No recent systematic review has examined definitions of precarious employment in the literature. This review showed how precarious employment was defined across 63 studies from different continents and research disciplines. Three dimensions of precarious employment emerged: employment insecurity, income inadequacy, and lack of rights and protection.

Objectives Precarious employment (PE) is a term used to describe non-standard employment forms characterized by low security that may have negative effects on mental health. The objective of this review was to systematically review the evidence for effects of PE on mental health and identify important areas for further research. Methods A protocol was developed following PRISMA-P guidelines. Web of Science, PubMed and PsycINFO were searched up to 4 September 2017. All unique records were assessed for eligibility and quality by at least two reviewers. Data from included studies were summarized in forest plots and meta-analyses using a randomeffects model. Evidence quality was rated using the GRADE method. Results We obtained 3328 unique records, of which 16 studies of sufficient quality met the inclusion criteria. Moderate quality evidence (GRADE score 3 of 4) was found for an adverse effect of job insecurity on mental health; summary odds ratio (OR) 1.52 [95% confidence interval (CI) 1.35-1.70]. There was very low quality (GRADE 1 of 4) evidence for effects of temporary employment or unpredictable work hours on mental health. Five studies on multidimensional exposures all showed adverse effects, weighted average OR 2.01 (95% CI 1.60-2.53). Conclusions Research on PE and mental health is growing, but high-quality prospective studies are still scarce. Job insecurity likely has an adverse effect on mental health. A clear multi-dimensional definition of PE is lacking, and harmonization efforts are needed. Further single-variable observational studies on job insecurity or temporary employment should not be prioritized.

Despite the growing use of the term precarious employment, there is no consensus on a theoretical framework or definition. This hampers the study of the subject, especially in public and occupational health. We propose a theoretical framework for understanding precarious employment as a multidimensional construct where unfavourable features of employment quality accumulate in the same job. Future research should apply an intersectional and multi-level approach to analysis, with a focus on improving exposure assessment and investigating mechanisms.

The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: ( a) PE will increase, ( b) workers in PE will become more precarious, ( c) workers in PE will face unemployment without being officially laid off, ( d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and ( e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.

Objective To study the impact of parity history on the risk of ACPA- (antibodies to citrullinated peptides antigens) positive/-negative rheumatoid arthritis (RA), in different age-groups. Method Data from a population-based case-control study of female incident RA cases were analysed (2035 cases, 2911 controls, aged 18-70). Parity history was assessed through questionnaire. Parous women were compared with nulliparous, by calculating odds ratios (OR) with 95% confidence interval (CI). Results Parity was associated with an increased risk of ACPA-negative RA in the age-group 18-44 (OR=2.1, 95% CI 1.4-3.2), but not in the age-group 45-70 (OR=0.9, 95% CI 0.7-1.3). Among young women, an increased risk of ACPA-negative RA was found in those with delivery during the year of symptom onset (OR=2.6, 95% CI 1.4-4.8) and at young age at first birth (<23) (OR=2.5, 95% CI 1.5-4.1).Parity and the postpartum period were not associated with ACPA-positive RA, but older age at first birth was weakly associated with a decreased risk. Conclusions The increased risk of ACPA-negative RA in parous women of reproductive age seemed to be conferred to an increased postpartum risk and to young age at first birth. Further research is needed to explore the biological mechanisms behind our findings.