STUDY OBJECTIVE To investigate the associations of various types of employment with six self reported health indicators, taking into account the part played by demographic variables, individual working conditions and four ecological indicators at the country level. DESIGN Cross sectional survey (structured interview) of a sample of the active population of 15 European countries aged 15 years or over. Main independent variables were nine types of employment categorised as follows: small employers, full and part time permanent employees, full and part time fixed term employees, full and part time sole traders and full and part time temporary contracts. Main outcome measures were three self reported health related outcomes (job satisfaction, health related absenteeism, and stress) and three self reported health problems (overall fatigue, backache, and muscular pains). Logistic regression and multilevel models were used in the analyses. SETTING 15 countries of the European Union. PARTICIPANTS 15 146 employed persons aged 15 or over. MAIN RESULTS Precarious employment was consistently and positively associated with job dissatisfaction but negatively associated with absenteeism and stress (as compared with full time permanent workers). Fatigue, backache and muscular pains also tended to be positively associated with precarious employment, particularly with full time precarious employment. Small employers reported high percentages of stress and fatigue, but absenteeism was relatively low. Sole traders generally reported high percentages of all outcomes, except for absenteeism, which was low. For each type of employment (except temporary contracts), full time workers tended to report worse health outcomes than part time workers. Patterns were generally consistent across countries. Associations persisted after adjustment for individual level working conditions and were not modified by country level variables. CONCLUSIONS This study is the first to examine the relations between various types of employment and six health related indicators for all 15 member states of the European Union. Suggestive patterns worthy of further exploration have been found. Standardised definitions of types of underemployment and health related outcomes, more potent epidemiological designs and the inclusion of socioeconomic information (for example, social security systems, incapacity benefit schemes) at the regional level are proposed for inclusion in further research.

Background Despite the fact that labour market flexibility has resulted in an expansion of precarious employment in industrialised countries, to date there is limited empirical evidence concerning its health consequences. The Employment Precariousness Scale (EPRES) is a newly developed, theory-based, multidimensional questionnaire specifically devised for epidemiological studies among waged and salaried workers. Objective To assess the acceptability, reliability and construct validity of EPRES in a sample of waged and salaried workers in Spain. Methods A sample of 6968 temporary and permanent workers from a population-based survey carried out in 2004–2005 was analysed. The survey questionnaire was interviewer administered and included the six EPRES subscales, and measures of the psychosocial work environment (COPSOQ ISTAS21) and perceived general and mental health (SF-36). Results A high response rate to all EPRES items indicated good acceptability; Cronbach's α coefficients, over 0.70 for all subscales and the global score, demonstrated good internal consistency reliability; exploratory factor analysis using principal axis analysis and varimax rotation confirmed the six-subscale structure and the theoretical allocation of all items. Patterns across known groups and correlation coefficients with psychosocial work environment measures and perceived health demonstrated the expected relations, providing evidence of construct validity. Conclusions Our results provide evidence in support of the psychometric properties of EPRES, which appears to be a promising tool for the measurement of employment precariousness in public health research.

Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010. A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes. Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did. This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

Objectives This paper summarizes the information on immigrant occupational health available from recent studies, incorporating varied study designs. Methods A systematic search was carried out in PubMed employing terms of interest to the study and related terms supplied by the same search engine. Articles were selected through the following process: (i) reading the title and abstract, in English or Spanish, for the period 1990–2005, (ii) reading of the entire text of selected articles; (iii) making a manual search of the relevant citations in the selected articles; (iv) eliminating articles without a focus on the themes of central interest (immigration, work, and health), and (v) reading and analyzing the definitive article set. No quality criteria were used in the article selection. Results The location of studies was not straightforward and required careful thought about the search terms. The included 48 papers were often multifaceted and difficult to categorize. They generally came from countries historically associated with immigration and described occupational risk factors, health consequences, and the social, economic, and cultural influences on worker health. They were also based on data, surveillance, training, and preventive measures that were inadequate. Conclusions Increased migration is a reality in industrialized countries all over the world, and it has social, political, and economic consequences for migrating groups, as well as for their sending and host societies. More reliable data, targeted appropriate interventions, and enforcement of existing regulations are necessary to improve the health of immigrant workers. Furthermore, studies in sending and developing countries should be encouraged to form a more complete understanding of this complex situation.

Objective:To determine whether observed higher risks of occupational injury among temporary workers are due to exposure to hazardous working conditions and/or to lack of job experience level.Methods:Data systematically recorded for 2000 and 2001 by the Spanish Ministry of Labour and Social Affairs on fatal and non-fatal traumatic occupational injuries were examined by type of employment and type of accident, while adjusting for gender, age, occupation, and length of employment in the company. In the study period there were 1500 fatal and 1 806 532 non-fatal traumatic occupational injuries that occurred at the workplace. Incidence rates and rate ratios (RR) were estimated using Poisson regression models.Results:Temporary workers showed a rate ratio of 2.94 for non-fatal occupational injuries (95% CI 2.40 to 3.61) and 2.54 for fatal occupational injuries (95% CI 1.88 to 3.42). When these associations were adjusted by gender, age, occupation, and especially length of employment, they loose statistic significance: 1.05 (95% CI 0.97 to 1.12) for non-fatal and 1.07 (95% CI 0.91 to 1.26) for fatal.Conclusions:Lower job experience and knowledge of workplace hazards, measured by length of employment, is a possible mechanism to explain the consistent association between temporary workers and occupational injury. The role of working conditions associated with temporary jobs should be assessed more specifically.