Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark.
Occup Environ Med. 2023 Apr;80(4):179-185. doi: 10.1136/oemed-2022-108604. Epub 2022 Dec 30.
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.
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.
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).
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.
不稳定就业(PE)被认为是职业伤害(OIs)的一个风险因素。然而,报告不足和风险时间等几个问题给获得风险的无偏估计带来了障碍。
调查不稳定就业是否是瑞典职业伤害的一个风险因素。
这项基于登记的研究包括年龄在 18-65 岁之间、2006 年至 2014 年期间居住在瑞典的就业工人。不稳定就业被定义为一个多维结构(得分)和五个项目(合同不安全感、合同临时性、多份工作/多个部门、收入水平、集体谈判协议)。我们的结果是下一年的职业伤害。分别对女性和男性进行多变量逻辑回归模型计算职业伤害与不稳定就业及不稳定就业项目的比值比(OR)。
与非不稳定就业者相比,不稳定就业者的职业伤害风险较低(OR<1),即使对报告不足进行加权并调整风险时间(兼职工作)也是如此。男性代理工人的职业伤害风险较高(OR 1.19,95%CI 1.15 至 1.23),男性和女性多份工作/多个部门的职业伤害风险也较高(OR 1.25,95%CI 1.23 至 1.28 和 OR 1.10,95%CI 1.07 至 1.13),低收入组的女性工人职业伤害风险也较高(OR 1.11,95%CI 1.09 至 1.12)。集体谈判协议覆盖率低与男性和女性的职业伤害风险降低有关(OR 0.30,95%CI 0.29 至 0.31 和 OR 0.26,95%CI 0.24 至 0.27)。
虽然一些机制可以解释为什么瑞典的不稳定就业者职业伤害风险较低,但不稳定就业的几个方面,如临时机构工作和多份工作,可能是职业伤害的重要风险因素,值得进一步研究。