Michael Quinlan University of NSW, University of Sydney
& Middlesex University
How precarious employment
damages health: Evidence from
(Vulnerable workers, precarious work: a global
perspective symposium)
Paper presented to 64th LERA Annual Meeting, Chicago
8 January 2011
Changes to work and OHS effects of this
How to explain this – four models
Explaining the PDR model
Evidence testing PDR risk factors
Testing the model itself – preliminary results
Conclusion and references
Changes to Work Organisation and
its health and safety effects
Over past 30 years significant changes to work & labour
markets including widespread business restructuring,
downsizing & outsourcing, growth of temporary and
insecure work (and precarious workforces including
increasingly global contingent labour)
Matching this shift is mounting evidence that the
changes are having substantial adverse effect on
occupational health and safety (eg global reviews of
downsizing, subcontracting and temporary work – see
Attempts to explain adverse OHS
effects of precarious employment
Karasek’s demand/control or job strain
model (too task focused)
Siegrist’s effort/reward model
Lewchuk’s employment strain model
(includes job search and social support)
Sydney Uni Work Health Team (M. Quinlan,
P Bohle & M. McNamara) PDR model
(pressure, disorganisation & regulation)
PDR model: Risk factors associated
with Insecure and contingent work
Regulatory Failure
Insecure jobs
(fear of losing
Short tenure,
Poor knowledge of
legal rights,
Extra tasks,
Poor induction,
training &
Limited access to
OHS, workers comp
Eroded pay,
Long or irregular
work hours
procedures &
Fractured or
disputed legal
Eroded work
quality, public
Multiple jobs
(may work for
Ineffective OHSMS
/ inability to
Non-compliance &
regulator oversight
Example 1:Underhill study of agency
workers (Rel Ind 66:3 2011)
Stratified sample of injured workers
• Investigated workers’ compensation claims in Victoria; 198
agency & direct hire matched by occupation & year of injury
• Statements from injured workers, witnesses,
employers & host supervisors, medical reports
Focus groups and survey of agency workers
147 surveyed, mostly blue collar
5 Focus groups in Melbourne & regional Victoria
Mostly blue collar, plus call centres, health sector
Example 1: Explaining the risk - economic
and reward pressures
• High levels of employment & income
Irregular hours (27% of injured workers) & irregular
income (Eg. storeperson – average weekly wage
A$276 but ranged from A$105 - $621 over 15
45% never/rarely had continuity of placements
32% different hourly wage dependent upon host
• Interchangeable - easily & quickly replaced
Worker asking for 2 days sick leave told he would
be replaced by another worker
Example 1: Contributing to workplace
risk - economic pressures
Work with injury
I kept working and put up with the pain which was worse when I stopped and I
didn’t mention it to anyone at the time as I was concerned my job would be
terminated…I needed the money and didn’t want to attract attention by
wearing a brace.” (process worker)
Accept work intensification
We’ve had labour hire guys pass out, working hard…was stifling hot up there
(3rd level, warehouse) …they were under the impression they wouldn’t get
hours, so they went flogging themselves then they passed out (storeperson,
distribution, focus group)
Perform more hazardous tasks
The permanent staff here always get priority on the better shifts…certain jobs are
regarded as easier than others, and the permanent and host casuals get priority
on those ahead of the agency… (storeperson, distribution, focus group).
Example 1: Explaining the risk disorganisation
Characteristics of agency workforce and
Younger workers (more than double direct hire but
older workers injured earlier in a placement too)
 Lack of familiarity with workplace
 Inexperienced, inadequate training or
 Poor person-job match
 Poor communication
 Undermining of OHS management system
Example 1: Disorganisation
When I started my only training with the pump was
being shown the on/off switch and the reversing
Each driver is responsible for the ongoing cleanliness
on a daily basis of any fork he is using. While
permanent employees of the company use the same
forklift each day, casuals can swap and change from
one fork to another during the course of the day
depending on the type of work being undertaken…
(claims investigator).
Example 1: Regulatory failure - culture
of non-compliance
Most examples provided are also examples of
lack of compliance
Lack of, poor standard of training
Placements involving high risk tasks
Failure to respond to OHS issues
Dismissal for raising issues
Underpinned by:
Vulnerability to dismissal – weak employment protection
Large number of small agencies & ability to avoid
Example 2: Agency workers in
Based on convergent interviews with 30 temporary
agency homecare workers (some self-employed) in two
regions of South Australia working in
Aged care
Disability care
Troubled youth
Example 2: Economic and reward
Employment and income irregular (eg if elderly person
hospitalised) , unpaid overtime & vulnerable (if try to impose
rules lose job)
You might not have work for two or three months. So you
think, I might as well just do this because then there won't be
much work. It sort of goes off and on… There's what they call
‘the quiet times’ and that's usually around like Christmas,
January. And then it sort of starts picking up. (Adelaide, female
You don’t always get in to a place at nine o’clock and walk out
the door at 10:30, on an hour and a half job for instance.
Because you potentially need to meet other needs than just
what’s written on the sheet in terms of what you’re doing as a
support work… You have to attend to the person’s emotional
needs as well… (Adelaide, male #4)
‘As far as conditions go, there are no conditions. We have no
holiday pay. We have no sick pay. We have no superannuation.
We have no insurance. All those things we have to provide
ourselves’ (Barossa, female #6)
Example 2: Disorganisation
Identified problems with risk assessment, management
systems & rules (some impractical eg mobile numbers), training
(amount & quality), poor design etc
We were put at risk… our safety was at risk. We would be put
in motel rooms with violent children that couldn’t be placed in
foster care, and we had no training… Basically, they gave us no
formal training. (Adelaide, female #2)
You can pick up the kid at any given time when they phone
you… and they’ll fail to give you some information which could
be, you know – the child has sexualised behaviours, the child
needs medication, the child this and that… And there’s no risk
assessment. It’s, pick the ball up and run with it and hopefully
you don’t fall over. (Adelaide, male #3)
Probably the most risky place to work in people’s homes is
usually the bathroom: slippery floors, dealing with unsteady
clients, dealing with taps that aren’t set up for people or shower
heads that aren’t set up for people with a disability. (Barossa,
female #3)
Example 2: Regulatory failure
OHS regulators only beginning to address homecare,
(limited guidance material, inspection & enforcement) &
low unionisation, industry fragmented
No workers’ compensation whatsoever. If you hurt
yourself, it’s your responsibility. You need to have
income insurance as a self-employed contractor,
otherwise you get nothing… But as an employee,
there’s workers compensation. (Adelaide, female #4)
If the agency moved in and tried to change everything
to suit the contractor, [the client would] either drop out
of the service or go and find somebody else. So it's all
pretty low key… Yes, they were turning a blind eye...
Really, people are screaming out just to get a bit of
respite. (Barossa, male #2)
Example 3: Survey of 1541 older
Australians (45-65 years)
Representative population sample conducted in 2009
by phone using phase 1 of PDR model (phase 2 used
in second survey undertaken in 2011)
Phase 2 PDR model has better measures of
disorganisation and regulatory failure
841 in paid employment (subdivided into temporary
employed, ongoing employed & self employed)
Predictive efficacies of PDR and ERI models in
relation to work-life conflict & health(SF12), were
compared, controlling for demographic variables and
working hours
Example 3: Survey of 1541 older
workers (45-65 years): Findings
Significant differences between 3 employment groups in
terms of health & work-life conflict (but also independent
measure of precariousness)
PDR & ERI both predictive & independent
When mental health was predicted by the elements of PDR,
ERI and employment status, the significant predictors in the
final model were: gender *, working hours*, reward pressure**,
financial pressure***, and work-life conflict***(R²=.16).
When work-life conflict was predicted by the elements of PDR,
ERI and employment status, the significant predictors in the
final model were: age**, gender*, working hours***, reward
pressure***, financial pressure***, and ERI*** (R²=.30).
* p< .05, ** p<.01, *** p<.001
Overall conclusion
Substantial research links precarious employment to poor
OHS outcomes but still trying to understand how this occurs
Model building in early stages
Both Lewchuk model and PDR (defining precariousness?)
suggest not just employment status but relationship of this to
other factors (eg interaction with living conditions & spill-over
PDR model is multi-factorial (but related) and evidence to
support this approach
PDR model appears to have elements of ERI but operates
Need further refinement, international collaborative studies
and constructive engagement re model development
Also need to use multiple research methods (not just surveys,
cohort studies or longitudinal panel data). Qualitative data
useful too
Some references
Quinlan, M. & Bohle, P. (2008) Under pressure, out of control or home
alone? Reviewing research and policy debates on the OHS effects of
outsourcing and home-based work, International Journal of Health
Services, 38(3): 489-525.
Lewchuk, W., Clarke, M. & de Wolff, A. (2008). ‘Working without
commitments: precarious employment and health’, Work, employment &
society, 22(3): 387-406.
Quinlan, M. & Bohle, P. (2009), Over-stretched and Unreciprocated
Commitment: Reviewing research on the OHS effects of downsizing and
job insecurity International Journal of Health Services 39(1): 1-44.
Bohle, P., Finn, J., Quinlan, M. & Rawlings-Way, O. (2009) A Report on
the Occupational Health and Safety of Homecare Contract Workers in
Adelaide and the Barossa Region. A report prepared for The South
Australian Office of the Employee Ombudsman. University of Sydney.
Underhill, E. and Quinlan, M. (2011) How precarious employment affects
health and safety at work: the case of temporary agency workers.
Relations Industrielles 66(3):397-421.

Bohle, P. & Quinlan, M. Contingent work and occupational