title: Contingent employment, health and sickness absence.
abstract: OBJECTIVE
  This study explored the health and sickness absences of contingent employees.
  
  
  METHODS
  Analyses of self-reported health and recorded spells of sickness absence were based on a cohort of 5650 employees (674 men, 4976 women) in 10 Finnish hospitals.
  
  
  RESULTS
  After adjustment for demographic and work-related characteristics, contingent employees had a better self-rated health status [odds ratio 0.76, 95% confidence interval (95% CI) 0.62-0.94 of poor or average health status]. There were no differences in the prevalence of diagnosed chronic diseases and minor psychiatric morbidity between the groups. After adjustment for self-rated health and confounding, female, but not male, contingent employees had a lower rate of self-certified (1-3 days) sickness absences than permanent employees (rate ratio 0.90, 95% CI 0.85-0.95). Contingent employees, irrespective of gender, had a 0.77 (95% CI 0.71-0.84) times lower rate of medically certified (>3 days) sickness absence than permanent employees. Poor self-rated health status, reported diagnosed chronic diseases, and minor psychiatric morbidity were associated with medically certified absences to a less extent among contingent employees than among permanent employees.
  
  
  CONCLUSIONS
  These findings suggest better self-rated health and a lower sickness absence rate for contingent employees than for permanent employees. The difference in sickness absence between the groups seems not only to be associated with actual differences in health, but also with different thresholds of taking sick leave or working while ill.
authors.affiliation: Finnish Institute of Occupational Health, Department of Psychology, Helsinki. marianna.virtanen@ttl.fi
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
authors.forename: M
authors.initials: M
authors.lastname: Elovainio
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
authors.forename: C L
authors.initials: CL
authors.lastname: Cooper
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012306:Risk; D012647:Self-Assessment; D018582:Sick Leave / Q000706:statistics & numerical data*