Effort-reward imbalance and its association with health among permanent and fixed-term workers

Our study subjects were 709 male workers aged 30 to 49 years in a suburb of Tokyo, Japan. In 2008, we conducted a cross-sectional study to compare job stress using an effort-reward imbalance (ERI) model questionnaire. Lifestyles, subjective symptoms, and body mass index were also observed from the 2008 health check-up data.The rate of job stress of the high-risk group measured by ERI questionnaire was not different between permanent and fixed-term workers. However, the content of the ERI components differed. Permanent workers were distressed more by effort, overwork, or job demand, while fixed-term workers were distressed more by their job insecurity. Moreover, higher ERI was associated with existence of subjective symptoms (OR = 2.07, 95% CI: 1.42-3.03) and obesity (OR = 2.84, 95% CI:1.78-4.53) in fixed-term workers while this tendency was not found in permanent workers.Our study showed that workers with different employment types, permanent and fixed-term, have dissimilar sources of job stress even though their degree of job stress seems to be the same. High ERI was associated with existing subjective symptoms and obesity in fixed-term workers. Therefore, understanding different sources of job stress and their association with health among permanent and fixed-term workers should be considered to prevent further health problems.In the past decade, the changing labor market seems to have diminished the traditional standards of employment and a variety of non-standard forms of work have emerged in their place. To overcome recession and a high unemployment rate, national labor market policy began to support work sharing, deregulation of employment, and flexibility of work in developed countries [1]. These non-standard forms of work are known as precarious employment (or contingent work, firstly introduced by Freedman [2]). World Health Organization Commission on Social Determinants of Health, Employment Conditions Knowledge Network, described precarious employment as