Non-standard employment and mortality in Belgian workers: A census-based investigation

Objectives Evidence is growing that non-standard employment is associated with adverse health. However, little is known about the relationship between different non-standard employment arrangements and subsequent all-cause and cause-specific mortality. Using population-wide data, the present study investigated this link. Methods Data was derived from the 2001 Belgian census and a 13-year-long follow-up. The analyses comprised 1 454 033 healthy and disability-free employees aged 30-59 years at baseline. Cox regressions were fitted to analyze the mortality risks of those in non-standard employment forms (temporary agency, seasonal, fixed-term, causal work and employment program) compared to permanent employees. Results Several groups of workers in non-standard employment arrangements in 2001 exhibited a higher mortality risk relative to permanent employees during the follow-up after adjusting for socio-economic and work-related factors. This was especially the case among men. The relative mortality disadvantage was particularly elevated for male temporary agency workers. External causes of death played an important role in this association. Conclusions A mortality gradient between the core and outer periphery of the Belgian labor market has been observed. This study also shows that the excess risk of death, previously attributed to non-permanent employment as a whole, hides inequalities between specific forms of non-standard work (eg, temporary agency, seasonal, fixed-term employment).