Safety or Profit?

International Studies in Governance, Change and the Work Environment

Theo Nichols, David Walters

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9780895038173
• eBook ISBN: 9781351860000
• Topic: Psicología
• Subtopic: Salud mental en psicología

As the title <em>Safety or Profit?</em> suggests, health and safety at work needs to be understood in the context of the wider political economy. This book brings together contributions informed by this view from internationally recognized scholars. It reviews the governance of health and safety at work, with special reference to Australia, Canada, Sweden, and the United Kingdom. Three main aspects are discussed. The restructuring of the labor market: this is considered with respect to precarious work and to gender issues and their implications for the health and safety of workers. The neoliberal agenda: this is examined with respect to the diminished power of organized labor, decriminalization, and new governance theory, including an examination of how well the health-and-safety-at-work regimes put in place in many industrial societies about forty years ago have fared and how distinctive the recent emphasis on self-regulation in several countries really is. The role of evidence: there is a dearth of evidence-based policy. The book examines how policy on health and safety at work is formulated at both company and state levels. Cases considered include the scant regard paid to evidence by an official inquiry into future strategy in Canada; the lack of evidence-based policy and the reluctance to observe the precautionary principle with respect to work-related cancer in the United Kingdom; and the failure to learn from past mistakes in the Deepwater Horizon disaster in the Gulf of Mexico.

PART I

Economic Restructuring, Labor Market Stratification, and Their Consequences for Health and Safety

What happens with respect to health and safety at work is affected not only by internal relations and external regulation but over and beyond this by the wider political economy, including, among other things, growth rates, unemployment, the structure of the labor market, trade union rights, and coverage. Historically, variable types of work contracts are a constituent part of this wider context, and Part I begins with a review of the resurgence of precarious forms of work by Michael Quinlan in Chapter 1. Drawing upon research not only from his native Australia but also extensively from a range of other countries on other continents and from different historical periods, Quinlan documents a variety of way in which workers are and have been rendered insecure and the consequences of these precarious forms of work for their health and safety (and indirectly for the well-being of yet other workers). Chapter 2 then provides a gender perspective. Here, Katherine Lippel and Karen Messing present a wide-ranging discussion of the regulation of women’s work over the last century, which casts light on women’s occupational health, a subject that has often been ignored, including sometimes by those interested in women’s public health who are apt to forget women in their role as workers. In doing this, they too draw not only on their native Quebec but on research conducted in several different continents and countries.

CHAPTER 1
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Precarity and Workplace Well-Being: A General Review

Michael Quinlan

INTRODUCTION: NEO-LIBERALISM, FRACTURING OF THE LABOR MARKET, AND INCREASED INEQUALITY AT WORK

Over the past 4 decades, changes to business practices along with the dominance of neo-liberal policy discourse have reshaped the organization of work and the social protection framework in ways that a growing body of evidence has shown to be antithetical to the health, safety, and well-being of workers, their families, and the broader community. Stripped of euphemistic spin, the shift to “flexibility” that typifies the “new” world of work is one marked by precariousness, disorganization, and regulatory retreat as labor is increasingly treated as an expendable commodity to be traded globally like any other factor of production. The growth of precarious work provides a stark and arguably pivotal example of how workplace health and safety has been subordinated to the pursuit of profit and sectional interest. This chapter points out that precarious employment is not a new phenomenon nor is evidence of its health-damaging effects. Rather, it is a problem that has reemerged with the rise of neo-liberalism. This chapter points to what can be learned from historical experience as well as recent attempts to explain how precarity damages health (including the economic pressure, disorganization, and regulatory failure, or PDR model).

Since the mid-1970s, there have been a number of profound global changes to labor markets and work organization. These changes were integral to the abandonment of the postwar Keynesian policy accord that operated in most rich countries. In its place, there was the reassertion of a “market-based” policy framework that eschewed collective organization of workers, public sector economic activity, and social protection/state intervention (except to privilege private property and its owners) that came to be termed neo-liberalism. The shift was linked to and interacted with a renewed assault by capital (and especially some elements within it such as the finance sector) on organized labor and the “restrictions” it imposed on labor-market flexibility. The changes to work organization include repeated rounds of organizational restructuring through downsizing, outsourcing, and privatization often in association with the increased use of extended supply chains (global and nationally) that rely on elaborate networks of subcontracting. For workers, the effects of these changes has overwhelmingly entailed work intensification and less employment security as capital sought to extract ever-greater surpluses from a given input of labor (with fancy titles such business process reengineering and lean production barely disguising the central object of cost cutting, including labor costs). It has also impacted the structuring of work arrangements in terms of legal status and entitlements. Notable here (especially for old-developed rich countries) has been a growth (more accurately, a reemergence to prominence) of more precarious or contingent work arrangements, multiple job-holding, and long or irregular working hours.

As studies increasingly show, the shift to more flexible (flexible for whom?) work also impacts the work intensity and security of even those who retain nominally secure employment. The aging of the population in many rich (and some poor) countries and the increased use of foreign workers (not just migrants) has added layers of complexity and vulnerability to the growth of precarious work. As a result, the changes just described impact the vast bulk of the working population. As will also be shown, the effects of these changes are not only profound for workers but also extend to their families and the community more generally.

A series of terms has been used to describe these changes in work arrangements, most notably contingent work and precarious employment. This chapter uses the term precarious work rather than precarious employment because work is a broader term, and a substantial number of those found in these arrangements (such as subcontractors and many homecare workers) are not engaged under an employment relationship.

The aim of this chapter is to review the current state of knowledge about how precarious work impacts the health, safety, and well-being of workers and others in the community. It is divided into four parts. The first puts the current debate over precarious work and its health effects into historical context. The next two sections then look at contemporary evidence on the health effects and regulation/social infrastructure, respectively. The fourth and final section then examines a number of attempts to explain the mechanisms by which precarious work arrangements damage health.

PUTTING PRECARIOUS WORK AND ITS EFFECTS INTO HISTORICAL CONTEXT

What is often termed the “new” world of work is not especially new. Indeed, what was termed or seen as the standard employment (relatively secure full-time work) was only really dominant among wealthy countries for a period of around 50 to 60 years in the middle quarters of the 20th century. It was the contingent result of a prolonged period of mobilization by organized labor and other progressive groups, as well as Keynesian full employment and income redistribution policies. The abandonment of the latter (and rise of neo-liberalism as the dominant policy framework for all social decisions) in the early 1970s also coincided with the beginning of the shift in business practices that promoted more contingent/precarious work arrangements such as outsourcing/subcontracting, corporatization, privatization, downsizing/restructuring, increased use of temporary workers, and various forms of “lean” management. It was not until the 1980s and 1990s that the consequences of this for patterns of employment began to be widely recognized.

However, in many respects, this marked a return to widespread precarious employment that had been pervasive in the 150 years prior to the Second World War. During this period, secure employment was the exception, with large numbers of workers holding jobs that were low paying and precarious, including sweated labor and outworkers (mainly women), child labor, casual labor (e.g., docks, agriculture, navvies), indentured immigrants (especially non-European), merchant seamen, fishermen, and an array of subcontracted labor (in construction, transport, and mining).

Indeed, the very term precarious employment, coined in the 1980s, was actually a reinvention, because the very same term had been used to describe temporary and insecure work in the policy sphere (such as UK House of Commons debates) on a regular basis since the early 19th century until the 1930s (its demise coinciding with the rise of “standard employment”). During this earlier period, the social ills associated with precarious employment had been painstakingly documented and recognized. The final report of the UK Royal Commission on Labour (1894: 73–87) devoted a substantial section to irregularity of employment, including the various forms it took (in agriculture, the docks, and in the sweated trades, for example) and reasons for it. Among the solutions canvassed by the Royal Commission (1894: 75, 79) for “employment that was irregular and precarious” was an extension of employment by government authorities (including local government) and movement away from putting such work out to private tender. Some 14 years later, the Royal Commission into Poor Laws (1909: 223–224, 631) in the UK identified the casual labor system (i.e., temporary work) as the single most important industry-related cause of poverty/pauperism (which in turn had cascading effects on children, education, and health), identifying casual dockworkers as an archetypal case. The report canvassed various ways of securing decasualization, but no measures were undertaken until World War II and, decasualization was not achieved until the 1960s (a similar timeline applied in Australia).

Just as precarious modes of work are not new, nor should the mounting evidence of their adverse effects on worker health, safety, and well-being (discussed later) come as a surprise, since there was copious evidence linking precarious work arrangements to injury, disease, and ill-health during the first industrial revolution. Prefiguring contemporary concerns with the adverse OHS effects of precarious employment, there is actually manifold evidence of the impact of insecure work arrangements, contingent payment systems, subcontracting, and irregular or long working hours on worker health in the 19th century and early 20th century (Quinlan, 2011, under review). In addition to material collected by social reformers, unions, and the like, this evidence can be found in parliamentary papers, disaster inquiries, and royal commissions into working conditions in factories, mines, and shops; the writings of academics; and in medical/public health and other learned journals.

One example of this was the practice labeled as “sweating” in clothing and other trades, where the combination of low pay and long hours and subcontracting to poor health outcomes were extensively documented between 1880 and 1920. In 1888, for example, the leading medical journal The Lancet commissioned its own special sanitary commission into sweating, which pointed to the pervasive nature of these arrangements, the exploitive role of middlemen, and the recurring connection between low and irregular earnings; poor quality food; cramped working conditions; crowded, drafty, poorly ventilated, and dirty accommodation; filth and poor sanitation; fatigue, chronic injuries, and poor health; and susceptibility to all too common infectious diseases (such as scarlet fever), which led to a higher mortality rate among children, both those working and those not (The Lancet, 1888: 37–39).

Like a number of informed observers in North America (such as Florence Kelley), Australasia (such as factory inspector Charles Levey), and elsewhere, The Lancet (1888) emphasized the connection between subcontracting, low pay, and poor health. It also emphasized that these forms of work organization were the result of deliberate choices and open to alteration. While conditions were worst for those concentrated at the bottom of the subcontracting chain (predominantly women and children), the competitive pressure of progressive subcontracting of work had spillover effects on wages, employment security, and health, even of male journeymen tailors engaged in factories and “better” workshops. The absence of income security also eliminated any incentive for the employer to allocate work in a planned and efficient manner. Writing about journeymen tailors, The Lancet observed,

The irregularity of employment and of income must be a fruitful source of disease. For instance, while there is much enforced idleness, a tailor has often to perform “nine days’ work in a week.” The insufficient sleep, the strain to the eyes, the lack of proper time to take meals or out-door exercise, and the prolonged confinement in unwholesome and over-heated workshops are naturally important factors in undermining the constitution of even the most fortunate among the journeymen tailors (The Lancet, 14 July 1888: 740)

As the reports made clear, women tailoresses and machinists were in an even worse situation, with The Lancet reporting a case in which a tailoress in Manchester, unable to earn a subsistence living (or repay debts for food), attempted suicide.

The Lancet pointed out how low paid and insecure work had cascading effects on families, requiring women and children to take on the most hard and poorly paid tasks. Referring to outworkers near Dudley, The Lancet, 2 June 1888: 1101) observed,

Groups of girls may be seen trudging along with bundles balanced on their heads. The bundles generally contain moleskin trousers, often weigh half a hundredweight, and have been carried sometimes for more than miles. These are the home workers, the wives and daughters of men [predominantly miners] whose earnings are insufficient to keep their families (The Lancet, 2 June 1888: 1101).

The Lancet also pointed to adverse effects of these precarious forms of work on public health (including the reluctance of outworkers to report infectious diseases for fear of losing work), not only the children of children of sweated labor but also consumers (often unaware of the origins of the products) and the public more generally.

The clothes at times are contaminated, the workers so starved and exhausted that they must soon fall victims to wasting disease when they are not actually driven to suicide. This is a matter of such immediate importance, and which every sentiment of humanity is so concerned, that petty quibbles over the details of doctrinaire political economy must not be allowed to stand in the way of those sweeping and far-reaching reforms that alone can deal with the widespread evils now fully revealed to the public’. (The Lancet, 2 August, 1890: 246)

In a statement that applies just as much today, The Lancet argued that irrespective of where they are produced, when goods are produced for public consumption, the public has a right to have a say in the conditions of production (The Lancet, 2 August 1888: 246).

The foregoing is just a small illustration of the substantial body of historical evidence linking precarious work arrangements to adverse health outcomes. In addition to sweated labor (itself by no means confined to clothing workers but found in an array of other industries), adverse health and safety effects were also well documented in government inquiries, health journals, and the like with regard to casual work such as dock laborers, construction workers/navvies, and rural/agricultural workers; fixed contract workers like seamen, whalers, and fishermen; children working as itinerant labor (in factories, homes, and as street hawkers); and own-account subcontractors such as some mineworkers in the period 1880–1930 (Quinlan, 2013, under review). Again and again inquiries and the like pointed to the health-damaging effects of long or irregular hours, low/erratic pay, and work regimes in which labor was treated as entirely expendable. As with sweating, these reports pointed to externalities or spillover effects, including the effects of low and irregular pay on diet and accommodation, the spread of infectious diseases to the broader community (especially in the case of sweated home-workers, dockworkers, and seamen), the growth of child labor (and effects on children’s education), and the “burden” imposed on the community/state as older/disabled precarious workers were discarded by employers. Unfortunately, this rich vein of prior knowledge on the health effects of work organization was all but forgotten by researchers examining the “new world of work” from the 1980s and ignored by those promoting flexibility in the labor market.

REDISCOVERING THE ADVERSE HEALTH EFFECTS OF PRECARIOUS WORK

Since the mid-1980s, a growing body of research has linked these changes—and downsizing/job insecurity, subcontracting, temporary employment, and outsourcing/home-based work in particular—to a substantial deterioration of OHS outcomes. There are now literally hundreds of published studies undertaken in dozens of countries, using an array of different methods (longitudinal, crosssectional, case-study, etc.), study groups (general population samples, workingage cohort studies, workplace and industry-specific studies), and indices (injury statistics, hazard exposures, physiological health measures, psychological wellbeing, drug use, work/family balance, etc.). A series of reviews of these studies has found substantial consistency in results as to the health-damaging effects of these work arrangements; results that have been maintained over time (Benach, Muntaner, and Santana, 2007; Quinlan and Bohle, 2008, 2009; Quinlan, Mayhew, and Bohle, 2001; Virtanen, Kivimaki, Joensuu, Virtanen, Elovainio, and Vahtera, 2005).

More recent research has continued to refine and expand understanding of the complex interconnections between insecure and contingent work/payment systems and health, including drug use by contingently paid truck drivers and workers experiencing downsizing (Kivimaki, Honkonen, Wahlbeck, Elovainio, Pentti, Klaukka, et al., 2007; Williamson, 2007). Other studies point to the health-damaging effects of intermittent work and bouts of unemployment (Melanfant et al., 2007). There are also complex interactions between precarious work and working hours/work/life balance, including the health-damaging effects of presenteeism and irregular working hours, especially when workers have no control over the variability (Aronsson, Gustafsson, and Dallner, 2000; Bohle, Willaby, Quinlan, and McNamara, 2011; Dembe, Erickson, Delbos, and Banks, 2005; Simpson, 2000). Important gender dimensions have also been identified. In a recent study of how nurses with atypical work schedules reconcile family responsibilities based on 24-hour observation, Barthe, Messing, and Abbas (2011) found that for workers with heavier family responsibilities, choice of work schedules was almost entirely conditioned by family considerations, leaving little leeway to manage workers’ own health protection. Recent research also suggests perceptions of organizational justice have effects on work/life balance (Elovainio, Kivimaki, Linna, Brockner, van den Bos, Greenberg, et al., 2010).

There have also been efforts to place the health effect of changes in work into a global context. As part of a World Health Organization (WHO) initiative on the social determinants of health—or more accurately, health inequalities—the EMCONET group produced a report (Benach et al., 2007) on employment-related health inequalities that extensively documented the extent/trends and health effects of four specific arrangements, notably precarious employment, the inf...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• List of Tables and Charts
• Abbreviations
• Preface
• Acknowledgments
• Introduction
• Part I. Economic Restructuring, Labor Market Stratification, and Their Consequences for Health and Safety
• Part II. New Governance, Organized Labor, Deregulation, Decriminalization, and the Neo-Liberal Agenda
• Part III. The Role and Limits of Evidence
• References
• Contributors
• Index