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.

Informal employment in high-income countries for a health inequalities research: A scoping review.

BACKGROUND: Informal employment (IE) is one of the least studied employment conditions in public health research, mainly due to the difficulty of its conceptualization and its measurement, producing a lack of a unique concept and a common method of measurement. OBJECTIVE: The aim of this review is to identify literature on IE in order to improve its definition and methods of measurement, with special attention given to high-income countries, to be able to study the possible impact on health inequalities within and between countries. METHODS: A scoping review of definitions and methods of measurement of IE was conducted reviewing relevant databases and grey literature and analyzing selected articles. RESULTS: We found a wide spectrum of terms for describing IE as well as definitions and methods of measurement. We provide a definition of IE to be used in health inequalities research in high-income countries. Direct methods such as surveys can capture more information about workers and firms in order to estimate IE. CONCLUSIONS: These results can be used in further investigations about the impacts of this IE on health inequalities. Public health research must improve monitoring and analysis of IE in order to know the impacts of this employment condition on health inequalities.

Psychosocial risk exposures and labour management practices. An exploratory approach.

AIM: The purpose was to explore the relationship between psychosocial risk exposures and labour management practices (LMP), as indicators of work organization and pertinent features for primary preventive intervention. METHODS: Cross-sectional study of a representative sample of salaried working population in Spain (n = 7,612). Information was obtained in 2004-2005 using a standardized questionnaire administered through personal interviews at the household. Questions on working conditions were used to establish LMP indicators and the psychosocial exposures data were obtained on the basis of the Copenhagen Psychosocial Questionnaire (COPSOQ) I (ISTAS21). A multivariate description was performed through multiple correspondence analysis, and associations between LMPs and psychosocial exposures were assessed by ordinal logistic analysis adjusting for age and sex. RESULTS: Correspondence analysis showed a good-bad coherent pattern regarding both psychosocial dimension and LMPs, though several LMPs categories were placed in the centre. Among the 14 possible associations of each psychosocial scale with LMP variables, several scales showed significant associations with more than eight LMP variables. Most relevant results referred to the LMP variable ''Consultative and delegative participation in methods''. CONCLUSIONS: In line with previous research, psychosocial exposures were associated with LMP. LMP may constitute a step on a pathway from work organization to health. Our exploratory work suggested that good psychosocial exposures were related to participatory working methods, being hired with a permanent labour contract, not being made to feel easily replaceable, having superiors with non-authoritarian and non-aggressive manners, not being threatened with dismissal, upward functional mobility, being paid according to the number of working hours and occupation, working between 31 and 40 hours per week and in regular morning shifts. Hence, the more these features became part of LMP in the workplace, the better the psychosocial work environment would be.

Incidencia de incapacidad permanente en una cohorte de trabajadores afiliados a la Seguridad Social, 2004–2007 / Incidence of permanent disability in a cohort of social security-affiliated workers (2004–2007)

Objetivo Describir la incidencia de incapacidad permanente, común y laboral, según variables sociolaborales y territoriales.Métodos Cohorte retrospectiva de 768.454 afiliados al régimen general de la Seguridad Social, seguidos entre 2004 y 2007, basándose en la Muestra Continua de Vidas Laborales de la Seguridad Social. En los 4 años de seguimiento se identificaron 7.749 casos con un tiempo total de exposición de 1.937.921 trabajadores-año. Se calcularon las tasas de incidencia y las razones de tasas crudas y ajustadas mediante regresión Poisson.Resultados La incidencia de incapacidad permanente de origen común fue 10 veces superior a la de origen laboral (36,3 frente a 3,7 por 10.000 trabajadores-año). La incidencia de ambos orígenes fue más alta en los hombres, aumenta con la edad y disminuye a medida que aumenta el nivel de estudios. Por comunidades autónomas y para incapacidad permanente común, Asturias presentó la mayor incidencia y Madrid la menor (56,7 frente a 23,3). Para incapacidad permanente laboral, Asturias sigue teniendo la mayor incidencia, mientras que Navarra tiene la menor (7,8 frente a 1,4). Estas diferencias se mantuvieron, respectivamente, para incapacidad común y laboral para Asturias, después de ajustar por sexo, edad, nivel educativo, tamaño de la empresa y actividad económica. Conclusiones En este estudio sobre la incapacidad permanente observamos que su incidencia presenta importantes diferencias demográficas, sociales y territoriales, que deben estudiarse con más detalle, en especial las observadas por comunidades autónomas (AU)

Objective To describe the incidence of permanent disability, both work-related and non-work-related, by several socioeconomic and geographical variables.Methods We performed a retrospective study of a cohort of 768,454 workers covered by the General Social Security Regimen, followed-up from 2004 to 2007. This study was based on the Continuous Working Life Survey. In the 4 years of follow-up, 7,749 cases in 1,937,921 workers-years were identified. Incidence rates and crude and adjusted rate ratios were estimated by Poisson regression models.Results The incidence of non-work-related permanent disability was 10 times greater than that of work-related disability (36.3 versus 3.7 per 10,000 workers-years). The incidences for both non-work-related and work-related disability were higher in men and increased with age and lower education level. For non-work-related permanent disability, the region with the highest incidence was Asturias and that with the lowest was Madrid (56.7 vs. 23.3). For work-related permanent disability, the highest incidence was found in Asturias and the lowest in Navarre (7.8 vs. 1.4). This differential was maintained for work-related and non-work-related permanent disability for Asturias, after adjustment was made by sex, age, educational level, company size and economic activity.Conclusions In this study, we observed substantial differences in the incidences of permanent disability by demographic, social and geographical characteristics, which should be analyzed in greater depth, especially the differences observed by regions (AU)

[Incidence of permanent disability in a cohort of social security-affiliated workers (2004-2007)]. / Incidencia de incapacidad permanente en una cohorte de trabajadores afiliados a la Seguridad Social, 2004-2007.

OBJECTIVE: To describe the incidence of permanent disability, both work-related and non-work-related, by several socioeconomic and geographical variables. METHODS: We performed a retrospective study of a cohort of 768,454 workers covered by the General Social Security Regimen, followed-up from 2004 to 2007. This study was based on the Continuous Working Life Survey. In the 4 years of follow-up, 7,749 cases in 1,937,921 workers-years were identified. Incidence rates and crude and adjusted rate ratios were estimated by Poisson regression models. RESULTS: The incidence of non-work-related permanent disability was 10 times greater than that of work-related disability (36.3 versus 3.7 per 10,000 workers-years). The incidences for both non-work-related and work-related disability were higher in men and increased with age and lower education level. For non-work-related permanent disability, the region with the highest incidence was Asturias and that with the lowest was Madrid (56.7 vs. 23.3). For work-related permanent disability, the highest incidence was found in Asturias and the lowest in Navarre (7.8 vs. 1.4). This differential was maintained for work-related and non-work-related permanent disability for Asturias, after adjustment was made by sex, age, educational level, company size and economic activity. CONCLUSIONS: In this study, we observed substantial differences in the incidences of permanent disability by demographic, social and geographical characteristics, which should be analyzed in greater depth, especially the differences observed by regions.

A new occupational health agenda for a new work environment.

At the beginning of the 21st century, the emergence of new forms of work organization are transforming what had become standard types of work arrangements in industrialized countries. In this new labor market environment, new firms, types of workers, and risk factors are powerfully emerging. Contrary to common belief, emergent occupational health hazards should not be approached only as "technical" or "economic" value-free problems. Instead, many of the challenges faced by occupational health policy makers are predominantly related to professional values and to the political ideologies and economic interests of key stakeholders in the decision-making process. In this paper some of the key principles leading to efficient and equitable occupational health policies in the new work environment are discussed. An alternative is also proposed for dealing with the conditions and settings needed to meet the new challenges related to establishing an effective occupational health policy.