When Foxconn, the world’s largest electronics subcontractor, decided robots were the solution to its high volume production headaches, the latest much vaunted hope for future jobs followed its mines, mills and manufacturing predecessors on the giant slide towards redundancy. In July 2011, the Taiwan-based multinational announced its intention to increase its contingent of 10,000 robots to 300,000 in 2012 and1 million within three years.

Foxconn’s Terry Gou, whose company supplies firms including Apple, Sony and Hewlett Packard and currently has more than one million employees worldwide, endorsed the trend towards automation in brutally frank language. In January 2012 he told the official Chinese news agency Xinhua: “As human beings are also animals, to manage one million animals gives me a headache.”

Work is becoming increasingly workerless, and it’s a phenomenon that has spread way beyond manufacturing. A sprinkling of Amazon warehouse workers can hoover up the business online once occupying High Streets full of shop workers. But even these new generation jobs aren’t safe. Forklifts are increasingly driverless, and the smattering of human ‘pickers’ directed by computers to the shelves are finding high-speed robotic go-carts are nudging them aside.

Even the call centres and help desks dealing with our orders and queries may now employ voice-recognition software and synthethised speech, not real human voices. The talk used to be about whether to outsource the service to cheaper nations. Not so much anymore. There’s less real talk full stop.stress

The most reliable product of many modern workplaces is now insecurity, with those in permanent jobs fearing the axe in the name of automation or austerity, and a growing slice of the workforce already outsourced or semi-detached from employment, on zero hours contracts, temping or skirting around for scraps in the informal economy.

 “The majority of the world’s workforce is informal and is in an extremely precarious position,” the 2008 report of a World Health Organisation (WHO) commission on social determinants of health 1 observed. It noted: “The global dominance of precarious work, with its associated insecurities, has contributed significantly to poor health and health inequities.”

It is a problem affecting workers in the developed as well as the developing world.

Lives on hold’,2 the May 2012 report of an independent study commissioned by Australian national union federation ACTU, concluded 40 per cent of Australians were now in some form of insecure work and one is five is employed casually. It called for governments to conduct research into the health effects of insecure work and to identify the associated social costs.

ACTU president Ged Kearney commented: “The fear, vulnerability and powerlessness experienced by workers engaged in insecure work mean they are less likely to raise health and safety concerns, they accept poor conditions and exploitation, and therefore face greater risks of injuries and illness.

“It makes no economic sense to continue to let these workers fall through the gap… Both the OECD and World Health Organisation have found that insecure work has negative impacts on workers’ safety in the short term, and the associated uncertainty and anxiety damages the health of workers in the longer term.”

The union leader added: “The continued growth of insecure work will over time contribute to a widening of health inequalities, which is unacceptable.”

The situation is similar in the UK. Government figures published in August 2012 revealed soaring levels of part-time working and underemployment. The Office for National Statistics figures show the number of part-time workers reached a record high of 8.07 million while those working part-time because they can't find a full-time job hit 1.42 million - the highest figure since records began in 1992.

The country’s stock of temporary workers is in the region of 1.4 million. That means about one in every 10 workers is now either a reluctant part-timer or a temp. Either way, they are less likely to have access to a union or meaningful legal protection.

An analysis of official figures published on 4 September 2012 by the UK union federation TUC calculated one million more workers are under-employed now than on the eve of the recession in early 2008. ‘Under-employment crisis: A TUC analysis of under-employment across the UK’ reports the number of under-employed workers - those doing part-time jobs because they can't find full-time ones or wanting more hours in their current jobs - has increased by 42 per cent over the last four years to reach 3.3 million.

According to the union body, its analysis shows that under-employment is an even greater problem than has previously been realised, because it is not just those in part-time jobs who want to work full-time who are under-employed. Many more workers across the economy want more hours in their existing jobs.

For these workers, insecurity is more than a headache. It can mean injury, ill-health and an early grave.

Job insecurity kills

In July 2012, former France Telecom chief executive Didier Lombard and his deputy Louis-Pierre Wenes were forced to post bail pending the outcome of an official judicial investigation into a spate of suicides at the firm. The deaths in 2008 and 2009 coincided with the unfolding global financial crisis and restructuring of the company.

Unions at the firm had complained of a culture of fear and depression, where managers did not take staff mental health seriously. Some union officials said the company had intentionally created a stressful work environment to push employees into quitting in order to reduce its labour force and cut costs.

While in extreme cases stress can even lead to suicide, the director of the International Labour Organisation’s (ILO) Safework programme, Seiji Machida, said “we here in the ILO think that the crisis has become a factor of concern for the health and safety of workers around the world.” He said workers have to deal with the fear and stress of losing their jobs.

There had been a general rise in mental ill-health due to stress at the workplace in Europe and elsewhere, ILO reports. The reasons for this trend include information overload, intensification of work and time pressure, high demands on mobility and flexibility, being constantly “on call” due to mobile phone technology, and “last but not least the worry of losing one’s job.”

Restructuring and redundancies are the stock business responses to recession. As the bottom line suffers, workers become a cost item to be controlled, not an asset to be valued.

It is an old problem, but it is also a growing problem. A 2009 report from the Global Union Research Network (GURN), ‘Moving from precarious employment to decent work’ 3 noted “we are experiencing the wholesale destruction and the creation of new and evolving relationships with employers. The task is to ensure workers and their organisations have some influence and control over the conditions under which they must work.”

Businesses though may be less concerned at the creation of a new relationship which leaves workers with less control and fewer rights. A UK study published in 2012 in the International Journal of Knowledge, Culture and Change Management 4 concluded businesses really don’t care how constant change affects their staff. Gary Rees from the University of Portsmouth Business School said he and co-author Sally Rumbles were “alarmed” by the findings.

“Employees are an organisation’s most valuable asset and collectively have the power to help businesses survive and thrive in bad times as well as in good. Managers seem to think they have a licence to change, but our research has shown high-level executives admit only about a third of changes they’ve made are successful and have helped sustain their company through turbulent times.”

He added: “Employers and senior managers need to stop foisting continual change upon their staff in a bid to stay viable as a business. The secret is not to ignore the fact change can threaten the staff who, in turn, can become exhausted, cynical or depressed, which destabilises the organisation.”

Sally Rumbles said: “The worst thing is those who are more likely to burnout in the workplace are the most engaged and hardworking staff. If a business loses those people then it risks destabilising the business. Instead of seeing people as the most important asset and what gives a business its competitive advantage, too many senior managers think what is good for business is good for the workers.”

She added: “Continual change can feel like bereavement and employees need time to recover and adjust after change, not be thrust again and again into new periods of uncertainty and new initiatives and restructuring. Businesses need to plan change, execute it and then tell staff the turmoil is over.”

There is no mystery there. In bad times businesses made bad choices, and we’ve been warned about this for years. In 2000, Hazards warned that modern workplaces could make workers “mad, sad and bad” and pointed to research showing downsizing and excessive overtime were being accompanied by widespread occupational health problems, depression, occupational injuries and violence 5.

A 2001 review of ‘the global expansion of precarious employment, work disorganisation, and consequences for occupational health’, published in the International Journal of Health Services, 6 found: “Of the 93 published journal articles and monographs/book chapters reviewed, 76 studies found precarious employment was associated with a deterioration in occupational health and safety (OHS) in terms of injury rates, disease risk, hazard exposures, or worker (and manager) knowledge of OHS and regulatory responsibilities. Of the more than 25 studies each on outsourcing and organizational restructuring/downsizing, well over 90 per cent find a negative association with OHS. The evidence is fairly persuasive for temporary workers, with 14 of 24 studies finding a negative association with OHS.”

In 2003 Hazards warned suicides, heart disease and strokes were becoming “the thoroughly modern way to die at work” 7. And in 2006, Hazards repeated the warning, citing extensive research linking 'precarious' employment to higher rates of occupational accidents and ill-health and greater exposure to workplace risks 8.

The long-running Whitehall II investigation of the health of British civil servants has established job insecurity not only leads to increased and sometimes deadly ill-health, the effects are worse the more insecure work gets. A 2002 analysis published in the Journal of Epidemiology and Community Health 9 concluded: “Loss of job security has adverse effects on self-reported health and minor psychiatric morbidity, which are not completely reversed by removal of the threat and which tend to increase with chronic exposure to the stressor.”

The message is the same wherever you look. A study covering 16 European countries published in the journal Social Science and Medicine 10 in 2010 concluding “the public health impact of job insecurity is likely to be substantial.”

Job insecurity will hurt you

Australian research published in July 2012 echoed the findings of earlier studies, concluding casual workers are 50 per cent more likely to be injured at work. The study by national safety regulator Safe Work Australia 11 found casual workers without leave entitlements reported 54 injuries per million hours worked compared with a rate of 35 for those with leave entitlements. It noted: “On a per hour worked basis, male and female casual workers experienced the highest injury rates.”

Employers may opt to out-source more hazardous tasks to temporary workers.12  There is certainly evidence precarious workers can be exposed to greater risks. Canadian researchers, who developed the concept of “employment strain” to attempt to capture the characteristics of precarious employment, identified increased risks that included ergonomic problems, heavier workload, greater exposure to toxic substances and identified higher levels of back and muscular pain, fatigue and lower levels of job satisfaction. 13

A 2012 International Labour Organisation (ILO) report noted: “Precarious work arrangements are also associated with poor health conditions. Workers on temporary or agency contracts are often exposed to hazardous work environments, stressful psychosocial working conditions, increased workload and disproportional travel time between multiple jobs at multiple sites. Research in the field has also found that precarious workers are less likely to receive adequate training for the tasks they are required to perform and that their occupational safety and health is poorly monitored by inspection systems.” 14

The report added: “As job insecurity increases and social benefits decrease, workers face increasing pressure to accept job offers that put their health and safety at risk. Subcontracting is also often used by primary employers as a means of shifting risk by outsourcing more dangerous jobs to subcontracted and agency workers, forcing precarious workers to bear the brunt of more dangerous or risky tasks. Finally, in many countries (bogus) self-employed workers do not benefit from workers compensation or health insurance, leaving them at risk of long term unemployment if injured or ill.”

Precarious may also find themselves working longer hours. UK campaigners against blacklisting of construction health and safety whistleblowers warned in 2009 that agency workers who refused to sign an opt-out from the Working Time Regulations’ 48-hour ceiling on the working week could find themselves let go and would have difficulty finding future placements.

But a lack of control of working hours and an increased injury risk in ‘precarious’ employment is just the start of the problem. The related health consequences can break your body and blow your mind.

The 2010 Social Science and Medicine 10 paper that examined precarious work in Europe summarised the evidence of health effects. It noted: “Beside their effects on organisational functioning, insecure jobs are also known to detrimentally affect employees' health. Low job security has been repeatedly found to be related to somatic 15 and minor psychiatric morbidity, to poor self-rated health 15, as well as to incident coronary heart disease 16 and its risk factors, including high cholesterol, hypertension and obesity. Other, less direct measures of the health status, such as sickness absence 17 and health services use have also been found to be associated with job insecurity.”

The effects can be both immediate and long-term. A Cambridge University study of UK workers concluded not only was there a marked health impact from the ‘shock’ realisation your job was possibly at risk, but the effects lingered and caused lasting harm.

The February 2011 paper in Sociological Research Online 18 “found that the unexpected announcement of job insecurity can cause a sudden and marked spike in psychological symptoms. Looking at longer-term effect for prolonged periods of job insecurity, wellbeing (ie. symptoms of anxiety and depression) continues to deteriorate for at least a year, with no sign of levelling off or recovery.”

The impact on mental health of a badly paid, poorly supported, or short-term job can be as harmful or worse than no job at all. A study published in Occupational and Environmental Medicine 19 in 2011 looked at the “psychosocial” quality of jobs, grading them on demands and complexity, level of control, and perceived job security. Those in the poorest quality jobs experienced the sharpest decline in mental health over time. There was a direct straight-line association between the number of unfavourable working conditions experienced and mental health, with each additional adverse condition lowering the mental health score. Moving from worklessness to a poor quality job was significantly more detrimental to mental health than remaining unemployed.

Co-author Professor Lyndall Strazdins of Australian National University, cited in the British Medical Journal, commented: “Some jobs are corrosive to health… and insecurity is part of that.”

In a 1 August 2012 commentary in the British Medical Journal 20, ‘Job insecurity contributes to poor health,’ Australian academic Ray Moynihan concluded: “To some, the harmful effects of insecure and poor quality work will be seen as the unavoidable side effect of an increasingly globalised and sometimes brutal marketplace. To others, the growing body of evidence about these connections will boost arguments that employers’ need for flexibility and employees’ need for security must somehow become more integrated.”

A 2011 paper on the health consequences of precarious employment, published in the journal Work 21 and authored by researchers from Canada’s Institute for Work and Health (IWH) argued: “Proactive regulatory initiatives and all-encompassing benefits programmes are urgently required to address emerging work forms and arrangements that present risks to health.”

The authors of the 2010 Social Science and Medicine10 study of the impact of job insecurity on health, gave their own prescription for action. “Given that job insecurity is likely to increase as the labour market becomes more globalised, governments and labour unions need to pay attention to job insecurity and its public health consequences.”

While employers and governments mull over the evidence, unions and labour rights organisations are taking matters into their own hands. For them secure work is a matter of common decency, and there are pressing health reasons why they are unwilling to contemplate an indecent and inevitably deadly wait.




Closing the gap in a generation: Health equity through action on the social determinants of health, WHO Commission on Social Determinants of Health – final report, 2008 [pdf].


Lives on hold: Unlocking the potential of Australia’s workforce. Report of the independent inquiry into insecure work in Australia, May 2012 [pdf]. ACTU news release and secure jobs, better future website.


John Evans and Moving from precarious employment to decent work, discussion paper number 13,Euan Gibb, Global Union Research Network (GURN), 2009 [pdf]. GURN portal on precarious work.


Gary Rees and Sally Rumbles. Continuous organizational change and burnout, International Journal of Knowledge, Culture and Change Management, Volume 11, Issue 3, pages 179-194, 2012 [abstract]. University of Portsmouth news release.


Not what we bargained for. Hazards 69, 2000 [pdf].


Michael Quinlan, Claire Mayhew and Philip Bohle. The global expansion of precarious employment, work disorganisation, and consequences for occupational health, International Journal of Health Services, volume 31, number 2, 2001 [abstract].


Drop dead. Hazards 83, 2003.


HSE is broke, Hazards 96, 2006.


Ferrie JE, Shipley MJ, Stansfeld SA, Marmot MG. Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study. Journal of Epidemiology and Community Health, volume 56, pages 450-454, 2002 [pdf].


László KD, Pikhart H, Kopp MS, Bobak M, Pajak A, Malyutina S and others. Job insecurity and health: a study of 16 European countries, Social Science and Medicine, volume 70, pages 867-74, 2010.


Australian work-related injury experience by sex and age, 2009-2010, Safe Work Australia, 30 July 2012 [pdf]. Safe Work Australia news release. ACTU news release.


At Work, Issue 69, IWH, Summer 2012 and related research presentation, The management of OHS and return-to-work issues in temporary work agencies [pdf].


Wayne Lewchuk, Alice de Wolff, Andy King, Michael Polanyi. From job strain to employment strain: Health effects of precarious employment, Just Labour, volume 3, pages 23-35, 2003 [pdf] and Wayne Lewchuk, Alice di Wolff, Andrew King and Michael Polanyi. The hidden costs of precarious employment: Health and the employment relationship. In Leah F Vosko, ed., Precarious Employment: Understanding Labour Market Insecurity in Canada, pages 141-162, 2006. Canada: McGill-Queens University Press.


From precarious work to decent work: outcome document to the workers' symposium on policies and regulations to combat precarious employment, International Labour Office, Bureau for Workers' Activities (ACTRAV), ILO, 2012 [pdf].


Ferrie JE, Shipley MJ, Newman K, Stansfeld SA, Marmot M. Self-reported job insecurity and health in the Whitehall II study: potential explanations of the relationship. Social Science and Medicine, volume 60, pages 1593–1602, 2005. [PubMed]


Lee S, Colditz GA, Berkman LF, Kawachi I. Prospective study of job insecurity and coronary heart disease in US women, Annals of Epidemiology, volume 14, pages 24–30, 2004. [PubMed]


Kivimaki M, Vahtera J, Thomson L, Griffiths A, Cox T, Pentti J. Psychosocial factors predicting employee sickness absence during economic decline, Journal of Applied Psychology, volume 82, pages 858–872, 1997. [PubMed]


Brendan Burchell. A Temporal Comparison of the Effects of Unemployment and Job Insecurity on Wellbeing, Sociological Research Online, volume 16, issue 1, published 28 Feb 2011.


P Butterworth, LS Leach, L Strazdins, SC Olesen, B Rodgers, DH Broom. The psychosocial quality of work determines whether employment has benefits for mental health: results from a longitudinal national household panel survey. Occupational and Environmental Medicine, 2011; DOI: 10.1136/oem.2010.059030 Science Daily news release, 15 March 2011


Ray Moynihan. Job insecurity contributes to poor health, British Medical Journal, volume 345, e5183, 1 August 2012.


H Scott-Marshall and E Tompa. The health consequences of precarious employment experiences, Work, volume 38, number 4, pages 369-382, 2011. Related IWH article.