Under Pressure,Out of Control,or Home Alone? Reviewing Research and Policy Debates on the Occupational Health and Safety Effects of Outsourcing and Home-Based Work
Restricted accessResearch articleFirst published online July, 2008
Under Pressure,Out of Control,or Home Alone? Reviewing Research and Policy Debates on the Occupational Health and Safety Effects of Outsourcing and Home-Based Work
The practice of outsourcing or subcontracting of work has grown rapidly in most countries over the past two decades. Outsourcing, de-institutionalization, and a range of other practices have also resulted in a growth of home-based work. Home-based workers, even when not part of a subcontracting process, operate in an isolated situation remote from their employer and other workers. Do such work arrangements expose workers to greater risk of injury, illness, or assault? The authors reviewed international studies of the occupational health and safety (OHS) effects of subcontracting and home-based work undertaken over the past 20 years. Of the 25 studies analyzed, 92 percent found poorer OHS outcomes. The studies were examined for clues about the reasons for these negative outcomes. The authors also identified similarities and differences between subcontracting and home-based work. Despite the evidence of poor OHS outcomes, research into outsourcing has stalled in recent years. With notable exceptions, governments have taken little account of findings on these work arrangements in their laws and policies, in part because neoliberal ideas dominate national and global policy agendas. The authors examine policy challenges and regulatory responses and make suggestions for future research and policy interventions.
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References
1.
QuinlanM.MayhewC., and BohleP.The global expansion of precarious employment, work disorganization, and consequences for occupational health: A review of recent research. Int. J. Health Serv.31:335–414, 2001.
2.
VirtanenM.Temporary employment and health: A review. Int. J. Epidemiol.34:610–622, 2005.
3.
LouieA.Empirical study of employment arrangements and precariousness in Australia. Relat. Ind.61(3):465–489, 2006.
4.
PlattS.PavisS., and AkramG.Changing Labour Market Conditions and Health: A Systematic Literature Review (1993–98). Report to European Foundation for the Improvement in Living and Working Conditions, Dublin, 1998.
5.
BaugherJ., and Timmons RobertsJ.Perceptions and worry about hazards at work: Unions, contract maintenance, and job control in the US petrochemical industry. Ind. Relat.38(4):522–541, 1999.
6.
BlankV.Hidden accident rates and patterns in the Swedish mining industry due to the involvement of contract workers. Saf. Sci.21(1):23–35, 1995.
7.
BoydC., and BainP.“Once I get you up there, where the air is rarified”: Health, safety and the working conditions of airline cabin crews. New Tech. Work Employ.13(1):16–28, 1998.
8.
BrulinC.WinkvistA., and LangendoenS.Stress from working conditions among home care personnel with musculoskeletal symptoms. J. Adv. Nurs.31(1):181–189, 2000.
9.
CollinsonD.“Surviving the rigs”: Safety and surveillance on North Sea oil installations. Org. Stud.20(4):579–600, 1999.
10.
DentonM.Job stress and job dissatisfaction of home-care workers in the context of health care restructuring. Int. J. Health Serv.32:327–357, 2002.
11.
Doniol-ShawG.Travail en sous-traitance et sante mentale. Arch. Mal. Prof. Med. Travail60(6):563–565, 1999.
12.
GlaznerJ.Construction injury rates may exceed national estimates: Evidence from the construction of Denver International Airport. Am. J. Ind. Med.34:105–112, 1998.
13.
GlaznerJ.Contractor safety practices and injury rates in construction of the Denver International Airport. Am. J. Ind. Med.35:175–185, 1999.
14.
GyiD.HaslamR., and GibbA.Case studies of occupational health management in the engineering construction industry. Occup. Med.48(4):263–271, 1998.
15.
HannerzH., and TuchsenF.Hospitalizations among female home-helpers in Denmark, 1981–1997. Am. J. Ind. Med.41:1–10, 2002.
16.
HasleP.Outsourcing and employer responsibility: A case study of occupational health and safety in the Danish public transport sector. Relat. Ind.62(1):96–117, 2007.
17.
IwiD.The self-reported well-being of employees facing organisational change: Effects of an intervention. Occup. Med.48(6):361–368, 1998.
18.
JohanssonJ.Psychosocial work factors, physical work load and associated musculoskeletal symptoms among home care workers. Scand. J. Psychol.36(2):113–129, 1995.
19.
LoweryJ.Risk factors for injury among construction workers at Denver International Airport. Am. J. Ind. Med.34:113–120, 1998.
20.
MayhewC., and QuinlanM.The effects of outsourcing on occupational health and safety: A comparative study of factory-based and outworkers in the Australian clothing industry. Int. J. Health Serv.29:83–107, 1999.
21.
MayhewC., and QuinlanM.Occupational violence in long distance road transport: A study of 300 Australian truck drivers. Curr. Issues Crim. Justice13(1):36–46, 2001.
22.
MayhewC., and QuinlanM.Economic pressure, multi-tiered subcontracting and occupational health and safety in Australian long haul trucking. Emp. Relat.28(3): 212–229, 2006.
23.
MayhewC.QuinlanM., and FerrisR.The effects of subcontracting/outsourcing on occupational health and safety: Survey evidence from four Australian industries. Saf. Sci.25(1–3):163–178, 1997.
24.
MeyerJ., and MuntanerC.Injuries in home health care workers: An analysis of occupational morbidity from a state compensation database. Am. J. Ind. Med.35:295–301, 1999.
25.
MontreuilS., and LippelK.Telework and occupational health: A Quebec empirical study and regulatory implications. Saf. Sci.41(4):339–358, 2003.
26.
NetterstromB., and HansenA.Outsourcing and stress: Physiological effects on bus drivers. Stress Med.16:149–160, 2000.
27.
OnoY.Reports of work related musculoskeletal injury amongst home care service workers compared with nursery school workers and the general population of employed women in Sweden. Occup. Environ. Med.52:686–693, 1995.
28.
QuinlanM., and MayhewC.Precarious employment and workers' compensation. Int. J. Law Psychiatry22(5–6):491–520, 1999.
29.
RebitzerJ.Job safety and contract workers in the petrochemical industry. Ind. Relat.34(1):40–57, 1995.
30.
SaksvikP., and GustafssonO.Early retirement from work: A longitudinal study of the impact of organisational change in a public enterprise. Policy Pract. Health Saf.2(2):43–55, 2004.
31.
GustafssonO., and SaksvikP.Outsourcing in the public refuse collection sector: Exploiting old certainties or exploring new possibilities. Work25(2):91–97, 2005.
32.
SalminenS.Organisational factors influencing serious occupational accidents. Scand. J. Work Environ. Health19:352–357, 1993.
33.
SpangenbergS.The construction of the Oresund Link between Denmark and Sweden: The effect of a multi-faceted safety campaign. Saf. Sci.40:457–465, 2002.
34.
Thébaud–MonyA.Contracting and subcontracting by the French nuclear power industry. Int. J. Occup. Environ. Health5(4):296–299, 1999.
35.
SiefertA., and MessingK.Cleaning up after globalization: An ergonomic analysis of the work activity of hotel cleaners. Antipode38(3):557–578, 2006.
36.
MenendezM.Is precarious employment more damaging to women's health than men's?Soc. Sci. Med.64:776–781, 2007.
37.
BarlingJ.RogersA., and KellowayE.Behind closed doors: In-home workers' experience of sexual harassment and workplace violence. J. Occup. Health Psychol.6(3):255–269, 2001.
38.
HoodJ.Competition and safety in UK local authorities. Public Manage. Rev.4(1):575–592, 2002.
39.
JamalM.Burnout and self-employment: A cross cultural empirical study. Stress and Health23:249–256, 2007.
40.
MirabelliM.Employment status and the use of respiratory protection among metalworkers, solderers and welders. Occup. Environ. Med.64:548–552, 2007.
41.
KinesP., and Lyngby MikkelsenK.Effects of firm size on risks and reporting of elevation fall injury in construction trades. Occup. Environ. Med.45:1074–1078, 2003.
42.
FabianoB.CurroF., and PastorinoR.A study of the relationship between occupational injuries and firm size and type in the Italian industry. Saf. Sci.42: 587–600, 2004.
43.
CostabileF.Prevention of accidents caused by construction work. Ann. Ig.1(6):1587–1600, 1989.
44.
LaceyR.LewisM., and SimJ.Piecework, musculoskeletal pain and the impact of workplace psychosocial factors. Occup. Med.57:430–437, 2007.
45.
CoxR.DesmaraisJ., and LippelK.Les enjeux juridiques du télétravail au Québec.CEFRIO, Quebec City, 2001. www.cefrio.qc.ca.
46.
QuinlanM.MayhewC., and BohleP.The global expansion of precarious employment, work disorganization, and occupational health: Placing the debate in a comparative historical context. Int. J. Health Serv.31:507–536, 2001.
47.
EganM.“Profits before people”? A systematic review of the health and safety impacts of privatizing public utilities and industries in developed countries. J. Epidemiol. Community Health61:862–870, 2007.
48.
ChoC.An interfaith workers' centre approach to workplace rights: Implications for workplace safety and health. J. Occup. Environ. Med.49:275–281, 2007.
49.
GuthrieR., and QuinlanM.The occupational health and safety rights and workers compensation entitlements of illegal immigrants: An emerging challenge. Policy Pract. Saf. Health3(2):69–89, 2005.
50.
WilliamsonA.Predictors of psychostimulant use by long distance truck drivers. Am. J. Epidemiol.166:1320–1326, 2007.
51.
SaltzmanG., and BelzerM.Truck Driver Occupational Safety and Health: 2003 Conference Report and Selective Literature Review.National Institute for Occupational Safety and Health, Cincinnati, 2007.
52.
JarmanB.Explaining differences in English hospital death rates using routinely collected data. BMJ318:1515–1520, 1999.
53.
AikenL.Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction. JAMA288:1987–1993, 2002.
54.
GrundmanH.Factors for the transmission of methicillin-resistant Staphylococcus aureus in an adult intensive care unit: Fitting a model to the data. J. Infect. Dis.185:481–488, 2002.
55.
StegengaJ.BellE., and MatlowA.The role of nurse understaffing in nosocomial viral gastrointestinal infections on a general pediatrics ward. Infect. Control Hosp. Epidemiol.23(3):133–139, 2002.
56.
WestM.The link between the management of employees and patient mortality in acute hospitals. Int. J. Hum. Res. Manage.13(2):1299–1310, 2002.
57.
AndersenB.Spread of methicillin–resistant Staphylococcus aureus in a neonatal intensive care unit associated with understaffing, overcrowding and mixing of patients. J. Hosp. Infect.50:18–24, 2002.
58.
SaulnierF.Assessing excess nurse work load generated by multiresistant nosocomial bacteria in intensive care. Infect. Control Hosp. Epidemiol.22(5): 273–278, 2001.
59.
UnruhL.Nursing staff reductions in Pennsylvania hospitals: Exploring the discrepancy between perception and data. Med. Care Res. Rev.59(2):197–214, 2002.
60.
JonesL., and AranaG.Is downsizing affecting incident reports?Joint Commission: J. Qual. Improvement22(8):592–594, 1996.
61.
National Institute for Occupational Safety and Health. Incidence of Needlestick and Sharps Injuries and Medical Safety Device Availability/Use among Non-Hospital Health Care Workers. Cincinnati, 2003.
62.
MananganL.Feasibility of national surveillance of health-care-associated infections in home-care settings. Emerg. Infect. Dis.8(3), 2002.
63.
BenachJ., and MuntanerC.Precarious employment and health: Developing a research agenda. J. Epidemiol. Community Health61:276–277, 2007.
64.
CarayonP., and ZijlstraF.Relationship between job control, work pressure and strain: Studies in the USA and the Netherlands. Work and Stress13(1):32–48, 1998.
65.
ClarkeM.“This just isn't sustainable”: Precarious employment, stress and workers' health. Int. J. Law Psychol.30(4–5):311–326, 2007.
66.
MalenfantR.LaRueA., and VezinaM.Intermittent work and well-being: One foot in the door, one foot out. Curr. Sociol.55(6):814–835, 2007.
67.
QuinlanM., and BohleP.Contingent work and occupational safety. In The Psychology of Workplace Safety, ed. BarlingJ. and FroneM., pp. 81–106. American Psychological Association, Washington, DC, 2004.
MayhewC., and QuinlanM.Subcontracting and occupational health and safety in residential building. Ind. Relat. J.28(3):192–205, 1997.
70.
RamM.The dynamics of informality: Employment relations in small firms and the effects of regulatory change. Work Employ. Society15(4):845–861, 2001.
71.
RamM.EdwardsP., and JonesT.Staying underground: Informal work, small firms and employment regulation in the United Kingdom. Work Employ. Society34(3):318–344, 2007.
72.
HainesF.Responses to death in complex industrial work sites: The nexus between workplace safety and economic development. Aust. J. Soc. Issues.31(3): 253–269, 1996.
73.
JohnstoneR.MayhewC., and QuinlanM.Outsourcing risk? The regulation of OSH where contractors are employed. Comp. Labor Law Policy J.22(2–3):351–393, 2001.
74.
JohnstoneR.QuinlanM., and WaltersD.Statutory occupational health and safety workplace arrangements and the modern labour market. J. Ind. Relat.47(1):93–116, 2005.
75.
WaehrerG.Occupational injury costs and alternative employment in construction trades. J. Occup. Environ. Med.49:1218–1227, 2007.
76.
HainesF.The show must go on: The response to fatalities in multi–employer workplaces. Soc. Prob.40(4):547–563, 1993.
77.
BernsteinS.LippelK., and LamarcheL.Women and Homework: The Canadian Legislative Framework.Status of Women Canada, Ottawa, 2001. www.swc-cfc.gc.ca/pubs/pubsalpha_e.html.
78.
LippelK.Precarious employment and occupational health and safety regulation in Quebec. In Precarious Employment: Understanding Labour Market Insecurity in Canada, ed. VoskoL.. McGill–Queen's University Press, Montreal, 2005.
79.
DonahueL.LamareJ., and KotlerF.The Cost of Worker Misclassification in New York State. ILR Collection Research Studies and Reports. Cornell University, Ithaca, NY, 2007.
80.
MasKowsky, E. v Fed Ex Ground and Crawford & Co, Workers' Compensation Commission, State of Connecticut File No. 300072257, 31 January 2007.
81.
HarcourtM.LamH., and HarcourtS.The impact of workers' compensation experience-rating on discriminatory hiring practices. J. Econ. Issues41(3):681–699, 2007.
82.
QuinlanM.Workers' compensation and the challenges posed by changing patterns of work: Evidence from Australia. Policy Pract. Health Saf.2(1):25–52, 2004.
83.
PalmerK.Employment characteristics and job loss in patients awaiting surgery on the hip or knee. Occup. Environ. Med.62(1):54–57, 2005.
84.
KochanT.Human resource strategies and contingent workers: The case of safety and health in the petrochemical industry. Hum. Res. Manage.33(1):55–77, 1994.
85.
LindoeP., and HansenK.Integrating internal control into management systems: A discussion based on Norwegian case studies. In Systematic Occupational Health and Safety Management: Perspectives on an International Development, ed. FrickK., pp. 437–455. Pergamon, Amsterdam, 2000.
86.
WoolfsonC.Business organisation, precarious employment and risk transfer mechanisms in the offshore oil industry. Policy Pract. Health Saf.2(2):57–76, 2004.
87.
LoosF., and Le DeautJ.Rapport Fait Au Nom de la Commission D'Enquete sur la Surete des Installations Industrielles et des Centres de Recherche et sur la Protection de Personnes et de L'environnment en cas D'Accident Industriel Majeur. Assemblee Nationale No. 3559. Paris, 2002.
88.
JamesP.Regulating supply chains for safety and health. Ind. Law J.36(2): 163–187, 2007.
89.
RawlingM.The regulation of outwork and the federal takeover of labour law. Aust. J. Lab. Law20:189–206, 2007.
90.
WattersonA.Regulation of occupational health and safety in the semiconductor industry. Int. J. Occup. Environ. Health12(1):72–80, 2006.
91.
LabonteR., and SingerM.Glossary of the World Trade Organisation and public health: Part 1. J. Epidemiol. Community Health60:655–661, 2006.
92.
LabonteR., and SingerM.Glossary of the World Trade Organisation and public health: Part 2. J. Epidemiol. Community Health60:738–744, 2006.
93.
DoridesD.On the job training at construction sites of the hospital corporation of Careggi. G. Ital. Med. Lav. Ergon.28(1 suppl.):77–80, 2006.
94.
BrownG.Protecting workers' health and safety in the global economy through international trade treaties. Int. J. Occup. Environ. Health11(2):207–209, 2005.
RosenstockL.CullenM., and FingerhutM.Advancing worker health and safety in the developing world. J. Occup. Environ. Med.47(2):132–136, 2005.
97.
FritschS.The UN global compact and the global governance of corporate social responsibility: Complex multilateralism for a more human globalisation?Global Society22(1):1–26, 2008.
98.
MacklemP.Labour law beyond borders. J. Int. Econ. Law5(3):605–645, 2002.
99.
DooreyD.Who made that? Influencing foreign labour practices through reflexive domestic disclosure regulation. Osgoode H. Law J.43(4):353–405, 2005.
100.
MorinM.Labour law and new forms of corporate organisation. Int. Labor Rev.144(1):5–30, 2005.
101.
RawlingM.A generic model of regulating supply chain outsourcing. In Labour Law and Labour Market Regulation, ed. ArupC., pp. 520–554. Federation Press, Sydney, 2006.
102.
LockeR.Beyond corporate codes of conduct: Work organisation and labour standards at Nike's suppliers. Int. Labor Rev.146(1–2):21–40, 2007.
103.
SampsonH., and BloorM.When Jack gets out of the box: The problems of regulating global industry. Sociology41(3):551–569, 2007.
104.
ChastangF.Suicide attempts and job insecurity: A complex association. Eur. Psychiatry13:359–364, 1998.
105.
GallagherJ.Suicide and occupation in New Zealand, 2001–2005. Int. J. Occup. Environ. Health14(1):45–50. 2008.
106.
ChenM.SebstadJ., and O'ConnellL.Counting the invisible workforce: The case of homebased workers. World Dev.27(3):603–610, 1999.
107.
FelsteadA.A Statistical Portrait of Working at Home in the UK: Evidence from the Labour Force Survey. ESRC Future of Work Working Paper No. 4. University of Leicester, Leicester, UK, 2000.
108.
HeyesJ., and GrayA.Homeworkers and the national minimum wage: Evidence from the textile and clothing industry. Work Employ. Society15(4):863–873, 2001.
109.
WorkCover New South Wales. Working from Home: A Guide to Occupational Health and Safety, Rehabilitation and Workers' Compensation Requirements. Sydney, 1996.
110.
Queensland Division of Workplace Health and Safety. Working from Home Guide.Department of Employment, Training and Industrial Relations, Brisbane, 2000.
111.
Queensland Division of Workplace Health and Safety. Employers' Guide to Health and Community Service Workers in Peoples' Homes.Department of Employment, Training and Industrial Relations, Brisbane, 2001.
112.
QuinlanM.Developing Strategies to Address OHS and Workers' Compensation Responsibilities Arising from Changing Employment Relationships. Report to WorkCover New South Wales. Sydney, 2002.
113.
TietzeS.When “work” comes “home”: Coping strategies for teleworkers and their families. J. Business Ethics41:385–396, 2002.
114.
KossekE.LautschB., and EatonS.Telecommuting, control, and boundary management: Correlates of policy use and practice, job control, and work-family effectiveness. J. Vocational Behav.68:347–367, 2006.
115.
FelsteadA.JewsonN., and WaltersS.The shifting locations of work: New statistical evidence on the spaces and places of employment. Work Employ. Society19(2):415–431, 2005.
116.
National Institute for Occupational Safety and Health. The Changing Organization of Work and the Safety and Health of Working People: Knowledge Gaps and Research Directions.Department of Health and Human Services, Cincinnati, 2002.
117.
Health and Safety Commission. Report on Progress with the Changing Patterns of Employment Programme of Work. Health and Safety Commission Discussion Paper. London, 2001.
118.
ZeytinogluI., and DentonM.Satisfied Workers, Retained Workers: Effect of Work and Work Environment on Homecare Workers' Job Satisfaction, Stress, Physical Health, and Retention.Canadian Health Services Research Foundation, Ottawa, 2005.
119.
OstryA., and SpiegelJ.Labour markets and employment security: Impacts of globalisation on service and healthcare-sector workforces. J. Occup. Environ. Med.10(4):368–374, 2004.
120.
SnyderW.Hospital downsizing and increased frequency of assaults on staff. Hosp. Community Psychiatry45(4):378–380, 1994.
121.
WoodwardC.The impact of re-engineering and other cost reduction strategies on the staff of a large teaching hospital: A longitudinal study. Med. Care37:556–569, 1999.
122.
TrinkoffA.Staffing and worker injury in nursing homes. Am. J. Public Health95:1220–1225, 2005.
123.
BurkeR., and GreenglassE.Work-family conflict, spouse support, and nursing staff well-being during organizational restructuring. J. Occup. Health Psychol.4(4):327–336, 2000.
124.
AllenC.The hidden organisational costs of using non-standard employment. Personnel Rev.29(2):188–202, 1998.
125.
McKennaH.The “professional cleansing” of nurses: The systematic downgrading of nurses damages patient care. BMJ317:1403–1404, 1998.
126.
MillerJ.Liability relating to contracting infectious diseases in hospitals. J. Legal Med.25:211–227, 2004.
127.
BeltramiE.The nature and frequency of blood contacts among home healthcare workers. Infect. Control Hosp. Epidemiol.21:765–770, 2000.
128.
AllenP.A socio-legal and economic analysis of contracting in the NHS internal market using a case study of contracting for district nursing. Soc. Sci. Med.54: 255–266, 2002.
129.
KwonJ., and YoonB.Prevalence of outsourcing and perception of clinical nutrition managers on performance of health care dietetics services. J. Am. Diet. Assoc.103:1039–1042, 2003.
130.
RandallG., and WilliamsA.Exploring the limits to market-based reform: Managed competition and rehabilitation home care services in Ontario. Soc. Sci. Med.62: 1594–1604, 2006.
131.
JiangB.BakerR., and FrazierG.An analysis of job dissatisfaction and turnover to reduce global supply chain risk: Evidence from China. J. Operations Manage.9, 2007. doi: 10.1016/j.com.2007.09.002.
132.
FelfJ.Does form of employment make a difference? Commitment of traditional, temporary and self-employed workers. J. Vocational Behav.10, 2008. doi: 10.1016/j.jvb.2007.10.008.
133.
NytroK.An appraisal of key factors in the implementation of occupational stress interventions. Work and Stress13:213–225, 2000.
134.
SaksvikP.Developing criteria for healthy organisational change. Work and Stress21(3):243–263, 2007.
135.
DaveziesP.Transformations des organisations du travail, nouvelles pathologies: Defis a clinique medicale. Arch. Mal. Prof. Med. Travail60(6):542–551, 1999.
136.
LaDouJ.The rise and fall of occupational medicine in the United States. Am. J. Prev. Med.22(4):285–295, 2002.
137.
WrightC.Routine deaths: Fatal accidents in the oil industry. Sociol. Rev.34(2): 265–289, 1986.
138.
WrightC.A fallible safety system: Institutionalised irrationality in the offshore oil and gas industry. Sociol. Rev.42(1):79–103, 1994.
