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eMployMent relations and health inequalities: pathways and MechanisMs Figure 24. theoretical framework linking working conditions and health inequalities (studied pathways are highlighted). eMPloyMenT Employment Conditions - Full-time Permanent Employment - Unemployment - Precarious Employment - Informal Employment - Child Labour - Slavery and Bonded Labour WorK orGanisaTion Working conditions Exposures, Hazards and Risk Factors: - Physical - Chemical - Biological - Ergonomic - Psychosocial Material Deprivation and Economic Inequalities Health-related Behaviours Health-related Outcomes Physio-pathological Changes Health Inequalities Health Systems Social and Family Networks meaning of the arrows represented in the model: influence Mutual influence interaction or buffering influence at various levels source: prepared by the authors Material working conditions research on material working conditions has largely followed two approaches. clinically-oriented studies have often investigated very specific types of working conditions in specific occupations. in those studies, social inequalities often remain unaddressed. social epidemiological studies mostly rely on broad, self-reported material working conditions. in the overview below, essentially the latter approach is followed. Material working conditions are discussed in different groups: load-related hazards, vibrations, noise, extreme temperatures, dangerous situations, ergonomic risk factors and toxic exposures. load-related risks are the result of mechanical shocks, forceful gripping of tools and machines, external loads related to the use of force and the impact of hard or sharp edges (Muggleton, allen, & chappell, 1999). important risk groups include various kinds of industrial workers (hansson & Jensen, 2004), maintenance personnel (Kumar & Kumar, 2008), construction workers (hildebrandt, Bongers', dul, Van dijk, & Kemper, 2000) and health 263
EmploymEnt, Work, And hEAlth InEquAlItIEs - a global perspective care personnel (dawson et al., 2007). research on the consequences of load-related working conditions is concentrated on complaints concerning the upper limbs, neck/shoulders (andersson, fine, & silverstein, 2000; van der Windt et al., 2000) or lower back (andersson et al., 2000; Keyserling, 2000). More serious disorders, such as hernias, spinal degeneration, carpal tunnel syndrome, tendinitis or inflammations, are also associated with load-related working conditions (andersson et al., 2000; hoozemans, Van der Beek, frings-dresen, Van dijk, & Van der Woude, 1998; Muggleton et al., 1999). furthermore, effects on exhaustion and occupational stress are also common (akerstedt et al., 2004; laaksonen, rahkonen, Martikainen, & lahelma, 2006). The impact of vibrations is defined by their magnitude, frequency, duration and direction. Vertical vibrations seem to involve the highest discomfort (Griffin, 1998). There is also a difference between whole-body vibrations and hand-transmitted vibrations. The first are common in drivers and operators of construction equipment (Kittusamy & Buchholz, 2004). hand-transmitted vibrations are most common in workers using hand-operated tools and machines. long-term and daily exposure to vibrations is associated with health problems ranging from cardiovascular, respiratory, and physiological changes to musculoskeletal problems, effects on the central nervous system, gastro-intestinal complaints, reproductive problems and various stress reactions (Griffin, 1998; Keyserling, 2000). noise can be considered as one of the most common workplace hazards in the world (dunn, hands of a child miner. Goldmines of komabangou (niger). 2000). it is most prevalent in manufacturing, source: © ilo/M. crozet (2003) transportation, construction and the primary economic sector (dunn, 2000). hearing loss and tinnitus are the most prominent health consequences (suter, 1992). in most cases, the hearing loss is only temporary, though chronic consequences often go unnoticed until the hearing loss has attained disabling proportions (suter, 1998). at that point, psychosocial consequences related to communication problems start to emerge (riediker & Koren, 2004). indirect health effects also include general irritation, sleeping problems and fatigue, hormonal changes, increased blood pressure, cardiovascular problems, health and safety impairment and concentration problems (Passchier-Vermeer & Passchier, 2000). in order to preserve the body temperature between its ideal limits, the human organism has developed a set of reactions and 264
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EmploymEnt, Work and HEaltH InEqual
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CORE GROUP* Carlos H. Alvarado, Fra
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policies and interventions employme
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policies and interventions Pública
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policies and interventions conditio
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policies and interventions factors
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policies and interventions informat
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policies and interventions financin
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policies and interventions better i
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policies and interventions referenc
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policies and interventions Table 14
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policies and interventions urban ar
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policies and interventions home-bas
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Epilogue: the economic crisis 10
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epilogue: the econoMic crisis this
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Conclusions & recommendations 11 "I
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conclusions and recommendations sho
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Appendix
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AppeNdIx recommendation no. 190 and
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AppeNdIx employment conditions. emp
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AppeNdIx Forced labour. Although th
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AppeNdIx Job discrimination. this t
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AppeNdIx in: muntaner, c., Benach,
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AppeNdIx in: Bartley, m., & Ferrie,
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AppeNdIx work intensification. work
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AppeNdIx Bank's Atlas method (adjus
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AppeNdIx table a2. descriptive stat
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AppeNdIx table a3. labour market fa
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AppeNdIx CorE sEmi-pEriphEry pEriph
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AppeNdIx Country clusters table A5
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AppeNdIx semi-peripheral countries
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AppeNdIx Figure a6. Health indicato
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RefeRences RefeRences 1. IntroductI
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arrangements and precariousness in
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International Labour Organization.
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Benach (Eds.), Desigualtats en salu
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Instituto Nacional de Estadística
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desde América Latina y el Caribe.
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Woldehanna, T., Guta, F., & Ferede,
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unemployment Chan, W. S., Yip, P. S
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International Labour Organization.
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Clarke, S., Sloane, D., & Aiken, L.
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among residents in the Trent region
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Sales, E. C., & Santana, V. S. (200
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Parent-Thirion, A., Fernandez, M. E
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Unemployment and mental health: Und
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Tytherleigh, M. Y., Jacobs, P. A.,
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Chilcoat, E. (2008). Pinkie promise
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Africa. Perspective of Global Devel
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freight transport and distribution
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Índex LIST OF FIGURES 2. Fair empl
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Table A5. Country clusters by labou
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Case study 43. Sexual orientation,
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acronyms and abrevIatures AIDS - Ac
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autHors and contrIbutors CORE GROUP
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Maria da Graça Luderitz Hoefel. Ho
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Maria da Graça Luderitz Hoefel. Ho
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INSTITUTIONS AND ASSOCIATIONS THAT
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