Presenteeism is an emerging work-related health problem among train drivers. It is more serious than absenteeism, as it accounts for higher productivity losses over the long term and may increase the risk of occupational accidents. Train drivers have high rates of mental and physical health conditions that may put them at high risk of presenteeism. Methods: A comparative cross-sectional study was conducted on 100 train drivers working in Mansoura railway station and 100 administrative employees

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... working in the Faculty of Medicine, Mansoura university as a comparison group to estimate the prevalence of presenteeism and its associated factors among train drivers working in Mansoura railway station, Egypt. A questionnaire was used to collect socio-demographic, occupational and medical data. The Kessler Psychological Distress Scale (K10) was used to measure non-specific psychological distress. The Stanford Presenteeism Scale (SPS-6) was used to assess productivity loss related to sickness presenteeism. Results: The prevalence of presenteeism was significantly higher among train drivers (76%) compared to the comparison group (31%). All participants (100%) with psychological distress reported presenteeism. Being a train driver (adjusted odds ratio [AOR]=5.4) and having hypertension (AOR=4.03) are independent predictors for presenteeism. Conclusions: The prevalence of presenteeism and its associated risk