Precarious work and the risk of receiving a disability pension.

AIMS: Precarious employment is an emerging determinant of occupational health, but its association with work-related disability remains little understood. We operationalised precarious work as a multidimensional construct and examined how the accumulation of precarious job features predicts the incidence of receiving a disability pension (DP).

METHODS: The study comprised 13,228 employees aged 20-54 who had been interviewed for the Finnish Quality of Work Life Surveys in 1984, 1990, 1997, or 2003. We measured precarious work with five variables that reflect both subjective and objective job insecurity: the threat of dismissal/unemployment; poor employability; low earnings; previous unemployment; and temporary contract. An eight-year follow-up was merged with the pooled cross-sectional data, and Cox proportional hazard ratios (HR) for receiving a DP were compared between the insecurity measures, controlling for sociodemographic covariates, job characteristics and health at the baseline with a step-wise procedure.

RESULTS: Precarious employees had an elevated risk of receiving a DP (all covariates adjusted for). The risk of receiving a DP was associated with subjective job insecurity, with the strongest indicator being poor employability. The association between the threat of unemployment and receiving a DP was weak before controlling for health. Among objective insecurity measures, low earnings and earlier unemployment were weakly connected to receiving a DP before controlling for sociodemographic covariates, job characteristics and health.

CONCLUSIONS: We recommend the evaluation of several precarious job features in future studies. The risk of receiving a DP could potentially be offset by improving individuals' employability.