title: Piecework, musculoskeletal pain and the impact of workplace psychosocial factors.
abstract: OBJECTIVE
  To investigate the impact of piecework on musculoskeletal pain and general health, and the influence of perceived workplace psychosocial factors on any such associations, in a general UK population.
  
  
  METHODS
  A questionnaire was mailed to an age-stratified random sample of 10 000 adults aged 18-75 in North Staffordshire, UK. Respondents reporting a current main job were asked if this job was paid by a piecework system. Health measures were (i) number of pain areas according to a body manikin and (ii) general health (SF-12v2). Other measures included questions on occupational history and psychosocial aspects of the work environment.
  
  
  RESULTS
  The adjusted response was 54%. A total of 1193 respondents reported a current main job, of whom 201 (17%) reported piecework. Pieceworkers were more likely to be older (P < 0.05), male (P < 0.001) and in lower socioeconomic groups (P < 0.001) than non-pieceworkers. Piecework was associated with perceptions of a poor psychosocial working environment, more pain areas (P < 0.05), more elbow (P < 0.01), forearm (P < 0.001) and hand pain (P < 0.05), and a lower physical health score (SF-12v2; P < 0.01), but no difference in mental health score (P = 0.60), compared with non-pieceworkers. After controlling for psychosocial factors, and socioeconomic group, the associations between piecework and pain areas, or physical health, were no longer statistically significant.
  
  
  CONCLUSIONS
  These results show that piecework was associated with poorer self-reported general physical health and more areas of pain, which may be attributed to low socioeconomic group, and workplace perceptions of little job control, high physical demand and little supervisor support.
authors.affiliation: Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK.
authors.forename: Rosie J
authors.initials: RJ
authors.lastname: Lacey
authors.forename: Martyn
authors.initials: M
authors.lastname: Lewis
authors.forename: Julius
authors.initials: J
authors.lastname: Sim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D012456:Salaries and Fringe Benefits; D012959:Socioeconomic Factors