Introduction The effects of poor-quality work (characterised by high job demands, low job control, job insecurity, and effort-reward imbalance) are known to be harmful to health but it isn’t clear whether exposure to these psychosocial work stressors over time translates into an increased risk of mortality.

Objectives To examine the effect of time-varying exposures and covariates on mortality, including the effects of unemployment, not in the workforce and retirement and to investigate if gender is an effect-modifier on the relationship between long-term exposure to adverse psychosocial work stressors and mortality.

Methods Over 20,000 participants from the HILDA survey with self-reported repeated exposure measures were followed for up to 15 waves. Survival analysis models with baseline hazard specified by the Weibull distribution were used to examine the association between psychosocial work stressors over time and mortality.

Results Low job control (HR=1.39; 95% CI: 1.06–1.83) and job insecurity (1.36; 1.06–1.74) were associated with increased risk of mortality. High job demands (1.01; 0.75–1.34) and effort-reward unfairness (1.20; 0.90–1.59) were not associated with mortality. The effect of job insecurity was attenuated (1.20; 0.93–1.54) after controlling for sociodemographic and health risk factors. Male participants exposed to low job control and job insecurity had an 81% and 39% increased risk of mortality, respectively, after adjustment for sociodemographic and health risk factors.

Conclusions Long-term exposure to low job control and low job security is associated with increased risk of all-cause mortality. Effects were largely restricted to males and persisted after adjustments for sociodemographic and health characteristics. Awareness of the implications of the adverse effects of psychosocial work stressors on health and mortality in workplaces, and interventions to improve job control and job security could contribute to better health and wellbeing, reducing the effect of psychosocial work stressors on mortality.