviour and physiology. K-FK/Shutterstock We know many infectious diseases are highly seasonal. Some, like the flu, peak in winter. But heat and humidity increase the risk of certain infections caused by bacterial, viral and fungal pathogens.
For example, warmer weather and higher humidity can increase the survival of bacteria, such as Salmonella, on foods, which increases the risk of food poisoning.
Hot weather can also increase the risk of ear infections. Children may be at greater risk during hot weather because they often swim or play at the beach or pool. Water can stay in the ear after swimming and a moist environment in the ear canal can cause growth of pathogens leading to ear infections.
Which children are most vulnerable?
During heatwaves, we found infants aged under one were at increased risk of ED visits and hospital admission for any reason compared to older children. This is not surprising, because babies can’t regulate their body temperature effectively and are reliant on their caregivers to keep them cool.
Our study also found children from the most disadvantaged areas were more vulnerable to heat-related illness on heatwave days. Although we don’t know exactly why, we hypothesised families from poorer areas might have limited access to air-conditioning and could be more likely to live in hotter neighbourhoods.
Keeping kids cool: tips for parents
The highest levels of heat exposure on hot days for young children is usually when they’re taken outside in prams and strollers. To protect their children from direct sunlight, parents often instinctively cover their stroller with a cloth such as a muslin.
However, a recent study from our group showed this actually increases temperatures inside a stroller to as much as 3–4˚C higher than outside.
But if the cloth is wet with water, and a small fan is used to circulate the air close to the child, stroller temperatures can be 4–5˚C lower than outside. Wetting the cloth every 15–20 minutes (for example, with a spray bottle) maintains the cooling effect.
When young children are not in a stroller, and for older children, there are a few things to consider to keep them cool and safe.
Remember temperatures reported on weather forecasts are measured in the shade, and temperatures in the sun can be up to 15˚C higher. So sticking to the shade as much as possible is important.
Exercise generates heat inside the body, so activities should be shortened, or rescheduled to cooler times of the day.
Sunscreen and hats are important when outdoors, but neither are especially effective for keeping cool. Spraying water on the child’s skin – not just the face but arms, legs and even the torso if possible – can help. Wetting their hats is another idea.
Proper hydration on hot days is also essential. Regular water breaks, including offering water before, during and after activity, is important. Offering foods with high water content such as watermelon and orange can help with hydration too.
Wen-Qiang He, Research Fellow in Biostatistics and Epidemiology, Faculty of Medicine and Health, University of Sydney; James Smallcombe, Post-doctoral Research Associate, Faculty of Medicine and Health, University of Sydney; Natasha Nassar, Professor of Paediatric and Perinatal Epidemiology and Chair in Translational Childhood Medicine, University of Sydney, and Ollie Jay, Professor of Heat & Health; Director of Heat & Health Research Incubator; Director of Thermal Ergonomics Laboratory, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Exercise That Protects Older Adults From Cancer
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The relationship between exercise and cancer has sometimes been laden with confusion, and in particular, it was long popularly believed that exercise accelerates cancer once it occurs, but now it seems that’s not the case.
You might have read about that, and specifically about how a research team (Dr. Alice Avancini et al.) analysed data from 22 randomized controlled trials (total n=968 participants) that investigated the effects of exercise on various pro-inflammatory biomarkers (mostly interleukin variants, but also c-reactive proteins) that are known to increase breast cancer reoccurrence risk.
What they found was:
❝Exercise induced small to large significant reductions in IL-6 (SMD = -0.85; 95% CI = -1.68 to -0.02; p = .05) and TNF-α (SMD = -0.40; 95% CI = -0.81 to 0.01; p = .05) and a trend for a decrease in CRP.
When stratifying by exercise mode, trends toward reduction in IL-6 and TNF-α were observed for combined exercise, whilst changes were not generally affected by exercise program duration❞
The “combined exercise” mentioned?
Aerobic exercise and resistance training.
This is important, because as regular 10almonds readers may remember…
What Your Metabolism Says About How Aggressive Cancer Is Likely To Be For You ← this makes a huge difference to survival chances
So, this study’s findings are very consistent with that, because:
- Aerobic training increases cardiovascular fitness, improving metabolism
- Resistance training increases muscle mass, improving metabolism*
*because muscle “costs” calories to maintain, prompting an increase in metabolism, whereas fat prompts our metabolism to slow, to conserve energy to face the obvious food shortage that must be coming
See also: Stop Cancer 20 Years Ago
Exercise & aging muscle
Yes, we said “older adults” specifically in the title, and now we’re getting to that part!
Most recently, another team of scientists (Dr. Jun Nishiyama et al.) that healthy skeletal* muscle acts as an anti-tumor organ, releasing tiny particles called extracellular vesicles (EVs) that help suppress the development of tumors.
*This means the muscles that move your skeleton, as opposed to different kinds of muscle such as, for example, the smooth muscle that operates the peristaltic motion of your intestines, or that forms the main part of the walls of your uterus (if you have one), or that wiggle your ears, and so forth.
As muscles age and lose mass (per sarcopenia), they produce fewer of these vesicles. The vesicles that are released also contain lower levels of a molecule (known as miR-7a-5p to its friends) that normally helps restrain tumor growth. As a result, aging muscle can lose a lot of its natural cancer-fighting ability.
The good news is that exercise appears to reverse part of this process. The researchers found that physical activity reactivates a biological pathway involved in EV production, restoring the release of protective signals from muscle.
In other words: exercise more (be it with aerobic activity or resistance training, though ideally both), and greatly reduce your risk of cancer.
You can find this paper in full, here: Sarcopenia promotes tumorigenesis by disrupting NOTCH-SDC2-regulated biogenesis of muscle-derived extracellular vesicles
Want to learn more?
You might like this excellent book we reviewed:
Moving Through Cancer – by Dr. Kathryn Schmitz
Take care!
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Can I drive when taking medicinal cannabis? Is it safe?
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Your doctor has just prescribed medicinal cannabis. You think it’s helping. But you rely on your car to get to work and pick up the kids.
Are you allowed to drive? And more importantly, is it safe?
Here’s what the evidence says and what it means for you.
Medicinal cannabis is now widely prescribed in Australia for conditions such as chronic pain, anxiety and sleep disorders.
You can take it in a variety of different ways – for instance, by inhaling it using a vaporiser, or by ingesting an oil. There are many different active compounds. However, the main ones – known as cannabinoids – are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is also the intoxicating part of cannabis that gets you “stoned”. So this is where things get complicated.
What happens when you take medicinal cannabis?
When cannabis is inhaled, the effects peak in the first hour. They taper off over two to three hours, but can last for up to four to six hours.
When taken orally – for example as an oil – the effects don’t start straight away and can last for up to 8 to 12 hours. That’s because the cannabinoids are absorbed by your gut and metabolised more slowly.
THC negatively impacts cognitive functions, such as attention and memory. It impairs driving in a simulator and in the real world on a highway.
The effects of THC on driving are roughly comparable to low blood alcohol concentrations. But this depends on the dose and how often someone uses cannabis.
Medicinal cannabis used for insomnia does not cause impairment the next day, and regular cannabis users show no driving impairment after 48 hours or more of abstinence.
CC BY-NC Medicinal cannabis prescriptions have skyrocketed in Australia, mostly for legal but unapproved products we don’t even know work or are safe. In this series, experts tease out what’s fuelling the rise of medicinal cannabis, the fallout, and what needs to happen next.
Unlike alcohol, THC can make people more cautious behind the wheel. So drivers sometimes try to drive more carefully or leave a larger gap behind the car ahead.
However, such strategies may not be enough to offset the impairing effects of THC, and they become less effective under more complex driving conditions.
CBD does not impair cognition or driving.
Most cannabis and driving studies have used healthy volunteers and deliberately intoxicating doses of THC. So we don’t know whether people are as impaired when using prescribed medicinal cannabis to manage a chronic health condition.
In theory, a patient is likely to be less impaired if they use a low dose of THC, if they use the exact same amount of medicinal cannabis on a regular basis, or if medicinal cannabis relieves symptoms that can affect normal functioning, such as chronic pain.
Can I legally drive after taking it?
In every Australian state and territory, except Tasmania, it is illegal to drive with any detectable amount of THC in your system.
Roadside drug testing, which checks for the presence of THC in saliva rather than impairment, cannot distinguish between prescribed medicinal cannabis and illicit cannabis.
In Tasmania, you can lawfully drive with THC in your system so long as you are unimpaired and your medicinal cannabis was prescribed and dispensed in Tasmania.
Other medications that can impair driving – such as opioids and benzodiazepines – do not carry the same prohibition on driving. You can drive with these medications in your system so long as you are unimpaired and using your medication as prescribed.
Driving while impaired (as opposed to driving with the presence of a drug in your system) is a separate offence and applies to both medicinal cannabis and other medications.
The discrepancy between how medicinal cannabis and other impairing medications are treated has been the focus of a parliamentary inquiry in New South Wales and broader law reform discussions.
Victoria has now amended its road safety act to give magistrates the power to decide whether or not to cancel someone’s licence if they test positive for THC, are unimpaired, and have a valid medicinal cannabis prescription. Nonetheless, it remains illegal to drive in Victoria with THC in your system.
You can lawfully drive if you are using a CBD-only medication, so long as you are not impaired.
How can I drive safely?
If you have been prescribed medicinal cannabis, there are practical steps you can take to reduce your risk when driving.
First, speak to your doctor. Let them know you drive, especially if you rely on driving for work or caring responsibilities, or if you work in a safety-sensitive environment, such as construction. Together, you can discuss whether a product containing THC is appropriate, or whether a CBD-only product might be more suitable.
Second, don’t just rely on how you feel when determining whether you are safe to drive. Even if you feel completely normal, your driving ability may still be compromised.
Even if you are unimpaired, you can still test positive on a roadside drug test for hours after taking medicinal cannabis. The length of time is highly variable and depends on factors such as the dose, route of administration, and how often you take medicinal cannabis.
The penalties for driving with THC in your system vary by state and territory. They range from fines to licence disqualifications and potential jail time for repeat offences.
A blood test can detect THC days after taking it. So if you are involved in a crash and have THC in your blood, you could face severe legal penalties, and your car insurance may be voided.
Roadside drug tests do not check for CBD.
What don’t we yet know?
Studies are underway to look at how medicinal cannabis impacts driving in people who take it for long-term health conditions, such as chronic pain. Researchers are also testing to see if sensors can detect cannabis impairment in real time while driving.
Once these and other studies are complete, we’ll have a clearer picture of how medicinal cannabis affects drivers who take it for long-term medical conditions.
To find out more about medicinal cannabis and driving, visit the Therapeutic Goods Administration’s medicinal cannabis hub or ask your health-care practitioner.
Tom Arkell, NHMRC Emerging Leadership Fellow, School of Health Sciences, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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10 Oft-Ignored Symptoms Of Diabetes
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Due in part to its prevalence and manageability, diabetes is often viewed as more of an inconvenience than an existential threat. While very few people in countries with decent healthcare die of diabetes directly (such as by diabetic ketoacidosis, which is very unpleasant, and happens disproportionately in the US where insulin is sold with a 500%–3000% markup in price compared to other countries), many more die of complications arising from comorbidities, and as for what comorbidities come with diabetes, well, it increases your risk for almost everything.
So, while for most people diabetes is by no means a death sentence, it is something that means you’ll now have to watch out for pretty much everything else too. On which note, Dr. Siobhan Deshauer is here with things to be aware of:
More than your waistline
Some of these are early symptoms (even appearing in the prediabetic stage, so can be considered an early warning for diabetes), some are later risks (it’s unlikely you’ll lose your feet from diabetic neuropathy complications before noticing that you are diabetic), but all and any of them are good reason to speak with your doctor sooner rather than later:
- Polyuria: waking up multiple times at night to urinate due to excess glucose spilling into the urine.
- Increased thirst: dehydration from frequent urination leads to excessive thirst, creating a cycle.
- Acanthosis nigricans: dark, velvety patches on areas like the neck, armpits, or groin, signalling insulin resistance.
- Skin tags: multiple skin tags in areas of friction may indicate insulin resistance.
- Recurrent Infections: high blood sugar weakens the immune system, making skin infections, UTIs, and yeast infections more common.
- Diabetic stiff hand syndrome: stiffness in hands, limited movement, or a “positive prayer sign” caused by sugar binding to skin and tendon proteins.
- Frozen shoulder and trigger finger: pain and limited movement in the shoulder or fingers, with a snapping sensation when moving inflamed tendons.
- Neuropathy: numbness, tingling, or pain in hands and feet due to nerve and blood vessel damage, often leading to foot deformities like Charcot foot.
- Diabetic foot infections: poor sensation, weakened immune response, and slow healing can result in severe infections and potential amputations.
- Gastroparesis: damage to stomach nerves causes delayed digestion, leading to bloating, nausea, and erratic blood sugar levels.
For more on all of these, plus some visuals of the things like what exactly is a “positive prayer sign”, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Cost of Insulin by Country 2024 ← after the US, the next most expensive country is Chile, at around 1/5 of the price; the cheapest listed is Turkey, at around 1/33 of the price.
Take care!
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The Secret To Better Squats: Foot, Knee, & Ankle Mobility
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We’ve talked before about how Slav squats, Asian squats, deep squats, sitting squats, or various other things they might by called (these are all different names for the same thing), are one of the most anti-aging exercises, if not outright the most anti-aging exercise. Yet, how to get good at them?
“Just squat more” is fine advice and will get you there eventually, but there are ways to shorten the time it takes, by unlocking whatever part(s) might be holding you back:
Piece by piece
The key to improving the whole is to not neglect any of the parts—so here they are:
- Foot rolls: roll your foot onto its outer and inner edges to stretch; repeat for both legs.
- Toe lifts: lift your toes up and down while keeping your legs straight.
- Toe curls: curl your toes to engage foot muscles.
- Foot circles: rotate your feet in circles; repeat for both legs.
- Heel raises: stand tall, raise your heels off the ground, and engage your core.
- Tibialis anterior exercise: lean against a wall or similar, and lift your toes off ground to strengthen your tibialis anterior (important and oft-forgotten muscle, responsible for more than people think!)
- Heel drops: perform dynamic heel drops with your feet back, to stretch your ankles.
- Hamstring curls & leg extension: curl your leg back toward your glutes, and then extend it forwards; alternate legs.
- Dynamic calf stretch: bend and straighten your knees alternately in a forward lunge position.
- Squat to heel raise: perform squats with your heels lifting off the floor and your arms raised.
- Banded ankle dorsiflexion: use a yoga strap or towel to stretch your feet, calves, and hamstrings.
- Seated feet circles: extend your legs and rotate your feet in outward and inward circles.
- Dorsiflexion/plantar flexion: alternate one foot up and the other down dynamically.
- Seated knee flexion & extension: alternate lifting your knees and extending your legs, while seated.
Note: “seated” in all cases means on the floor, not a chair!
For more on all of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
What Nobody Teaches You About Strengthening Your Knees ← about that tibialis anterior muscle and what it means for your knees
Take care!
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I have a bit of a cold. Am I sick enough to take a day off work?
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Whether it’s your first or fourth cold of the season, many Australians are waking up at the moment with a sniffle, a sore throat or feeling more tired than usual.
June to August is peak flu season in Australia. There are also high rates of COVID circulating, along with other respiratory viruses such as respiratory syncytial virus (RSV) and adenovirus.
Sometimes it’s clear when you need to spend the day in bed: you have a fever, aches and pains, and can’t think clearly. If it’s the flu or COVID, you’ll want to stay away from others, and to rest and recover.
But what about if your symptoms are mild? Are you sick enough to take the day off, or should you push through it? And what if you feel pressured to work?
Here’s what to consider.
Are you likely to spread it?
While it may seem like a good idea to continue working, especially when your symptoms are mild, going to work when infectious with a respiratory virus risks infecting your co-workers.
If you are in a client-facing role, such as a teacher or a salesperson, you may also infect others like students or customers.
The risks may be even greater for those working with vulnerable communities, such as in aged care work, where the consequences can be severe.
From an organisational perspective, you are likely less productive when you are not feeling well.
So, whenever possible, avoid going into work when you’re feeling unwell.
Should I work from home?
The COVID pandemic normalised working from home. Since then, more people work from home when they’re unwell, rather than taking sick leave.
Some employees join Zoom or Teams meetings out of guilt, not wanting to let their co-workers down. Others – and in particular, some men – feel the need to maintain their performance at work, even if it’s at the expense of their health.
A downside of powering through is that workers may prolong their illness by not looking after themselves.
Can you take leave when you need it?
Employees in Australia can take either paid or unpaid time off when they are unwell.
Most full-time employees get ten days of paid sick leave per year, while part-time employees get the equivalent pro-rata.
Employers can ask for reasonable evidence from employees to show they are unwell, such as asking for a medical certificate from a pharmacy or GP, or a statutory declaration. The type of evidence required may differ from organisation to organisation, with some awards and enterprise agreements specifying the type of evidence needed.
While taking a sick day helps many workers recuperate, a significant proportion of workers engaged in non-standard work arrangements do not receive these benefits. There are, for example, 2.6 million casual employees who don’t have access to paid sick leave.
Similarly, most self-employed people such as tradies and gig workers do not have any paid leave entitlements. Although these workers can still take unpaid leave, they are sacrificing income when they call in sick.
Research from the Australian Council of Trade Unions has found more than half of insecure workers don’t take time off when injured or sick.
So a significant proportion of workers in Australia simply cannot afford to call in sick.
Why pushing through isn’t the answer
“Presenteeism” is the phenomenon of people reporting for work even when they are unwell or not fully functioning, affecting their health and productivity.
While exact figures are hard to determine, since most organisations don’t systematically track it, estimates suggest 30%–90% of employees work while sick at least once a year.
People work while sick for different reasons. Some choose to because they love their job or enjoy the social side of work – this is called voluntary presenteeism.
But many don’t have a real choice, facing financial pressure or job insecurity. That’s involuntary presenteeism, and it’s a much bigger problem.
Research has found industry norms may be shaping the prevalence of “involuntary presenteeism”, with workers in the health and education sectors more likely to feel obligated to work when sick due to “at work” caring responsibilities.
What can organisations do about it?
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.
Your co-workers matter too. When teams step up and share the load, it creates a culture where people feel safe to take leave. A supportive environment makes wellbeing a shared responsibility.
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.
Alex Veen, Senior Lecturer and University of Sydney Business School Emerging Scholar Research Fellow, University of Sydney; Hannah Kunst, Lecturer in Leadership, University of Sydney, and Nate Zettna, Lecturer in Leadership, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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