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What’s casual? What’s causal? Advancing research on employment relationships and health
  1. Trevor Peckham,
  2. Noah S Seixas
  1. Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
  1. Correspondence to Trevor Peckham, Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98105, USA; tpeckham{at}

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The ‘changing nature of work’ has received increasing levels of attention within lay and research communities. In addition to the technologies of work, scrutiny has been focused on major shifts in the relationship between workers and their ‘employer’—namely the general trend of employers externalising economic and legal risk onto workers, producing more precarious and insecure labour market experiences. Such concerns have led researchers to investigate potential adverse health implications of working within various forms of temporary employment, which is typically framed as an objective marker of job insecurity.

As with other areas of occupational health research, careful definition and ascertainment of the ‘exposure’ are paramount to the interpretation of such studies. However, employment arrangements research continues to suffer from a lack of definitional clarity, stemming from underdeveloped theory about how employment relationships affect worker health. More challenging, this line of research also differs from classical occupational health studies in that the social context of the work and workers is integral to formulating and interpreting analyses. In this way, employment arrangements research requires a multilevel approach.

The article by Hahn et al1 in this issue exemplifies the importance of these definitional and contextual aspects of epidemiological research on relational aspects of employment, such as casual employment in the Australian context addressed in their paper. In this commentary, we explore further aspects of exposure definition and the importance of context in the interpretation of findings, in relation to the work by Hahn et al.

Observation 1: many heterogeneous definitions of ‘temporary employment’ have been applied without strong theoretical rationales

Definitions of employment arrangements have been a morass of confusion, with many different but related concepts being conflated.2 This can be seen in several of the longitudinal studies cited by Hahn et al, which operationalise ‘temporary employment’ as different combinations of multiple non-permanent employment forms, including fixed-term, seasonal, casual and temporary agency arrangements. While …

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  • Contributors TP and NSS contributed equally to the conception and writing of this commentary.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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