Research & figures
The numbers behind absence, burnout and shift pressure
A decade of TNO data in one place. Absence hasn't just become more expensive; it has changed in character: longer, more psychological and increasingly work-related.
Source: TNO Arbobalans 2024 (NEA/ZEA, 2015-2023) and TNO (2014), reference year 2012.
The story in short
Same problem, different character
When TNO first calculated it this way in 2012, absence cost employers €11.5 billion in wage continuation, of which €2.7 billion was tied to psychosocial workload. A psychological absence episode then lasted 31 days on average.
Just over a decade later the figure stands at €20 billion in total, €4.9 billion driven by psychosocial workload, and psychological absence lasts 63 working days on average. So the problem hasn't only grown. It has changed character: longer, more expensive per case and increasingly psychologically driven.
Within that trend, structural shift work is an independent, statistically significant risk factor, even after correcting for every other work, company and personal characteristic. It affects over 1.4 million Dutch employees. No one brings those signals together early. That is exactly the gap ShiftRecovery fills.
€20bnWage-continuation absence costs, 2023
€4.9bnOf which driven by psychosocial workload
63 daysAverage duration of psychological absence (21× the flu)
1.15×Absence odds for structural shift work (after correction)
19%Employees with burnout complaints (up from 13% in 2015)
Finding 1: Cost
Absence has become more expensive, and different
Total wage continuation for absence nearly doubled in ten years. The biggest rise sits in work-related absence, and within that, in psychosocial workload.
- Total absence cost (wage continuation): €11.5 billion (2012) to €20 billion (2023).
- Work-related absence: €5.1 billion (2015) to €8.3 billion (2023).
- Psychosocial workload alone: €2.7 billion (2012) to €4.9 billion (2023), over half of all work-related absence costs.
Wage-continuation absence costs, in € billion per year
Total absenceWork-relatedPsychosocial workload (PSA)
Share with burnout complaints (% per year)
EmployeesSelf-employed (measured biennially)
Finding 2: Burnout
Burnout keeps rising structurally
Among employees the share with burnout complaints climbed from 13% to nearly 1 in 5. Only the 2020 pandemic year briefly interrupted the trend.
- Employees with burnout complaints: 13% (2015) to 19% (2023), peaking at 20% in 2022.
- It is rising for the self-employed too: from 7% (2015) to 11% (2023).
- Employees in education and with a migration background report the most complaints; the middle age group (25 to 54) most often.
Finding 3: Duration
Psychological absence lasts by far the longest
The flu keeps someone home for three days. Psychological complaints for 63 working days on average, and in three quarters of cases the employee points to work as a (partial) cause.
21×longer than a flu or cold episode (63 against 3 working days)
| Absence complaint | Avg. work-days | % work-related |
|---|---|---|
| Flu, cold, viral infection | 3 days | 11% |
| Back complaints | 20 days | 57% |
| Cardiovascular | 46 days | 24% |
| Psychological complaints, burnout | 63 days | 75% |
| All complaints combined | 11 days | 22% |
Source: TNO Arbobalans 2024 (NEA, Table 3.2.2, 2023).
Finding 4: Shift pressure
Structural shift work is an independent risk factor
Employees who usually work shifts are absent more often, and that holds up as significant after correcting for every other work, company and personal characteristic.
1,15×Raised absence odds, multivariate-corrected (significant)
1.4M+Dutch employees in shift or rotating work (17.8%)
- 52% absence without shift work, 50% with occasional shifts, 58% with usual shift work.
- After correcting for all other factors, 'usually' keeps an odds ratio of 1.15×, a real and independent effect.
- Shift pressure and night/rotating shifts are exactly the signals ShiftRecovery brings together early.
Absence in the past year, by shift work (% of employees)
Wage cost per absence day, in € per day
Finding 5: Price per day
Every absence day costs more
It isn't just the number of absence days: wage cost per absence day rose from €230 to €299, before anything around it.
This is wage continuation only, calculated via the Human Capital Approach. Replacement, recruitment, lost productivity and presenteeism are on top of this, so in practice the real cost per absence day is higher.
Finding 6: Sectors
The mental pressure concentrates in a few sectors
Stressful work isn't equally common everywhere. Healthcare, a core market for ShiftRecovery, is structurally among the hardest-hit sectors.
- Stressful work: hospitality 27%, education 23% and healthcare 22% lead.
- Healthcare also has the highest sickness absence (7.8% in early 2024), followed by industry and government.
- In the shift-work sectors (healthcare, industry, transport and logistics) this mental pressure stacks on top of irregular shifts and roster strain.
Share with stressful work, by sector (%)
Finding 7: Causes
Work itself is the biggest lever
Not all absence is preventable. But the characteristics that matter most sit in the work, and so they can be influenced.
- Psychosocial workload relates more strongly to dropout than physical load.
- After excessive workload come emotionally demanding work and little room for autonomy.
- Because these levers sit in the work and the roster, early signalling can act on them.
Source: TNO Arbobalans 2024 (NEA, 2023), chapter 4.
Finding 8: International
The same pattern across four Western countries
Absence isn't rising only in the Netherlands. In the Netherlands, the UK, Switzerland and the US, health-related absence now sits higher than ten to fifteen years ago, and everywhere the statistics bureaus name mental load as the fastest-growing cause. The problem is structural, not pandemic-bound.
Rise in absence vs the base year (%)
5.2%NL · sickness absence 2024 (around 4% through 2017)
148.9MUK · working days lost in 2024
8.5 daysCH · absence days per full-time job (6.3 in 2010)
$225.8bnUS · annual productivity loss from illness
- Levels sit structurally higher than before 2019 everywhere, despite tight labour markets.
- The mental component grows fastest: burnout (NL 19%), emotional exhaustion (CH 30.3%) and mental absence days (UK 13.7%).
- More people are absent more often but more briefly, exactly the rising recovery pressure ShiftRecovery flags early.
Questions & answers
What do the numbers say about burnout and dropout?
The most-asked questions, answered with the TNO data behind this page.
How many employees have burnout complaints?
In 2023, 19% of employees had burnout complaints, nearly 1 in 5, up from 13% in 2015. Education stands out; employees with a migration background also report above-average levels.
Arbobalans 2024Is burnout work-related?
For the most part, yes. Of absence due to psychological complaints, 75% of employees attribute the cause (partly) to work. Excessive workload is the most-cited cause.
Arbobalans 2024 · Table 3.2.2Which sectors and occupations are hit hardest?
Stressful work is most common in hospitality (27%), education (23%) and healthcare (22%). By occupation it is pedagogical (26%), care and welfare (25%) and service roles (23%).
Arbobalans 2024How long does psychological absence last?
63 working days on average, over 21 times as long as a flu or cold episode (3 days). That makes psychological absence weigh heavily on costs, even though it is less frequent.
Arbobalans 2024 · Table 3.2.2What does work-related absence cost the employer?
In 2023, €8.3 billion in wage continuation, of which €4.9 billion is attributable to psychosocial workload. Total absence costs came to €20 billion.
Arbobalans 2024 · Figure 3.5.1Does shift work really make a difference?
Yes. Employees who usually work shifts have a 1.15× higher absence risk, a statistically significant effect that holds after correcting for every other work, company and personal characteristic.
Arbobalans 2024 · Table 4.2Which work characteristics relate most strongly to dropout?
Psychosocial workload weighs heaviest, more than physical load. Undesirable behaviour from colleagues or managers, for example, gives a 1.5× higher absence risk.
Arbobalans 2024 · Chapter 4Is the problem getting bigger or smaller?
Bigger and more persistent. Burnout rises structurally (13% to 19%), costs climb (€11.5 to €20 billion) and absence lasts longer. Only the number of fatal work accidents is falling.
Arbobalans 2024Free impact report
Curious what absence is costing you?
Calculate your own numbers in 2 minutes. No wearables, no medical data.
Accountability
Sources & method
- Arbobalans 2024 (TNO, 2025)Report TNO 2025 R11108. Based on the National Working Conditions Survey (NEA, employees) and the Self-Employed Working Conditions Survey (ZEA), TNO/CBS, figures 2015-2023.
- The cost of sickness absence for employers in the Netherlands (Van der Ploeg et al., 2014)Leiden: TNO. Reference year 2012. Used for the historical comparison of absence costs and wage cost per absence day.
How the costs are calculated
- Costs are wage continuation during absence, calculated via the Human Capital Approach (TNO/CBS).
- Replacement, recruitment, lost productivity, presenteeism and medical costs are not included and come on top.
- Figures are population-level estimates from sample research and self-report; read them with appropriate caution.
- Work-related means: attributed by the employee (partly or mainly) to their work.
Run the numbers for your own organisation
Translate these figures to your own absence, rosters and costs, and see what early recognition realistically delivers.