The results are in. According to a new survey conducted by Staples Advantage (the business services arm of the Staples office supply store) released today, more people go to work when they have the flu in a small business with fewer than 300 employees than larger companies. It's troubling, considering the CDC estimates that the flu is responsible for a total loss of $87B in economic burden annually and 17 million lost workdays.

The survey, conducted independently by Redshift Research, profiled 1,500 U.S. office workers in companies of all sizes with an even split between managers and individual contributors. This is the fifth survey conducted in five years. While the results show a slight decrease in the number of office workers who still show up at work with the flu, the numbers are still alarming: 60 percent of those in a small company said they still go to work with the flu, even though 88% of managers encourage them to stay home.

My guess is that workers in small businesses feel they can't call in sick because they don't want to be perceived as under producing. You tend to stick out more when you are part of a smaller team. But I didn't want to guess. I decided to ask Chris Correnti, the Vice President of Staples Facility Solutions at Staples Advantage, to explain a bit more about why people don't call in sick based on the survey results. I also wanted to find out what you can do if you are running a company to encourage staff to stay home.

1. From your survey and expertise, why do people not call in sick?

Our survey results revealed that of the 60 percent of workers who come to work sick, 48 percent feel pressure to tough it out, 40 percent come in because they feel there is too much going on at work to stay away, and 31 percent show up sick because they think their boss appreciates it.

2. What does the data say about how it impacts productivity?

Coming to work sick has a negative effect on productivity. Interestingly, more respondents think that presenteeism (i.e. people going into the office when sick but not fully functioning ) is a bigger problem than people being absent from work due to illness. In fact, more than a third of respondents (36 percent) say that their personal productivity is less than 50 percent of their usual level when they show up with the flu, indicating a significant drop in productivity levels. Plus, they risk spreading their germs to other people in the office, who could then suffer the same effects.

3. What are a few things the company founder can do to encourage people to call in sick?

It's important to create a culture of wellness in the office so employees feel comfortable calling in sick. The most important is to simply tell people to log off and rest. Employers need to encourage employees to take the necessary time to recover when they contract the flu to protect not only themselves, but those around them in the office. For those employees who insist on working despite being sick, it's valuable to have a telecommuting policy in your office. This way, people who insist on working, but are still contagious, can get work done without spreading germs to the rest of the office.

4. Is it safe to say this is a bigger problem in small business?

Smaller businesses mean closer quarters and many shared touch points, meaning if one person's sick, the whole office could get sick too. It's important that common touch points, such as doorknobs and microwave/refrigerator handles, are cleaned often and thoroughly to prevent germs from spreading.

Additionally, because smaller businesses may not have the same resources to cover a sick colleague's work, employees may feel pressured to come to work, despite being ill. In small businesses, its crucial for managers and executives to educate their staff on when to stay home in order to prevent the spread of germs throughout the office, and to allow sick employees to fully recover so they can be at their most productive levels when back in the office.