How does perceived leader attitudes influence sickness presenteeism? In the present study we approach sickness presenteeism in a new way. Organizational adjustment norms and attendance pressure norms measure antecedents of presenteeism and indirectly measure the occurrence. In our survey we analysed the answers provided by employee representatives (n=1658) in a nationwide study, representative of the study population. We employed the partial least squares path modelling (PLS-PM) approach to structural equation modelling (SEM) to test the hypothesised study model. Perceived superior attitudes influenced organizational adjustment norms and attendance pressure norms, with firm size, structural barriers, sector and sickness absenteeism change as control variables. Sickness absenteeism was collected from national registers based on the official individual sick-leave forms of general physicians and was included in our files as the firms average percentile of days absent of total contracted work days. This paper shows the importance of including attendance pressure norms, organizational adjustment norms and perceived leader attitudes within research on sickness presenteeism to emphasize a focus on health outcomes instead of on-the-job productivity.