Advocates of making paid sick days a basic labor standard say the United States should follow all other developed countries and require businesses to let ill or injured employees miss work without docking their pay or threatening their employment. But companies argue that such a requirement could drive some of them out of business.

Sick pay has emerged in national political campaigns as the top issue affecting wage earners. But states aren't waiting for Congress to make the first move.

In Ohio, a group is trying to put the issue on the November ballot. Meanwhile, lawmakers in 12 states and the District of Columbia are expected to consider sick pay legislation. Such proposals would require that workers be allowed to miss a certain number of days each year to recover from an illness or care for a family member without a reprimand or lost wages.

U.S. businesses voluntarily provide sick days for about half of all workers. But for the other half – about 59 million – missing work because of the flu or a minor injury means lost wages and sometimes a reprimand or dismissal.

As a result, many workers show up sick, often spreading illnesses to others, said Kate Kahn, policy analyst with the National Partnership for Women & Families, which advocates for paid sick days. In addition, they send their kids to school or day care, she said.

In fact, the industries with the most employees who lack paid sick days are those with the greatest exposure to the public: hotels and food services, home health care and child care, Ms. Kahn said.

According to a 2007 report by the Association of Community Organizations for Reform Now, or ACORN, which advocates for low- and moderate-income families, 85 percent of food service workers have no paid sick days.

On the campaign trail, Democratic front-runners Hillary Rodham Clinton and Barack Obama have said they support mandatory paid sick days. In Congress, Sen. Edward Kennedy, D-Mass., vowed to call a vote this year on a bill – the Healthy Families Act – that would require businesses with 15 or more employees to give workers at least seven paid sick days per year.

But the movement faces stiff opposition from business leaders who say the requirement would drive up costs, force layoffs and put some companies out of business.

"A one-size-fits-all paid sick-leave mandate threatens employee benefits," said Maureen Ryan of the National Restaurant Association. "Mandatory paid benefits that increase small-business costs would have to be recouped elsewhere, perhaps through reduced wages or fewer paid benefits in other areas."