The global expansion of precarious employment, work disorganization, and consequences for occupational health: a review of recent research

Trend analysis of occupational accidents during 2013-2020 based on various characteristics in Turkey

BACKGROUND

This study analyzes the role of factors such as gender, age, and work experience on occupational accidents and the sectoral variations in Turkey with official statistics.

OBJECTIVE

The specific aim of this study is to provide an epidemiological basis for gender, age, sector, and professional experience-specific work-related accident prevention programs.

METHODS

Turkish Social Security Institution's official secondary dataset was considered for 2013 and later because of a change in the official calculation method of the Institution in 2013. Trend analysis was used by using the Mann-Kendall Test to determine the trend in occupational accidents based on time and work experience (month-year).

RESULTS

In the eight sectors considered between 2013 and 2020, including construction, manufacturing, transport, mining, communication, health, electricity, and agriculture, 82% of injured workers were men, with the most accidents occurring in the 25-34 age group (33%). Manufacturing had the highest number of accidents (58.5%), followed by construction (19.4%). Occupational diseases were most common in manufacturing, affecting 73% of men and 63% of women. Accidents occurred mainly in men aged 25-34 (34.2%) and women aged 35-44 (29.3%). Occupational diseases showed a positive, statistically significant trend as work experience increased (p < 0.05). A positive and statistically significant trend was detected in occupational accidents from 2013 to 2020 (Tau = 0.786, p = 0.009).

CONCLUSIONS

In countries like Turkey, where informal employment obscures occupational accidents, trend analysis helps increase their visibility. However, discovering that gender, age, and work experience are key factors in sector-specific accidents is crucial for improving safety and developing prevention programs.

Depressive Symptoms Among South African Construction Workers: Associations with Demographic, Social and Work-Related Factors, and Substance Use

The construction industry exhibits higher rates of depression in its workforce compared to other industries. This study investigates the association between the prevalence of depressive symptoms and various demographic (e.g., age, ethnicity, education), social, and work-related factors (e.g., relationship status, living environment, work situation) and behavioural factors (e.g., alcohol and drug use). Survey data collected from 496 male construction workers working in the Western Cape were analysed using binomial logistic regression to determine the associations. The results showed that 'Black African' construction workers exhibited lower levels of depressive symptoms than 'Other' ethnic groups, and workers with at least secondary education had the highest levels of depressive symptoms compared to workers with other levels of education. Workers who were single or living with other adults without children had a significantly higher risk of depression compared to those in other forms of family relationships. Substance use was found to be associated with lower levels of depressive symptoms, suggesting that construction workers use alcohol and drugs as a coping strategy for short-term depressive symptom reduction. Construction organisations should develop strategies to protect the mental health of construction workers, particularly those who are prone to depression.

Precarious employment, strenuous working conditions and the long-term risk of diagnosed chronic musculoskeletal disorders

OBJECTIVES

To investigate the effect of precarious employment (PE) on the risk of diagnosed chronic musculoskeletal disorders (MSDs) among Swedish workers in occupations with strenuous working conditions.

METHODS

This nationwide register-based cohort study included workers registered as living in Sweden in 2005, aged 21-60 at the 2010 baseline. Three samples were included: workers with high biomechanical workload (n=680 841), repetitive work (n=659 422) or low job control (n=703 645). PE was evaluated using the SWE-ROPE (2.0) construct, which includes: contractual insecurity, temporariness, multiple jobs, income and collective bargaining agreement from 2010. Three exposure groups were created: PE, substandard and standard employment (SE). MSD data were obtained from outpatient registers (2011-2020). Cox proportional-hazards models estimated crude and adjusted sex-specific HRs with 95% CIs. Various outcomes were investigated for the different samples.

RESULTS

Among workers with heavy biomechanical workload, results suggest increased risks of back MSDs in PE compared with those in SE. No association was found between PE and tendonitis in repetitive work, but PE was associated with an increased Carpal Tunnel Syndrome risk among men. Among workers with low job control, PE was associated with increased risks of soft tissue disorders among men and fibromyalgia among women.

CONCLUSIONS

PE was associated with an increased risk of MSDs among workers with strenuous working conditions, with variations depending on disorder and sex. The findings suggest a differential exposure to biomechanical workload within occupations. Targeted interventions and strengthened workplace safety regulations are needed to protect the musculoskeletal health of workers in PE.

Magnitude of self-reported non-fatal work-related injuries and associated factors among construction workers in Aleta Wondo, Sidama, Ethiopia

Ethiopia has experienced rapid urbanization over the past three decades, leading to the explosion of building construction. The job created in the construction industry of the country was hazardous due to the nature of the activities involved in the industry. However there is paucity of evidence regarding the prevalence and risk factors of injuries in the industry to make evidence-based policy framework within the country. Therefore, this study seeks to examine the magnitude of non-fatal occupational injuries and the associated factors among building construction sites workers in Aleta Wodo, Sidama, Ethiopia. An institutional based cross-sectional study was conducted in South Ethiopia from September to October 2023. The study utilized a multi-stage sampling technique to select the 613 study participants. The data was collected using a structured interviewer administered questionnaire. Epi Inf version 7.2 was used to enter data and the data was analysed using IBM-SPSS version 22. Bivariate and Multivariate logistic regression was conducted to assess association between the outcome and predictor variables. During the multivariable regression p-value less than 0.05 were taken to determine significant association. The annual prevalence of wok-place injury in the current study was 64.1% (95 CI: 60.7, 67.9). Male construction workers [AOR = 3.6, 95% CI (2.12, 6.15)], monthly income of ≤ 1000 [AOR = 4.56, 95% CI (1.56, 13.36)], 1001-3000 [AOR = 9.7, 95% CI (3.45, 27.3)], and 3001-5000 [AOR = 6.56, 95% CI (1.96, 21.9)], working more than eight hours [AOR = 7.9, 95% CI (4.36, 14.64)], drinking alcohol [AOR = 3.28, 95% CI (1.63, 6.6)] and participants unsatisfied with their job [AOR = 3.12, 95% CI (1.36, 7.16)] were significantly associated with non-fatal occupational injury. The magnitude of non-fatal occupational injury among construction workers was high in the study area. The study concluded that sex, monthly income, length of working hours, drinking alcohol and dissatisfaction with job were risk factors for occupational injuries among construction employee.

A Systematic Review of Evaluated Labor Market Initiatives Addressing Precarious Employment: Findings and Public Health Implications

Precarious employment (PE) is a major determinant of population health and contributor to health and social inequities. The purpose of this article is to synthesize and critically appraise available evidence on labor market initiatives addressing PE identified through a systematic review. Of the 21 initiatives reviewed, grouped into four categories-labor market policies, legislation, and reforms; union strategies; apprenticeships and other youth programs; social protection programs-10 showed consistently positive outcomes and 11 a combination of negative, mixed, or inconclusive outcomes. In addition to reviewing the key findings, we discuss public health implications and recommendations related to PE and the implementation and evaluation of initiatives. Given the wide diversity of initiatives, implementation approaches, evaluation methods, and socioeconomic and historical contexts characterizing the labor markets of the countries studied, we refrain from making recommendations regarding the most effective initiatives to address PE. Instead, we discuss several implications concerning the four types of initiatives to further support those searching for solutions to address PE. We strongly recommend tailoring adopted initiatives to local contexts to match a country's specific PE problems and unique labor market and socioeconomic context.

The Nature of Employment in a High Socioeconomic Hardship Community: Data From the Greater Lawndale Healthy Work Survey

OBJECTIVES

This cross-sectional survey aimed to examine employment characteristics and their associations with employment precarity in two high socioeconomic hardship Chicago neighborhoods.

METHODS

We used a community-based participatory approach to develop and administer a survey to residents who perceived their work situations to be precarious.

RESULTS

A total of 489 residents were surveyed. Responses were skewed toward the most precarious work situations, with the majority of respondents employed outside of a traditional arrangement. Those in the highest precarity category were most likely to identify as Latinx and born outside of the United States. Unstable, low-quality employment conditions were nearly all significantly associated with highest precarity work situations.

CONCLUSIONS

Precarious employment is an important predictor of other employment conditions, and characterizing these at a hyperlocal level allows for a nuanced understanding of work as a determinant of health.

Improving Identification of Gig Workers in National Health and Behavior Surveys

This paper describes the work-related information collected in several important U.S. national health and behavior surveys, to highlight data gaps that prevent identifying responses by vulnerable workers in the gig economy, with emphasis on the growing digital platform sector of the work force. The national information systems used to understand health status and health behaviors, including drug use, rely on outdated census categories for self-employed workers. This paper describes the importance of understanding the needs of this growing part of the labor sector and describes how some of the most well-known and utilized national surveys fail to meet this need. For the agencies conducting national health and behavior surveys, we propose revisions to the categories used to classify type of worker and recommend adoption of a new Worker-Employer Relationship Classification model.

Practices and challenges of safety management in outsourced facilities management

INTRODUCTION

Outsourcing is a commonly occurring organizational activity, but one associated with negative occupational safety outcomes. Improving the management of safety in workplaces where contractors are employed is vital, but under-researched in the service sectors. The aims of this paper were to investigate both the practices and challenges of safety management in outsourced facility management (FM), an important global service sector.

METHOD

Twenty-three semi-structured interviews were conducted with clients and contractors in three different FM outsourcing arrangements between large corporations in the UK. Data were thematically coded against frameworks derived from existing literature to identify deployed safety management practices and reveal challenges associated with safety management in these outsourced relationships.

RESULTS

Safety management practices in outsourced FM conformed to known practices clustering into four previously identified categories (planning, selecting, on-site working, and checking). A fifth category (reviewing) was not observed. Operating across national boundaries, applying national contracts locally, working with mandated KPIs, and contract specifications all created new challenges for safety management not previously reported. Other known challenges associated with economic pressure and disorganization were observed.

CONCLUSION

Safety management practices observed in safety critical industries also apply in FM. However, the challenges of safety management in these three cases included regulatory failures that have not been routinely identified in other empirical studies of safety in outsourcing arrangements.

PRACTICAL APPLICATION

Adopting widely accepted safety management practices support safer working in outsourced FM and encourage cross-sector learning. New challenges for safety management noted here encourage consideration of unintended consequences of contract terms and conditions, require corporate agreement on how to ensure safety compliance when working transnationally, and a review of decision-making and processes and procedures to enable effective and safe working locally.

Beyond boundaries: The mechanisms by which host organizations' safety climates impact on-site contractors' safety and retention

INTRODUCTION

Despite growing concerns over safety risks associated with on-site contractors in high-risk industries, little research has examined how host organizations affect their safety. Drawing from the open systems perspective, this study investigated the influence of host organizations' safety climates on on-site contractor employees' safety and job attitudes.

METHOD

The study used multi-level structural equation modeling (MSEM) to test hypothesized relationships among variables with survey data collected from 1,720 employees of 68 on-site contractor organizations and 3,205 employees of six host organizations.

RESULTS

At the organization-level, host organizations' safety climates were associated with their on-site contractor employees' safety behaviors, job attitudes, and injuries, and these effects were mediated by the safety climate of the on-site contractor organizations.

CONCLUSIONS

This study demonstrates that the safety climates of host organizations can extend to their on-site contractor organizations. Therefore, fostering a positive safety climate not only benefits the host organizations themselves but also creates a crucial environmental cue that shapes the safety climate and outcomes of on-site contractors.

PRACTICAL APPLICATIONS

Leading by example and fostering a positive safety climate within the organization are effective ways for a host organization to ensure the safety of its on-site contractors.

Is precarious employment an occupational hazard? Evidence from Ontario, Canada

OBJECTIVES

To examine the association between precarious employment and risk of occupational injury or illness in Ontario, Canada.

METHODS

We combined accepted lost-time compensation claims from the Workplace Safety and Insurance Board with labour force statistics to estimate injury and illness rates between January 2016 and December 2019. Precarious employment was imputed using a job exposure matrix and operationalised in terms of temporary employment, low wages, irregular hours, involuntary part-time employment and a multidimensional measure of 'low', 'medium', 'high' and 'very high' probabilities of exposure to precarious employment. Negative binomial regression models examined exposure to precarious employment in relation to risk of occupational injury or illness.

RESULTS

After adjusting for age, sex and year, all indicators of precarious employment were associated with increased risk of injury or illness. Workers with 'high' and 'very' high' exposure to precarious employment presented a nearly threefold risk of injury or illness (rate ratio (RR): 2.81, 95% CI 2.73 to 2.89; RR: 2.82, 95% CI 2.74 to 2.90). Further adjustment for physical demands and workplace hazards attenuated associations, though a statistically and substantively significant exposure-outcome relationship persisted for workers with 'high' and 'very high' exposures to precarious employment (RR: 1.65, 95% CI 1.58 to 1.72; RR: 2.00, 95% CI 1.92 to 2.08).

CONCLUSIONS

Workers exposed to precarious employment are more likely to sustain a lost-time injury or illness in Ontario, Canada. Workplace health and safety strategies should consider the role of precarious employment as an occupational hazard and a marker of work injury risk.

Data profile: the Korean Workers' Compensation-National Health Insurance Service (KoWorC-NHIS) cohort

The Korean Workers' Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers' compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.

Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol

INTRODUCTION

Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada.

METHODS AND ANALYSIS

This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression.

ETHICS AND DISSEMINATION

This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.

Atherogenic Index as a Cardiovascular Biomarker in Mexican Workers from Marginalized Urban Areas Occupationally Exposed to Metals

BACKGROUND

Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants.

AIM

This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk.

METHODS

A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices.

RESULTS

The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367).

CONCLUSIONS

Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.

The Struggle to Regulate Precarious Work Arrangements to Minimize Their Adverse Effects on Health and Safety in Australia

As in other countries, the growth of precarious work arrangements in Australia from the late 1970s has had significant adverse effects on occupational health and safety (OHS). While there is now a large body of global research on this issue and its connection to the rise of neoliberalism, there has been less investigation of efforts to address these problems. This article reviews regulatory interventions in Australia over the past two decades. It particularly focuses on industrial relations regulation, which can play a critical role in addressing at least some of the underlying reasons why precarious work undermines OHS. The most significant of these changes were passed by the Australian Parliament in February 2024, including a highly controversial but world-leading creation of minimum standards for platform workers.

Long-Term Health Effects of Work Trajectories Among Middle-Aged and Older Adults: The Mediating Role of Work, Material, and Social Environments

Using data from 14 waves (2003-2016) of the Korean Labor and Income Panel Study (KLIPS) (N = 1,627 individuals aged 45-64; 22778 observations), in this study, we conducted sequence analysis and a multi-categorical variable mediation analysis (1) to examine to what extent long-term work histories exhibit varying degrees of de-standardization and precariousness using sequence analysis (2) to explore the potential mediating effects of work, material, and social environments in the association between multiple work sequences and self-rated health. We found the coexistence of a relatively stable long-term employment pattern and a high prevalence of precariousness. The health and economic risks of precarious work fall disproportionately on older workers. Future researchers should continue to analyze whether the COVID-19 pandemic will lead to long-term changes in the workforce to improve our understanding of and response to working in later life and its health effects.

The future of work in shaping the employment inclusion of young adults with disabilities: a qualitative study

Purpose –

The world of work is changing and creating challenges and opportunities for the employment inclusion of young people with disabilities. In this article, the perceptions held by young adults with disabilities regarding participation in the future of work are examined.

Design/methodology/approach –

One-on-one interviews were conducted with Canadian young adults (ages 18-36 years) living with a disability. Participants were asked about their thoughts regarding the impact of the changing nature of work on their labor market involvement and career aspirations. A thematic analysis was performed to identify and examine emergent salient themes.

Findings –

In total, 22 young adults were interviewed; over half held secure employment. Career aspirations and work-related decisions were primarily shaped by a participant's health needs. The future of work was seen as a more proximal determinant to employment. Digital technologies were expected to impact working conditions and create barriers and facilitators to employment. Participants who indicated being securely employed held positive expectations regarding the impact of digital technology on their work. Participants working precariously held negative appraisals regarding the impact of digital technologies on employment opportunities. The role of technological and soft skills was critical to participating in a labor market reliant on advanced technology. Participants reported barriers to developing job skills related to their disability and their work arrangements.

Originality/value –

This research highlights the importance of considering changes in the future of work, especially the digital transformation of the economy, in the design of initiatives which promote the employment inclusion of young adults with disabilities. Despite the significance of the changing nature of work, supporting health needs and encouraging access to secure work arrangements also remain paramount.

Development and maturation of the occupational health services research field in the United States over the past 25 years: Challenges and opportunities for the future

Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.

Precarious employment and associated health and social consequences; a systematic review

OBJECTIVE

This systematic review aims to identify, evaluate, and summarise the consequences of precarious employment.

METHODS

We included studies published within the last ten years (Jan 2011-July 2021) that employed at least two of three key dimensions of precarious employment: employment insecurity, income inadequacy, and lack of rights and protection.

RESULTS

Of the 4,947 initially identified studies, only five studies met our eligibility criteria. These five studies were of moderate quality as assessed by the Newcastle-Ottawa Scale. Our review found that the current literature predominantly defines precarity based on the single criterion of employment insecurity. Our review identified evidence for the negative consequences of precarious employment, including poorer workplace wellbeing, general health, mental health, and emotional wellbeing. The findings indicated an increase in the magnitude of these adverse outcomes with a higher degree of job precariousness.

CONCLUSIONS

The rise of employment precariousness will likely continue to be a major issue in the coming years. More research is needed to inform effective policies and practices using a consensus definition of precarious employment.

IMPLICATIONS FOR PUBLIC HEALTH

The presence of adverse effects of precarious employment suggests workplace initiatives are essential to mitigate the negative consequences of precarity.

Health effects of informal precarious workers in occupational environments with high exposure to pollutants

The aim is to investigate and describe the health conditions of workers who are employed in precarious work settings in Mexico. Specifically, the study aims to provide insight on the health status of workers who are vulnerable due to the informal nature of their employment. Through the evaluation of three different scenarios of precarious employment (n = 110), including workers in mercury miner (workers A), brick-kilns (workers B), and quarries workers (workers C). The study analyzes clinical parameters to determine the workers' renal health condition and assesses their pulmonary function using spirometry. Multivariate analyses and Spearman correlation are performed to determine the contribution of length of service to workers' health parameters. Workers B have the highest incidence of clinical health alterations, with the highest BMI and prediabetes/diabetes index, albumin creatinine ratio, and eGFR. Moreover, pulmonary function parameters show a decrease in %FEV1/FVC in workers B and C compared to workers A, while workers A demonstrate a more significant decrease in %FEV1. Additionally, a negative correlation is observed between the length of service in precarious work settings and lung parameters (r = -0.538, p < 0.001). In conclusion, this study highlights the need to address the issue of precarious employment in Mexico by improving working conditions, access to healthcare and promoting social protection for workers, which can reduce the number of work-related illnesses and deaths and ensure the safety and health of workers.

Precarious employment and occupational injuries in Sweden between 2006 and 2014: a register-based study

BACKGROUND

Precarious employment (PE) has been suggested as a risk factor for occupational injuries (OIs). However, several issues such as under-reporting and time at risk pose obstacles to obtaining unbiased estimates of risk OBJECTIVE: To investigate if PE is a risk factor for OIs in Sweden.

METHODS

This register-based study included employed workers aged 18-65, resident in Sweden between 2006 and 2014. PE was operationalised as a multidimensional construct (score) and by its five items (contract insecurity, contractual temporariness, multiple jobs/multiple sectors, income level, collective bargaining agreement). Our outcome was OI in the following year. Pooled ORs for OIs in relation to PE and PE items were calculated by means of multivariate logistic regression models for women and men separately.

RESULTS

Precarious workers were at lower risk of OIs as compared with non-precarious workers among both males and females (OR <1) also when applying weights for under-reporting and adjusting for time at risk (part-time work). Male agencies workers had a higher risk of OIs (OR 1.19, 95% CI 1.15 to 1.23), as did male and female workers in multiple jobs/sectors (OR 1.25, 95% CI 1.23 to 1.28 and OR 1.10, 95% CI 1.07 to 1.13 respectively), and female workers in the low-income groups (OR 1.11, 95% CI 1.09 to 1.12). Low coverage of collective bargaining agreements was associated with a lower risk of OIs for both men and women (OR 0.30, 95% CI 0.29 to 0.31 and OR 0.26, 95% CI 0.24 to 0.27, respectively).

CONCLUSIONS

While several mechanisms may explain why precarious workers in Sweden present lower risks of OIs, several dimensions of PE such as temp agency work and multiple job-holding could be important risk factors for OIs and merit further research.

Late-Career Employment Trajectories and Postretirement Mortality: Evidence From Italy

In the last decades, the long-standing paradigm of life course theory postulating direct transition from lifetime employment to full retirement has been eroding in advanced economies. For many mature workers, the period between the end of stable employment and the attainment of eligibility requirements for accessing retirement benefits can be, in fact, quite discontinuous. Still, little is known about the health consequences of employment instability in later working life. This study addresses this issue by examining how late-career employment trajectories shape postretirement all-cause mortality. I use longitudinal register data from Italy to reconstruct the later-life employment history of a large sample of Italian retirees previously employed in the private sector for whom I can observe mortality up to 2018. I rely on sequence analysis to identify ideal-type, late-career trajectories and use them as further inputs for discrete-time survival analysis. Results show that going through a trajectory marked by employment instability in later working life is related to worse postretirement survival chances, with this relationship being stronger if unemployment spells are prolonged and not covered by social allowances. Given the current pressures to extend the length of working life, these findings highlight the relevance of policies aimed at improving the employment prospects of displaced senior workers and at ensuring adequate support in case of prolonged unemployment.

The Emergence of Precarious Employment as a Determinant of Health in Europe and the Relevance of Contextual Factors: A Critical Research Synthesis

Precarious employment as a determinant of health remains on the rise in Europe, in contrast to the European Pillar of Social Rights. Research in epidemiology, public health, and occupational health research has debated the health impacts of precarious employment. A number of studies have concluded that precarious employment contributes to poor health. More recent research has focused on the contextual influences of the association between precarious employment and health. Accordingly, we argue that the welfare state and the specific institutional arrangements on the national level determine and mediate the extent of the association between precarious employment and health. This research synthesis: (a) debates explanations for the rise of precarious employment in Europe, (b) illustrates how precarious employment has risen in Europe since the 1980s, (c) indicates empirical findings of the association between precarious employment and health in Europe, (d) discusses how research explains between-country differences of the association between precarious employment and health, and (e) presents empirical findings on the contextual determinants of the association between precarious employment and health in Europe.

Employment Precarity and Increased Risk of Hazardous Occupational Exposures Among Residents of High Socioeconomic Hardship Neighborhoods

BACKGROUND

While there is evidence that workers in nonstandard employment arrangements are disproportionately exposed to recognized occupational hazards, existing studies have not comprehensively examined associations between employment precarity and exposure to occupational hazards for these workers in the USA. The aim of this study was to examine relationships between employment precarity and occupational hazards in two contiguous high socio-economic hardship neighborhoods in Chicago.

METHODS

Using a community-based participatory research approach, community researchers administered a community-developed survey to 489 residents of Greater Lawndale who reported current or recent employment in a job that met at least one characteristic of precarious employment (e.g. unpredictable schedule, insecure work, no living wage/benefits). Employment precarity was calculated using a modified version of the Employment Precarity Index (EPI) developed by the Poverty and Employment Precarity in Southern Ontario group. We modeled the association between employment precarity and occupational exposures using logistic regression models.

RESULTS

We identified a high prevalence of precarious employment in this sample, as well as a high prevalence of self-reported exposure to recognized occupational hazards. Increases in relative employment precarity were significantly associated with self-reported exposure to chemical and biological hazards, physical hazards, and slip, trip, strike, fall, trap or crush hazards at work.

CONCLUSIONS

Results highlight the importance of using community research approaches and robust measures of employment characteristics, such as the EPI, to evaluate associations between employment precarity and hazardous exposures. These results suggest that variability in employment situations and resultant relative employment precarity are important predictors of exposure to recognized occupational hazards. Findings also suggest that health inequities observed among precariously employed workers may be partly explained by increased risk for exposure to occupational hazards, which has implications for community health and should be investigated in future longitudinal research.

Flexible working and its relations with work-life conflict and well-being among crowdworkers in Germany

BACKGROUND

New forms of digital work such as crowdwork promise to increase potentials for flexible working. As crowdworkers can work highly autonomous and from anywhere at any time via the internet, they may be able to make work and private demands more compatible and avoid role conflicts between the life spheres, and in turn, experience enhanced well-being.

OBJECTIVE

This research asked whether crowdworkers benefit from flexible working potentials. It investigated the association of the use of different dimensions of flexible working (flex-time, flex-place, and task autonomy) in crowdwork with work-life conflict and well-being. Moreover, it explored whether the relationship between flexible working and well-being was mediated by work-life conflict.

METHODS

The study drew upon a sample of 470 crowdworkers from a cross-sectional self-assessment survey on four different German crowdwork platforms. Structural equation modeling was conducted to estimate the effects of flexible working on work-life conflict, somatic health symptoms, and life satisfaction. Indirect effects were estimated to test the mediation hypothesis.

RESULTS

The findings suggest that if crowdworkers use temporal and task flexibility, they experience fewer work-life conflict, fewer somatic health symptoms, and greater life satisfaction. This does not apply to flex-place. The relationship between flexible working and well-being is partly mediated by work-life conflict experiences.

CONCLUSION

This study supports that crowdwork offers a high potential for working highly autonomous and flexibly in time and place. It is associated with lower levels of work-life conflict and enhanced well-being, but the benefits of this flexibility are not universally included in crowdwork.

Adapting, adopting, and advancing change: A framework for future research in the psychology of occupational safety

INTRODUCTION

While there are numerous reviews of the research on the psychology of occupational safety, these studies provide weak guidance on where the research should go next. Accordingly, we introduce a simple framework for thinking about future research in this area: the adapting, adopting, and advancing change framework. This framework summarizes how external, technological, and theoretical developments have driven research in the psychology of occupational safety and uses these observations as evidence to imagine ways in which they may continue to do so.

METHOD

We critically reviewed seminal research in the psychology of occupational safety using the adapting, adopting, and advancing change framework. Adapting to change means considering external changes such as the fluctuating nature of work and the labor market. Adopting change refers to incorporating the latest technological and technical advances to facilitate more robust research methods and analyses. Finally, advancing change refers to theoretical advances and how they will push psychology of occupational safety research forward.

RESULTS

We highlight several avenues for future research that emerge at the convergence of the framework's three themes, including developing the safety skill construct, assessing variation in demand appraisals on safety outcomes, distinguishing safety climate from related constructs, and examining safety constructs that are usually considered as outcomes (e.g., injuries) as predictors instead.

CONCLUSIONS

In doing so, we provide a clear structure to help researchers better identify the most effective directions for future research on the psychology of occupational safety.

Dualized Labor Market and Polarized Health: A Longitudinal Perspective on the Association between Precarious Employment and Mental and Physical Health in Germany

This study analyzes the longitudinal association between precarious employment and physical and mental health in a dualized labor market by disaggregating between-employee and within-employee effects and considering mobility in precariousness of employment. Analyses were based on the German Socio-Economic Panel from 2002 to 2018 considering all employees ages 18 to 67 years (n = 38,551). Precariousness of employment was measured as an additive index considering working poverty, nonstandard working time arrangements, perceived job insecurity, and low social rights. Health outcomes were mental and physical health. Random effects models were used and controlled for sociodemographic and socioeconomic variables. Results indicated that the association between precariousness of employment and mental and physical health is mainly based on between-employee differences and that prolonged precariousness of employment or upward or downward mobility are associated with poor health. We found evidence of polarization in health by precariousness of employment within a dualized labor market.

Occupational Safety and Health Staging Framework for Decent Work

The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.

Non-Standard Employment and Unemployment during the COVID-19 Crisis: Economic and Health Findings from a Six-Country Survey Study

The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health protection during the pandemic, or more specifically, to examine several links between non-standard employment, unemployment, economic, health, and safety outcomes during the COVID-19 pandemic in Sweden, Belgium, Spain, Canada, the United States, and Chile, based on an online survey conducted from November 2020 to June 2021. The study focused on both non-standard workers and unemployed workers and examined worker outcomes in the context of current type and duration of employment arrangements, as well as employment transitions triggered by the COVID-19 crisis. The results suggest that COVID-19-related changes in non-standard worker employment arrangements, or unemployment, are related to changes in work hours, income, and benefits, as well as the self-reported prevalence of suffering from severe to extreme anxiety or depression. The results also suggest a link between worker type, duration of employment arrangements, or unemployment, and the ability to cover regular expenses during the pandemic. Additionally, the findings indicate that the type and duration of employment arrangements are related to the provision of personal protective equipment or other COVID-19 protection measures. This study provides additional evidence that workers in non-standard employment and the unemployed have experienced numerous and complex adverse effects of the pandemic and require additional protection through tailored pandemic responses and recovery strategies.

The Path from Survey Development to Knowledge Activism: A Case Study of the Use of a Physical Loads Survey in a Retail Workplace

Workers at a multi-site retailer were concerned that they were experiencing higher than anticipated work-related musculoskeletal disabilities (MSDs). They approached union leadership and academic researchers and a Participatory Action Research (PAR) project was developed which culminated in a targeted online Physical Loads Survey (PLS). The goal was to initiate discussions to design a preventative collaborative ergonomic program. Survey results confirmed that during a shift, workers had significant exposure to standing, carrying loads of more than 25 lbs, pushing and pulling loads greater than 225 lbs, and repetitive arm and hand movements. The successful survey was the first step in the development of a proactive health and safety program. The union proceeded without management participation and was able to move beyond knowledge creation to knowledge activism and change.

Gereizt und grübelnd?

Zusammenfassung. Die Studie untersucht, welche Merkmale eines Veränderungsprozesses einen Einfluss auf die psychische Beanspruchung der Beschäftigten (kognitive und emotionale Irritation) ausüben und inwiefern diese Zusammenhänge durch Sozialkapitalfaktoren moderiert werden. Als Merkmale des Veränderungsprozesses werden Ausmaß und Nutzen der Veränderungen für die Arbeitseinheit, die Auswirkungen der Veränderungen auf den eigenen Arbeitsplatz sowie der Umfang der Beteiligung am Veränderungsprozess betrachtet. Befragt wurden Beschäftigte einer Organisation, die sich zum Befragungszeitpunkt in einem umfassenden, langfristigen Veränderungsprozess befunden hat (Vollerhebung, n = 219). Die Ergebnisse zeigen, dass sich bestimmte Merkmale eines Veränderungsprozesses bedeutsam auf die psychische Beanspruchung der Beschäftigten auswirken. Die Moderatorenanalysen bestätigen, dass positiv empfundene Mitarbeiterführung (Führungskapital) und ein gutes Beziehungsklima (Netzwerkkapital) die Irritation bei denjenigen abpuffern können, bei denen der Veränderungsprozess besonders große Auswirkungen auf den eigenen Arbeitsplatz hat. Außerdem zeigt sich, dass positiv empfundene Organisationskultur sowie Mitarbeiterführung die Irritationen bei denjenigen abpuffern können, die den konkreten Veränderungsprozess als wenig nützlich empfinden.

Precarious Work as Risk Factor for 5-Year Increase in Depressive Symptoms

Objectives: The aim was to investigate the longitudinal relationship between precarious work and depressive symptoms in a representative cohort of employees in Germany. Methods: In the German Study on Mental Health at Work (S-MGA) (n = 2009), depressive symptoms were assessed by the Patient Health Questionnaire (PHQ−9). Precarious work was measured through baseline (2012) self-reported job insecurity, marginal part-time, fixed-term contract, hourly wage and—during follow-ups 2012–2017—unemployment. Among employees without depressive symptoms at baseline (2012), we ran logistic regression analyses stratified by gender with depressive symptoms at follow-up in 2017 as the dependent variable, adjusting for baseline (2012) age, gender, socioeconomic position and partner status. Results: Among men, job insecurity (OR: 2.47; 95% 95% CI: 1.37–4.48) and low wage (3.79; 1.64–8.72) at baseline were significantly associated with depressive symptoms at follow-up. Among women, indicators of precarious work were not associated with depressive symptoms at follow-up. Among men, a cumulative exposure index of precarious work was significantly associated with the development of depressive symptoms (one indicator: 1.84; 0.94–3.60, ≥two indicators: 7.65; 3.30–17.73). This index was not associated with depressive symptoms among women. The population attributable fraction of precarious work due to depressive symptoms among men was approximately 30%. Conclusions: Among employees in Germany, precarious work seems to be a risk factor for the subsequent development of depressive symptoms among men, but not among women. Research on precarious employment in different countries is needed.

Flexible, Self-Determined… and Unhealthy? An Empirical Study on Somatic Health Among Crowdworkers

Crowdwork is a new form of digitally enabled work in which organizations assign tasks to an anonymous group of workers via platform intermediaries. For crowdworkers, crowdwork offers both opportunities and risks. On the one side, crowdworkers enjoy high flexibility on when, where, and how much to work. On the other side, risks comparable to other forms of atypical employment arise: no labor regulation, unstable income, and uncertainty about whether enough tasks are available. Regulation of working hours lies within the crowdworkers’ own authority. Also, crowdwork in industrialized nations is often conducted during leisure times as a side-job to some other kind of employment. In accordance with Conservation of Resources Theory, we state that when leisure time gets used up with crowdwork, regeneration cannot occur and health declines. On a sample of N=748 German crowdworkers recruited from four different platform types, we analyzed whether participation in crowdwork is linked to increased somatic symptoms compared to regularly employed personnel. We found that crowdworkers show significantly increased somatic symptoms as compared to a German norm sample, that are stable across different kinds of tasks and platforms, gender, and age groups, and that is statistically due to the extent of participation in crowdwork. Specifically, we found that total work hours per week were not associated with an increase in somatic symptoms, but we did find associations with strain-based work–family conflict and the primary motivation to do crowdwork being to earn money. Consequences for research and labor regulations are discussed.

Precarious employment and health in the context of COVID-19: a rapid scoping umbrella review

BACKGROUND

There are widespread concerns that workers in precarious employment have suffered the most in the COVID-19 pandemic and merit special attention. The aim of this rapid scoping umbrella review was to examine what evidence exists about how COVID-19 has affected the health of this highly vulnerable group, and what gaps remain to be investigated.

METHODS

Five databases were searched for systematic or scoping reviews from January 2020 to May 2021. The quality of the included reviews was determined using A MeaSurement Tool to Assess systematic Reviews.

RESULTS

We identified 6 reviews that reported 30 unique relevant primary studies. The included studies indicate that essential (non-health) workers are at greater risk of COVID-19 infection and case fatality than others in their surrounding community. The occupational risk of exposure to COVID-19 also seems to be greater among more precarious categories of workers, including younger workers and workers in low-income and low-skilled occupations. Further, hazardous working conditions faced by many essential workers appear to have amplified the pandemic, as several occupational sites became 'super-spreaders', due to an inability to socially distance at work and high contact rates among workers. Finally, employment and financial insecurity generated by the pandemic appears to be associated with negative mental health outcomes. The quality of the included reviews however, and their primary studies, were generally weak and many gaps remain in the evidence base.

CONCLUSIONS

Our study highlights that COVID-19 is creating new health risks for precarious workers as well as exacerbating the pre-existing health risks of precarious employment.

Community Resident Perceptions of and Experiences with Precarious Work at the Neighborhood Level: The Greater Lawndale Healthy Work Project

Work is a key social determinant of health. Community health and well-being may be impacted in neighborhoods with high proportions of people engaged in precarious work situations compounded by health inequities produced by other social determinants associated with their residential geography. However, little is known about how community residents experience work at the neighborhood level nor how work impacts health at the community-level, particularly in communities with a high proportion of residents engaged in precarious work. We sought to understand, through participatory research strategies, how work is experienced at the community level and to identify community interventions to establish a culture of healthy work. As part of a mixed-methods community health assessment, community researchers conducted focus groups with residents in two high social and economic hardship neighborhoods on Chicago’s southwest side. Community and academic researchers engaged in participatory data analysis and developed and implemented member-checking modules to engage residents in the data interpretation process. Twelve focus group discussions (77 community resident participants) were completed. Three major themes emerged: systematic marginalization from the pathways to healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. Findings were triangulated with findings from the concept-mapping research component of the project to inform the development of a community health survey focused on work characteristics and experiences. Listening to residents in communities with a high proportion of residents engaging in precarious work allows for the identification of nuanced community-informed intervention points to begin to build a culture of healthy work.

Under-reporting of non-fatal occupational injuries among precarious and non-precarious workers in Sweden

Background

Under-reporting of occupational injuries (OIs) among precariously employed workers in Sweden challenges effective surveillance of OIs and targeted preventive measures.

Objective

To estimate the magnitude of under-reporting of OIs among precarious and non-precarious workers in Sweden in 2013.

Methods

Capture–recapture methods were applied using the national OIs register and records from a labour market insurance company. Employed workers 18–65 resident in Sweden in 2013 were included in the study (n=82 949 OIs). Precarious employment was operationalised using the national labour market register, while injury severity was constructed from the National Patient Register. Under-reporting estimates were computed stratifying by OIs severity and by sociodemographic characteristics, occupations and precarious employment.

Results

Under-reporting of OIs followed a dose–response pattern according to the levels of precariousness (the higher the precarious level, the higher the under-reporting) being for the precarious group (22.6%, 95% CI 21.3% to 23.8%), followed by the borderline precarious (17.6%, 95% CI 17.1% to 18.2%) and lastly the non-precarious (15.0%, 95% CI 14.7% to 15.3%). Under-reporting of OIs, decreased as the injury severity increased and was higher with highest level of precariousness in all groups of severity. We also observed higher under-reporting estimates among all occupations in the precarious and borderline precarious groups as compared with the non-precarious ones.

Conclusions

This is the first register-based study to empirically demonstrate in Sweden that under-reporting of OIs is 50% higher among precariously employed workers. OIs under-reporting may represent unrecognised injuries that especially burden precariously employed workers as financial, health and social consequences shift from the employer to the employee.

Employment status and mortality among Korean men over a 13-year period

OBJECTIVES

This study explored the effect of employment status on mortality over a 13-year period in Korean men.

METHODS

Data were used from the Korean Labor and Income Panel Study from 1999 to 2012. This study started with 2,737 subjects and included employed men in good health, aged 30-69 years. Deaths were tracked for 13 years from 2000 to 2012. Employment status classifications were: (1) regular employees, (2) precarious employees, (3) petty bourgeoisie, and (4) employers. Hazard ratios (HRs) were calculated using a Cox proportional hazards model, and were adjusted for age, education, income, and occupation, with regular employees as the reference category. To examine the effect of employment status and include employment history, the risk ratios of mortality were measured using the Poisson regression model, considering the duration of each employment and using 0 years as the reference category.

RESULTS

Over the course of the 13-year study, being a precarious employee (HR, 1.84) or petty bourgeoisie (HR, 1.87) at a particular point in time had a negative effect on mortality when compared with regular employees. Furthermore, working as precarious employees or petty bourgeoisie had no positive effect on mortality. A positive effect was observed, however, on the overall mortality risk for regular employees.

CONCLUSIONS

These results suggest that a healthy social policy is needed for precarious employees and petty bourgeoisie to avoid disadvantages in the workplace and the social safety net.

Sense of security when new at work: a thematic analysis of interviews with young adult retail workers in Sweden

Purpose

Positive examples of situations in which young adults new at work experience feeling secure in the role as novice in the work force are here focused. The aim is to analyze how young adults who are new to the labor market express having a sense of security in the workplace. The long-term goal is to strengthen the conditions for the health and wellbeing of workers entering the retail labor market.

Design/methodology/approach

Thirteen individual in-depth telephone/video-interviews were conducted with young adults (aged 18–28) working within the retail sector in Sweden. Using a thematic interview schedule, the interviews focused how the interviewees contextualizing stories on being novice at the labor market. The study is based on those parts of the material in which stories on feeling secure was expressed.

Findings

The analysis resulted in two themes: A sense of security is related to carrying out work safely and a sense of security is related to receiving support. The first theme illuminates how work is structured and safety training respectively contributes to a sense of security and the latter reveal how social support from a variety of sources (managers, colleagues and others outside the work environment) contributes to a sense of security when new at work.

Originality/value

Using a health promoting perspective, the study complements the existing perspectives of challenges faced by novices as they enter working life. Also, the study highlights the importance of including relations outside the workplace when searching for the understanding of the experiences of being new at work. The study indicates that focusing on the sense of security by well-structured work, safety training and social support might contribute to the strive for a sustainable working life for young adults.

The role of nonstandard and precarious jobs in the well-being of disabled workers during workforce reintegration

BACKGROUND

Nonstandard employment arrangements are becoming increasingly common and could provide needed flexibility for workers living with disabilities. However, these arrangements may indicate precarious employment, that is, employment characterized by instability, powerlessness, and limited worker rights and benefits. Little is known about the role of nonstandard and precarious jobs in the well-being of disabled persons during workforce reintegration after permanent impairment from work-related injuries or illnesses.

METHODS

We used linked survey and administrative data for a sample of 442 Washington State workers who recently returned to work and received a workers' compensation permanent partial disability award after permanent impairment from a work-related injury. Multivariable logistic regression models were used to examine associations between nonstandard employment and outcomes related to worker well-being and sustained employment. We also examined associations between a multidimensional measure of precarious employment and these outcomes. Secondarily, qualitative content analysis methods were used to code worker suggestions on how workplaces could support sustained return to work (RTW).

RESULTS

Workers in: (1) nonstandard jobs (compared with full-time, permanent jobs), and (2) precarious jobs (compared with less precarious jobs) had higher adjusted odds of low expectations for sustained RTW. Additionally, workers in precarious jobs had higher odds of reporting fair or poor health and unmet need for disability accommodation. Workers in nonstandard and precarious jobs frequently reported wanting safer and adequately staffed workplaces to ensure safety and maintain sustained employment.

CONCLUSIONS

Ensuring safe, secure employment for disabled workers could play an important role in their well-being and sustained RTW.

Initiatives addressing precarious employment and its effects on workers' health and well-being: a protocol for a systematic review

BACKGROUND

Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers' exposure to precarious employment conditions and its effects on the health and well-being of workers and their families.

METHODS

The electronic databases searched (from January 2000 onwards) are Scopus, Web of Science Core Collection, and PubMed, along with three institutional databases as sources of grey literature. We will include any study (e.g. quantitative, qualitative, or mixed-methods design) evaluating the effects of initiatives that aim to or have the potential to address workers' exposure to precarious employment or its effects on the health and well-being of workers and their families, whether or not such initiatives were designed specifically to address precarious employment. The primary outcomes will be changes in (i) the prevalence of precarious employment and workers' exposure to precarious employment and (ii) the health and well-being of precariously employed workers and their families. No secondary outcomes will be included. Given the large body of evidence screened, the initial screening of each study will be done by one reviewer, after implementing several strategies to ensure decision-making consistency across reviewers. The screening of full-text articles, data extraction, and critical appraisal will be done independently by two reviewers. Potential conflicts will be resolved through discussion. Established checklists will be used to assess a study's methodological quality or bias. A narrative synthesis will be employed to describe and summarize the included studies' characteristics and findings and to explore relationships both within and between the included studies.

DISCUSSION

We expect that this review's findings will provide stakeholders interested in tackling precarious employment and its harmful health effects with evidence on effectiveness of solutions that have been implemented to inform considerations for adaptation of these to their unique contexts. In addition, the review will increase our understanding of existing research gaps and enable us to make recommendations to address them. Our work aligns with the sustainable development agenda to protect workers, promote decent work and economic growth, eliminate poverty, and reduce inequalities.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020187544 .

Impacts of the COVID-19 pandemic on health, financial worries, and perceived organizational support among people living with disabilities in Canada

BACKGROUND

Individuals with physical or mental health disabilities may be particularly vulnerable to the impact of COVID-19 on their health and employment.

OBJECTIVES

We examined COVID-19-related concerns for health, finances, and organizational support among workers with no disability, a physical, mental health, or both physical and mental health disability, and factors associated with COVID-19 perceptions.

METHODS

An online, cross-sectional survey was administered to a sample of Canadians in the first wave of the COVID-19 pandemic. Questions asked about COVID-19 perceptions, demographics (gender, age, education), work context (e.g., sector, contract work) and employment conditions (e.g., job stress, control, accommodation needs). Descriptive, multivariable, and nested regression analyses examined factors associated with COVID-19 perceptions.

RESULTS

A total of 3066 participants completed the survey. Workers with both a physical and mental health disability reported significantly greater health and financial concerns and less organizational support than those with no disability. Workers with a physical disability reported more health concerns and those with a mental health disability reported more financial concerns and less organizational support. Respondents with disabilities also reported significant differences in employment conditions (e.g., more contract work, stress, unmet accommodation needs) than those with no disability. Employment conditions were consistently significant predictors of COVID-19 perceptions and attenuated the significance of disability type in analyses.

CONCLUSIONS

Concerns about the impact of COVID-19 on one's health, finances, and organizational support reflected existing disability inequities in employment conditions and highlight the importance of creating more inclusive employment opportunities for people living with physical and mental health disabilities.

Factors Related to Physical and Mental Health in Workers With Different Categories of Employment

INTRODUCTION

We examined a large representative sample of workers in South Korea to compare the subjective well-being and musculoskeletal symptoms of those with standard employment and those with non-standard employment (temporary, daily, and part-time work).

METHODS

This was a secondary analysis of data from the fifth Korean Working Condition Survey, conducted in 2017.

RESULTS

Female part-time workers who had temporary and daily jobs were more likely to have poor subjective well-being, whereas female regular workers with part-time jobs were less likely to have poor subjective well-being than regular workers with full-time jobs. Daily workers of both sex with full-time jobs were more likely to have musculoskeletal pain than regular workers.

CONCLUSION

Our characterization of workers with precarious employment indicated that several modifiable factors affected the subjective well-being and musculoskeletal symptoms of these workers.

Analysis of urinary metabolites of polycyclic aromatic hydrocarbons in precarious workers of highly exposed occupational scenarios in Mexico

Exposure to polycyclic aromatic hydrocarbons (PAHs) is a risk factor for human health. Workers are a vulnerable group due to their high exposure and therefore require special attention to mitigation measurements; however, some groups of workers are especially vulnerable, precarious workers. The objective of this research was to evaluate mixtures of hydroxylated PAHs (OH-PAHs) in precarious workers in Mexico. The following activities were evaluated: (i) brickmakers (TER), stonemasons (ESC), indigenous workers (TOC) and mercury miners (CAM). Ten OH-PAHS were analyzed: 1-hydroxynaphtalene and 2-hydroxynaphtalene; 2-,3- and 9-hydroxyfluorene; 1-,2-,3- and 4-hydroxyphenanthrene; and 1-hydroxypyrene in urine by GC-MS, chemical fingerprints of the sites were established by multivariate analysis. One hundred forty-nine precarious workers participated in the study. The populations presented total OH-PAHs concentrations of 9.20 (6.65-97.57), 14.8 (9.32-18.85), 15.7 (6.92-195.0), and 101.2 (8.02-134.4) μg/L for CAM, ESC, TER, and TOC, respectively (median (IQR)). The results of the multivariate analysis indicate that the indigenous population presented a different fingerprint compared to the three scenarios. The chemical fingerprints among the brickmakers and mercury mining population were similar. The results of the concentrations were similar and in some metabolites higher than workers in occupations classified as carcinogenic by the IARC; therefore, the control of exposure in these occupations acquires great importance and surveillance through biological monitoring of OH-PAHs should be applied to better estimate exposure in these working populations.

Precarious Employment and Stress: The Biomedical Embodiment of Social Factors. PRESSED Project Study Protocol

The PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N = 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N = 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects.

Non-standard employment and mortality in Belgian workers: A census-based investigation

Objectives:

Evidence is growing that non-standard employment is associated with adverse health. However, little is known about the relationship between different non-standard employment arrangements and subsequent all-cause and cause-specific mortality. Using population-wide data, the present study investigated this link.

Methods:

Data was derived from the 2001 Belgian census and a 13-year-long follow-up. The analyses comprised 1 454 033 healthy and disability-free employees aged 30–59 years at baseline. Cox regressions were fitted to analyze the mortality risks of those in non-standard employment forms (temporary agency, seasonal, fixed-term, causal work and employment program) compared to permanent employees.

Results:

Several groups of workers in non-standard employment arrangements in 2001 exhibited a higher mortality risk relative to permanent employees during the follow-up after adjusting for socio-economic and work-related factors. This was especially the case among men. The relative mortality disadvantage was particularly elevated for male temporary agency workers. External causes of death played an important role in this association.

Conclusions:

A mortality gradient between the core and outer periphery of the Belgian labor market has been observed. This study also shows that the excess risk of death, previously attributed to non-permanent employment as a whole, hides inequalities between specific forms of non-standard work (eg, temporary agency, seasonal, fixed-term employment).

Risk Perception in the Construction Industry: Differences Between Italian and Migrant Workers Before and After a Targeted Training Intervention

We developed a visual tool to assess risk perception for a sample of male construction workers (forty Italian and twenty-eight immigrant workers), just before and after a sixteen-hour training course. The questionnaire included photographs of real construction sites, and workers were instructed to select pictograms representing the occupational risks present in each photograph. Points were awarded for correctly identifying any risks that were present, and points were deducted for failing to identify risks that were present or identifying risks that were not present. We found: (1) Before the course, risk perception was significantly lower in immigrants compared to Italians (p < .001); (2) risk perception improved significantly (p < .001) among all workers tested; and (3) after the training, the difference in risk perception between Italians and immigrants was no longer statistically significant (p = .1086). Although the sample size was relatively small, the results suggest that the training is effective and may reduce the degree to which cultural and linguistic barriers hinder risk perception. Moreover, the use of images and pictograms instead of words to evaluate risk perception could also be applied to nonconstruction workplaces.

The working disadvantaged: the role of age, job tenure and disability in precarious work

BACKGROUND

Precarious work is an increasingly common characteristic of industrialized labor markets that can widen health inequities, especially among disadvantaged workforce segments. Study objectives are to compare precarious employment in workers with and without disabilities, and to examine the modifying effect of disability in the relationships between age, job tenure and precarious work.

METHODS

Employed Canadians with (n = 901) and without disabilities (n = 901) were surveyed on exposure to precarious working conditions. Information on age and job tenure were collected from respondents along with sociodemographic, health and work context details. Multivariable logistic models examined the association between disability and precarious work. Also, multigroup probit models examined precarious work for young (18-35 yrs), middle-aged (36-50 yrs) and older adults (> 50 yrs) and job tenure and was stratified by participants with and without disabilities.

RESULTS

Almost equal proportions of young, middle-aged and older participants were recruited. Mean job tenure of participants was 9.5 years (SD = 9.0). Close to one-third of participants reported working precariously. At the multivariable level, a disability was not associated with working precariously. However, multigroup modelling indicated that disability was a significant effect-modifier. Older adults with a disability had a 1.88 times greater odds of reporting precarious work when compared to young adults (OR = 1.88, 95%CI 1.19, 2.98). When reporting a disability, longer job tenure was related to a 0.95 times lower odds of precarious work (OR = 0.95 95%CI 0.93, 0.98). The relationship between age and job tenure was not significant for those not reporting a disability.

DISCUSSION

Precarious work has the potential to affect workers with and without disabilities. For those with a disability, being an older adult and/or a new worker can contribute to a greater likelihood of being employed precariously. Policies and programs can be recommended to address precarious working conditions and related health inequities for people with disabilities based on life and career phase.

School performance and mortality: The mediating role of educational attainment and work and family trajectories across the life course

Evidence of a strong negative correlation between adolescent academic performance and mortality points to the importance of not only cognitive, but also non-cognitive, skills in predicting survival. We integrated two bodies of research to evaluate expectations regarding the role of educational attainment and trajectories of employment and marriage experience in mediating relationships between high school class rank and longevity. In particular, we used data from the Wisconsin Longitudinal Study (n = 9,232) to fit parametric mortality models from age 55 to age 77. Multiple mediator models allowed for quantification of the degree to which the association between high school class rank and mortality is mediated by life trajectories and educational attainment. Our results show that high school class rank is a statistically significant and substantively meaningful predictor of survival beyond age 55 and that this relationship is partially, but not fully, mediated by trajectories of employment and marriage experience across the life course. Higher educational attainment also mediates a substantial part of the relationship, but to varying degrees for men and women.

Risk factors for occupational heat-related illness among California workers, 2000-2017

BACKGROUND

As climate change increases global temperatures, heat-related morbidity and mortality are projected to rise. Outdoor workers and those who perform exertional tasks are particularly susceptible to heat-related illness (HRI). Using workers' compensation data, we aimed to describe rates of occupational HRI in California and identify demographic and occupational risk factors to inform prevention efforts.

METHODS

We identified HRI cases during 2000-2017 in the California Workers' Compensation Information System (WCIS) using International Classification of Diseases Ninth and Tenth Revision codes, WCIS nature and cause of injury codes, and HRI keywords. We assigned industry and occupation codes using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS). We calculated HRI rates by sex, age group, year, county, industry, and occupation, and estimated confidence intervals using generalized linear models.

RESULTS

We identified 15,996 HRI cases during 2000-2017 (6.0 cases/100,000 workers). Workers aged 16-24 years had the highest HRI rate (7.6) among age groups, and men (8.1) had a higher rate than women (3.5). Industry sectors with the highest HRI rates were Agriculture, Farming, Fishing, and Forestry (38.6), and Public Administration (35.3). Occupational groups with the highest HRI rates were Protective Services (56.6) and Farming, Fishing, and Forestry (36.6). Firefighters had the highest HRI rate (389.6) among individual occupations.

CONCLUSIONS

Workers in certain demographic and occupational groups are particularly susceptible to HRI. Additional prevention efforts, including outreach and enforcement targeting high-risk groups, are needed to reduce occupational HRI. Workers' compensation data can provide timely information about temporal trends and risk factors for HRI.

The impact of precarious jobs on mental health: a gender-sensitive literature review

PURPOSE

The aim of this study is to analyse the extent to which research and knowledge production on a key occupational health issue-the impact of precarious employment on health-incorporates, and is sensitive to, a gender perspective.

METHODS

A systematic literature review was carried out to identify studies that analysed the relationship between precarious employment and mental health in the period January 2010-May 2018 through. A minimum of two independent reviewers assessed each article for quality and eligibility. A checklist was used to determine whether the articles included in the review incorporated a gender perspective.

RESULTS

The search retrieved 1522 papers, of which 54 (corresponding to 53 studies) met the inclusion criteria. Of these 54 papers, 22 (40.7%) stratified the analyses by sex. Only 5.4% of the total of articles both stratified by sex and considered variables of household composition and marital status, while only 33.3% incorporated an intersectional perspective. None considered the distribution of domestic work and only a quarter (25.9%) approached the study and interpreted the results in terms of gender.

CONCLUSION

Too few studies researching paid work and health include a gender perspective. This omission necessarily implies a biased interpretation of the reality of precarious employment and its impact on health.