Paid sick leave emerges as key workplace support for frontline workers, new study shows

New evidence shows how paid sick leave may buffer stress, improve job satisfaction, and support frontline worker resilience during infectious disease crises.

Study: How Paid Sick Leave Access Influences Perceived Risk, Job Stress, and Job Satisfaction Among Home Service Workers. Image Credit: eldar nurkovic / Shutterstock

Study: How Paid Sick Leave Access Influences Perceived Risk, Job Stress, and Job Satisfaction Among Home Service Workers. Image Credit: eldar nurkovic / Shutterstock

In a recent study published in the Journal of Occupational and Environmental Medicine, researchers investigated how access to paid sick leave (PSL) was associated with perceived risk, job stress, and job satisfaction among 1,643 in-home service workers in South Korea during the COVID-19 pandemic. The study used path analysis to show that workers with unpaid leave or no leave reported higher perceived risk, which was associated with higher job stress and indirectly reduced job satisfaction. The findings suggest that PSL functions as an important job resource, potentially supporting worker retention by fostering a sense of employer support and security.

South Korea’s Limited Sick Leave Coverage

While most developed nations have statutory sick leave requirements, South Korea remains one of the few Organisation for Economic Co-operation and Development (OECD) countries without a nationwide policy covering the entire workforce. Legally mandated paid leave is often restricted to public employees, private school teachers, or cases involving work-related injuries, leaving many private-sector and gig workers dependent on employer discretion.

The COVID-19 pandemic reportedly exacerbated these disparities, with in-home service workers, ranging from repair technicians to childcare providers, facing unique challenges. Home environments are less regulated than traditional workplaces, increasing uncertainty around exposure and protection. Prior to this study, however, these concerns had not been systematically examined using empirical data.

Applying the Job Demands, Resources Model

The study aimed to address this gap by applying the Job Demands, Resources (JD-R) model to South Korea’s in-home service workforce. The JD-R framework posits that job demands, such as infection risk, contribute to stress, while job resources, such as PSL, buffer these negative effects and support well-being.

Using data from a cross-sectional survey conducted in May 2020 in collaboration with the Korean Confederation of Trade Unions, the researchers examined nine in-home service occupations to understand how leave access shaped workers’ psychological experiences during the early phase of the pandemic.

Study Sample and Leave Classification

The study included 1,643 participants, including home appliance technicians, gas inspectors, home health nurses, and childcare providers, and achieved a high response rate of 83%.

Participants were classified based on their reported access to sick leave for COVID-19 symptoms into four groups: paid leave, unpaid leave, no access to leave, and unsure of leave status.

Key Psychological Outcomes Measured

Three primary outcomes were assessed. Perceived risk was measured using a composite score ranging from 0 to 30, capturing fear of exposure, anxiety, and perceived seriousness of infection. Job stress was assessed using a single-item self-report of work-related tension. Job satisfaction was measured with a single-item overall rating of satisfaction with one’s current job.

Path analysis was used to examine both direct effects of leave access and indirect effects operating through perceived risk and job stress.

Psychological Chain Reaction of Leave Access

Only 25 percent of surveyed workers reported access to paid sick leave. Nearly half (46 percent) had access only to unpaid leave; 12 percent had no access at all; and 16 percent were unsure of their leave status.

Compared with workers who had PSL, those with unpaid leave (β = 0.087, p = 0.012) and no leave access (β = 0.080, p = 0.006) reported significantly higher perceived risk. Higher perceived risk was strongly associated with increased job stress (β = 0.189, p < 0.001), which in turn was associated with lower job satisfaction (β = −0.285, p < 0.001).

Direct and Indirect Effects on Satisfaction

Workers with no leave access (β = −0.060, p = 0.018) and those unsure of their leave policy (β = −0.057, p = 0.021) experienced a direct reduction in job satisfaction relative to workers with PSL. Unpaid leave did not show a statistically significant total effect on job satisfaction relative to PSL, despite its indirect effects through perceived risk and stress.

The group, unsure of their leave status, did not report higher perceived risk, possibly because they worked in regions with lower early infection rates. Nevertheless, uncertainty was associated with reduced job satisfaction, underscoring the importance of clear communication regarding employment protections.

Overall, the JD-R model explained 36.1 percent of the variance in job satisfaction, indicating that leave policy is a meaningful contributor to workers’ occupational well-being.

Implications for Worker Protection Policy

The findings suggest that PSL may reduce psychosocial strain by providing workers with security before a confirmed diagnosis, encouraging them to stay home when symptomatic, and potentially reducing viral transmission. By removing the trade-off between health and income, PSL may also alleviate stress during public health crises.

Although the study is limited by its cross-sectional design, which precludes causal inference, and its focus on unionized workers, it highlights the need for policy reforms. Expanding PSL coverage to gig workers, dependent self-employed individuals, and employees in small businesses may be critical to protecting frontline workers’ well-being during future health emergencies.

Journal reference:

Hugo Francisco de Souza

Written by

Hugo Francisco de Souza

Hugo Francisco de Souza is a scientific writer based in Bangalore, Karnataka, India. His academic passions lie in biogeography, evolutionary biology, and herpetology. He is currently pursuing his Ph.D. from the Centre for Ecological Sciences, Indian Institute of Science, where he studies the origins, dispersal, and speciation of wetland-associated snakes. Hugo has received, amongst others, the DST-INSPIRE fellowship for his doctoral research and the Gold Medal from Pondicherry University for academic excellence during his Masters. His research has been published in high-impact peer-reviewed journals, including PLOS Neglected Tropical Diseases and Systematic Biology. When not working or writing, Hugo can be found consuming copious amounts of anime and manga, composing and making music with his bass guitar, shredding trails on his MTB, playing video games (he prefers the term ‘gaming’), or tinkering with all things tech.

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