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Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent’s sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making.

Resumen En América Latina, el 15% de las mujeres son trabajadoras domésticas remuneradas. Esta ocupación se realiza casi en el 80% de los casos bajo la informalidad, por lo que se trata de una ocupación sin protección social ni derechos laborales. A su vez, la salud de las trabajadoras domésticas debe considerarse, al menos, bajo una triple determinación: la precarización del empleo, las desigualdades de clase social, y las de género. Es importante generar marcos normativos que reduzcan las desigualdades en salud de los/as trabajadores/as precarios/as, en este sentido, Argentina y Uruguay promovieron la promulgación de leyes laborales sobre trabajo doméstico remunerado. En el presente artículo se describen las experiencias entre ambos países sobre los alcances e impactos en la salud del proceso de regularización de este empleo. Sin embargo, se observa un impacto limitado de la formalización del empleo en el trabajo doméstico remunerado, con dificultades para aplicar el modelo de protección del trabajo asalariado tradicional. La legitimación de los derechos también puede llevar a la salud pública y a la salud de los/as trabajadores/as hacia nuevos desafíos y tensiones, que se agravan en el contexto de la pandemia por covid-19. Abstract In Latin America, 15% of women are paid domestic workers. Being a job without social security or labor rights, almost 80% of this work is done informally. In this sense, the health of these domestic workers should be considered at least under three aspects: precarization of work, social inequality, and gender inequality. Before the need for regulatory frameworks aimed at reducing health inequalities among informal workers, Argentina and Uruguay promoted the enactment of labor laws regarding paid domestic work. This study describes the experiences of both countries, considering the scope and impact of this formalization process on health. The results indicate that formalizing paid domestic work had but a limited impact, with difficulties in applying the traditional model of paid work protection. This legitimation of labor rights may also pose more challenges and tensions for public health and occupational health, which are worsened in the context of the covid-19 pandemic.

BackgroundDespite 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.ObjectiveTo assess the acceptability, reliability and construct validity of EPRES in a sample of waged and salaried workers in Spain.MethodsA 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).ResultsA 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.ConclusionsOur 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.

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.

The relevance of the psychosocial factors and occupational health is increasing worldwide. In Argentina a robust measuring instrument of them is needed. The COPSOQ (Copenhagen Psychosocial Questionnaire) is a comprehensive instrument for its assessment, and it was currently adapted in several countries. The Union Institute of Work Environment and Health (ISTAS) got its Spanish version, known as COPSOQ ISTAS 21. We founded our study on the updated long version of this questionnaire (95 items). The aims of the study were the semantic adaptation through a qualitative strategy, the detailed validation of the psychometric measurement properties, and the development of an abbreviated version of the instrument. We used an intentional sample with a maximum variation strategy, until we reached the theoretical saturation. The main criterion used to set the sample was the educational level (combined with sex and age). With a random sample of 200 wage-earners we performed the quantitative analysis of content validity, reliability, criterion validity and sensitivity. The cultural adaptation, reached by the analyses of the interpretational expected and emerged difficulties, provided us an acceptable and clear version of the questionnaire in our context. For the principal dimensions the Cronbach's alpha was mostly >0.7 (Demands 0.86, Double presence 0.75, Work organisation 0.83, Interpersonal relationships and leaderships 0.88, Insecurity 0.84, Confidence 0.68, Justice 0.84). The factorial analysis was also consistent. In addition, these psychometric properties were comparable to those in the Danish and German COPSOQ-studies. The adapted Argentinian version is comparable with the COPSOQ ISTAS 21 instrument in terms of validity and is suitable for assessment of the psychosocial work environment in Argentina. The next step is the construction of national reference values for its preventive use in our country.

As a consequence of labor market flexibilization, nonstandard employment has expanded and standard employment has declined. In many cases, these transformations are best described as an evolution toward precarious employment, which is considered a major determinant of health and health inequalities. Using the Employment Precariousness Scale (EPRES), this study aims to determine the prevalence of precarious employment in the waged and salaried workforce in Spain, to describe its distribution across social groups defined by occupational class, gender, age, and immigrant status, and to estimate the proportion of cases of poor mental health potentially attributable to employment precariousness. Data are from the Psychosocial Work Environment Survey conducted in 2004-5 on a representative sample of the Spanish workforce. Findings indicate a high prevalence of employment precariousness, affecting nearly 6.5 million workers, with almost 900,000 of them exposed to high precariousness. These estimates are higher than the proportion of fixed-term employment reported in regular statistical sources but may today be an underestimation, given the current economic crisis. Additionally, a significant proportion of cases of poor mental health are potentially attributable to employment precariousness. Both the proportion of cases of poor mental health attributable to and the prevalence of employment precariousness were highly unequally distributed across the study sample, indicating that this may be a significant contributor to social inequalities in mental health.

En América Latina, el 15% de las mujeres son trabajadoras domésticas remuneradas. Esta ocupación se realiza casi en el 80% de los casos bajo la informalidad, por lo que se trata de una ocupación sin protección social ni derechos laborales. A su vez, la salud de las trabajadoras domésticas debe considerarse, al menos, bajo una triple determinación: la precarización del empleo, las desigualdades de clase social, y las de género. Es importante generar marcos normativos que reduzcan las desigualdades en salud de los/as trabajadores/as precarios/as, en este sentido, Argentina y Uruguay promovieron la promulgación de leyes laborales sobre trabajo doméstico remunerado. En el presente artículo se describen las experiencias entre ambos países sobre los alcances e impactos en la salud del proceso de regularización de este empleo. Sin embargo, se observa un impacto limitado de la formalización del empleo en el trabajo doméstico remunerado, con dificultades para aplicar el modelo de protección del trabajo asalariado tradicional. La legitimación de los derechos también puede llevar a la salud pública y a la salud de los/as trabajadores/as hacia nuevos desafíos y tensiones, que se agravan en el contexto de la pandemia por covid-19.

The authors describe the major methods and sources of information used in the EMCONET study for researching global, employment-related health inequalities. A systematic review of the literature provides valuable knowledge for research in this area. However, the limited number of studies, the poor quality of methods used, and a lack of theories or concepts have produced inconsistent results. To minimize bias from these limitations and to reach a comprehensive understanding of the complexity and health effects of global employment conditions, this article outlines key strategies for a synthetic, comprehensive, participatory approach: adapting transdisciplinary knowledge acquisition, building a theoretical model, employing multiple sources for data collection, and using a variety of methods (qualitative/quantitative studies and narrative knowledge). This approach provides solutions to important research and policy needs regarding the global context of key employment relations, social mechanisms, and health inequalities. The strategies are adapted to synthesize input from several disciplines (epidemiology, sociology, and political science), social actors, and institutions. The study's main sources of information are a variety of digital, bibliographic databases; the authors reviewed the scientific literature from 1985 to 2008 and books, reports, and other documents from 2000 to 2008.