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      The association between part-time and temporary employment and sickness absence: a prospective Swedish twin study

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          Abstract

          Background

          Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.

          Methods

          This is a prospective twin study based on 21 105 twins born in Sweden 1959–85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).

          Results

          Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04–1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74–0.95) and the self-employed (OR=0.77 95%CI=0.62–0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73–0.94) and self-employed women (OR=0.65 95% CI=0.47–0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03–1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01–2.99) and municipalities (OR=1.41 95% CI=1.02–1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64–0.93). Familial factors did not confound the association between employment type and SA.

          Conclusions

          Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.

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          Most cited references25

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          Stress hormones in health and illness: the roles of work and gender.

          Two neuroendocrine systems are of specific interest in the study of stress and health; the sympathetic adrenomedullary system with the secretion of epinephrine and norepinephrine, and the hypothalamic pituitary adrenocortical (HPA) system with the secretion of cortisol. These hormones have often been used as objective indicators of stress in the individual. However, through their bodily effects, they are also a link between the psychosocial environment and various health outcomes. From a series of studies of women and men, it was concluded that gender roles and psychological factors are more important than biological factors for the sex differences in stress responses. The stress responses have been important for human and animal survival and for protection of the body. However, in modern society, some of these bodily responses may cause harm rather than protection. The catecholamines have been linked to cardiovascular disorders such as hypertension, myocardial infarction and stroke, cortisol to cardiovascular disease, Type 2 diabetes, reduced immune function and cognitive impairment. An adequate balance between catabolic (mobilization of energy) and anabolic processes (growth, healing) is considered necessary for long term health and survival. In modern society, which is characterized by a rapid pace of life, high demands, efficiency and competitiveness in a global economy, it is likely that lack of rest, recovery and restitution is a greater health problem than the absolute level of stress.
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            How do types of employment relate to health indicators? Findings from the second European survey on working conditions.

            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. 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. 15 countries of the European Union. 15 146 employed persons aged 15 or over. 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. 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.
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              Is precarious employment damaging to self-rated health? Results of propensity score matching methods, using longitudinal data in South Korea.

              We aimed to evaluate the health effects of precarious employment based on a counterfactual framework, using the Korea Labor and Income Panel Survey data. At the 4th wave (2001), information was obtained on 1991 male and 1378 female waged workers. Precarious work was defined on the basis of workers employed on a temporary or daily basis, part-time, or in a contingent (fixed short-term) job. The outcome was self-rated health with five response categories. Confounding factors included age, marital status, education, industry and occupation of current employment, household income, residential area, and prior health status. Propensity scores for each individual to be a precarious worker were calculated from logistic models including those covariates, and based on them, precarious workers were matched to non-precarious workers. Then, we examined the effects of precarious employment on health and explored the potential intermediary variables, using ordered logistic Generalized Estimating Equations models. All analyses were performed separately by gender. Precarious workers were found to be in a lower socioeconomic position and to have worse health status. Univariate matched analyses showed that precarious employment was associated with worse health in both men and women. By further controlling for socio-demographic covariates, the odds ratios were attenuated but remained significant. Job satisfaction, especially as related to job insecurity, and monthly wage further attenuated the effects. This suggests that to improve health status of precarious workers in Korea, policy strategies need to tackle the channeling of the socially disadvantaged into precarious jobs. Also, regulations to eliminate discrimination against precarious workers in working conditions or material reward should be introduced and enforced. There is no doubt that job insecurity, which is pervasive among workers in Korea, should be minimized by suspending market-oriented labor policies which rely on quantitative flexibility.
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                Author and article information

                Journal
                Eur J Public Health
                Eur J Public Health
                eurpub
                The European Journal of Public Health
                Oxford University Press
                1101-1262
                1464-360X
                February 2019
                02 August 2018
                02 August 2018
                : 29
                : 1
                : 147-153
                Affiliations
                [1 ]Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
                [2 ]Department of Psychology, Stockholm University, Stockholm, Sweden
                [3 ]Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
                [4 ]Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
                [5 ]The Swedish School of Sport and Health Sciences, Stockholm, Sweden
                Author notes
                Correspondence: Björg Helgadóttir, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden, Tel: +46 736271296, Fax: +46 852483205, e-mail: bjorg.helgadottir@ 123456ki.se
                Author information
                http://orcid.org/0000-0002-3901-4579
                Article
                cky145
                10.1093/eurpub/cky145
                6345142
                30084947
                3528047b-0a11-45ae-add7-212ad96e80d3
                © The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 7
                Funding
                Funded by: AFA Insurance
                Award ID: 140246
                Funded by: Swedish Research Council 10.13039/501100004359
                Award ID: 521-2008-3054
                Funded by: Swedish Research Council for Health, Working Life and Welfare 10.13039/501100006636
                Award ID: 2007-0830
                Funded by: Swedish Society of Medicine 10.13039/501100007687
                Funded by: Swedish Research Council 10.13039/501100004359
                Award ID: 2017-00641
                Funded by: National Institute of Health, USA
                Award ID: DK 066134
                Award ID: CA 085739
                Categories
                Work and Health

                Public health
                Public health

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