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Temporary and contract workers--their health

Is it the regulations or the personal behavior that cause "contingent" workers to be less healthy and have more accidents? It's a government funded report in the January 30, 2008 issue of JAMA (NIOSH and CDC), so without even reading the article, "Contingent workers and contingent health; risks of a modern economy," you just know it's going to be the fault of the federal government for not covering certain workers--usually part-timers who work for smaller firms or private contractor/self-employed. Otherwise, how would these ladies fund their positions?

I have a little experience with "involuntary" worker status. (In bureaucratic jargon that doesn't mean I was a slave or indentured, it means I would have preferred a permanent position some of those years, therefore my status of "involuntary.") One of my earliest part-time academic positions for which I received no benefits except a tuition waiver was translating medical newspapers from Russian into English. Later when I was a library grad student I had a hazardous 20 hour a week position keeping a PL480 shelving area clean and tidy and lifting heavy boxes of books upon which being cataloged no one would open, yea these 42 years. It was really dirty and I'm sure my lungs suffered from dirt, dust mites and chemical fumes from cheap Soviet paper. Also I experienced dangerous paper cuts from the ubiquitous LC cards we carried from room to room while cataloging, all the while risking ankle and arch damage wearing high heels on polished floors. "Real" workers (degreed librarians) didn't do those jobs--just we lowly peons. From 1978 to 1986 I had a series of temporary, contract positions ranging from 3 months to 3 years, and I thank God for them. I loved the start up, the risks, the poking my nose into places it didn't belong, meeting interesting people, being home with my kids after 3 p.m. and during summers, and not being required to attend faculty meetings or be on committees like my colleagues. And although I didn't know it then, I was being prepared in the school of experience and hard knocks for the best job of my life, Head of the Veterinary Medicine Library at the Ohio State University. My most memorable work-related injuries were all during full-time, faculty employment: rotator cuff problems from lifting heavy journals, and a fall outside a lab when water leaked into the hall. But I digress.

The authors of the article admit to two problems--most studies on the health of contingent workers have been done in Europe, and those studies and the few in the U.S. show that temporary workers tend to have a set of behavior and personal deficiencies that most regular workers don't. And it's most likely those deficiencies that impact their health. They are

• more alcohol-related deaths
  
• more smoking related cancers
  
• more psychological problems
  
• more musculoskeletal disorders
  
• more likely to be in high risk jobs
  
• less experience
  
• fewer hours of safety training
  
• more likely to be using equipment for which they hadn't trained
  
• more likely to have language deficiencies (illegals)
  
• self-employed, independent contractor not covered by current laws on health and safety

But not to worry, the authors plow ahead with plans to answer "the many questions that remain," and to "collect information on contingent status" which might now not be fully captured to explain workers' illnesses and injuries. No doubt they will recommend changing the current laws (last 40 years) which mostly exempt employers with <15 or <20 workers (age discrimination 1967, occupational safety 1970, health and retirement standards 1974; disabilities 1990; family leave 1993). This will be more of the ongoing destruction of the small businessman with more federal regulations, and the self-employed/ private contractor, creating a demand for more government services, a larger bureaucracy and universal, low quality health care for everyone except the politicians.

"Contingent Workers and Contingent Health Risks of a Modern Economy," Kristin J. Cummings, MD, MPH; Kathleen Kreiss, MD, JAMA. 2008;299(4):448-450.