Does the time spent in retirement improve health? An IV-Poisson assessment on the incidence of cardiovascular diseases.

In recent decades, pension reforms have been implemented to address the financial sustainability of social security systems, resulting in an increase in the retirement age. This adjustment has led to ongoing debates about the relationship between retirement and health. This study investigates the impact of time spent in retirement on the risk of cardiovascular disease (CVD) in Italy. It uses a comprehensive dataset that includes socioeconomic, health, and behavioural risk factors, which is linked to administrative hospitalisation and mortality registers. To address the potential endogeneity of retirement, we employ an instrumental variables approach embedded in a Poisson rate model. The results show that, on average, years spent in retirement have a beneficial effect on the risk of CVD for both men and women. Each additional year spent in retirement reduces the incidence of such diseases by about 17% for men and 29% for women. Stratified analyses and robustness tests show that the benefits of retirement appear to be more robust and pronounced in men and in certain groups, particularly men in manual occupations or with poor ergonomic conditions at work. These results highlight that delaying access to retirement may lead to an increased burden of CVD in the older population. In addition, the protective effect of retirement on the development of CVD among workers with poorer ergonomic conditions underlines the different impact of increasing the retirement age on different categories of workers and the need for targeted and differentiated policies to avoid hitting the more vulnerable.

Health and labor market effects of an unanticipated rise in retirement age. Evidence from the 2012 Italian pension reform.

As retirement ages increase around the world, not all workers may be equally able to extend their working lives. In this article, we examine the health and labor market effects of an Italian pension reform that suddenly increased the normal retirement age up to 7 years for women and up to 2 years for men. To do this, we use linked labor and healthcare administrative data, jointly with survey data and difference-in-difference methods. Our results show that the reform was effective in postponing retirement among both genders, as pension claiming dropped substantially for older workers. However, there were also side effects as the reform significantly pushed previously employed men and women into unemployment and disability pension. Among women only, the reform also increased sick leave and hospitalizations related to mental health and injuries. These effects were driven by women with previously low health status, suggesting that undifferentiated and abrupt increases in pension age might harm more vulnerable workers. Coherently with the milder tightening of retirement age experienced by men, labor market responses were smaller in size, and they did not suffer any significant health effects.

Differences in work injury risk between immigrants and natives: changes since the economic recession in Italy.

BACKGROUND: It is known that occupational injury rates are higher for immigrant than for native workers, however the effects of the economic cycles on these differences has not been assessed to date. The aim of the paper is to test if the crisis has the same mechanism of selection in the two groups by comparing injury rates in 2005 (before the crisis) and in 2010 (after the crisis). METHODS: The Work History Italian Panel-Salute integrated database was interrogated to identify employment contracts in the metalworking and construction industries for the years 2005 and 2010 and the occupational injuries. A definition based on the type of injury, less likely to be biased by underreporting, was used to select serious events. Immigrants and natives were matched using the propensity score method and injury rates were calculated in the two years. Analyses were stratified by industry. RESULTS: In the metalworking industry injury rates slightly increased over time for both groups, and were higher among immigrant than native workers in both 2005 and 2010. In the construction industry the 2005 injury rate was the same in the two groups, and there was a negative trend over time in both groups. However the decline in the 2010 injury rate for Italian workers was much larger, which led to a considerable increase of the incidence rate ratio of immigrants with respect to native (IRR 3.83, 95% CI 2.52-5.75). CONCLUSIONS: The economic recession had an impact on the risk of workplace injury. Though the main observed factors (18 variables) usually reported in literature to explain the higher injury rates of the immigrant workers were controlled through the matching, there were still differences between immigrants and natives. The main reason is that immigrants continue to be assigned to the more dangerous jobs and the more dangerous tasks within these job. Furthermore, also differences in the perception of workplace injury risks, linguistic barriers, and cultural factors may have a role in explaining this gap.

Austerity Resistant Social Policies to Protect Employment.

During the worse phase of the economic downturn, few social policies resisted to the austerity measures imposed to Italy by the European Union. Among them, the most important is the Wage Supplementation Fund, to protect workers and entrepreneurs from bankruptcy and unemployment. Adopting a realist methodology we studied the social mechanisms which are the roots of some political and administrative choices in that period; the public policy decision making approach gave us a theoretical base. Some main mechanisms have been discovered: technical and economic mechanisms overcame politics, social attitudes pushed political choices, the fear of political and social instability drove all parties.

Occupational injuries in times of labour market flexibility: the different stories of employment-secure and precarious workers.

BACKGROUND: The relationship between labour market flexibility, job insecurity and occupational injuries is not univocal. The literature generally focuses on the temporary character of work arrangements rather than on the precarity of careers. The aim of this paper is to identify, without defining a priori what a precarious career is, the most common professional profiles of young people who entered the labour market in the 2000s and to correlate them with occupational injury risks. METHODS: Using the Whip-Salute database, which combines individual work and health histories, we selected the subjects under 30 years of age whose first appearance in the database is dated after 2000. The occupational history of each individual between 2000 and 2005 was described according to 6 variables (type of entry contract, number of contracts, number of jobs, economic activities, work intensity and duration of the longest period of non-employment). Workers were grouped into homogeneous categories using cluster analysis techniques, which enable to identify different career profiles. Injury rates were calculated for each cluster, and compared within and between the groups. RESULTS: We selected 56,760 workers in the study period, who were classified in 6 main career profiles. About 1/3 of the subjects presented an employment-secure career profile, while about 45 % of them were classified into 3 clusters showing precarious career profiles with different work intensities. Precarious workers present significantly higher injury rates than those with secure careers, with an increase in risk between 24 and 57 % (p < 0.05). The comparison of injury rates at the beginning and at the end of the study period revealed a significant decrease in all clusters, but the gap between secure and precarious workers remained wide. CONCLUSIONS: Cluster analysis allowed to identify career patterns with clearly different characteristics. A positive association between injury risk and the level of career fragmentation was found. The association cannot be fully interpreted in a causal way, since reversed causality and selection processes may be in action. However the study indicates a disadvantage for precarious workers, who face significantly higher risks of both minor and severe injuries.

Work organization, exposure to workplace hazards and sickness presenteeism in the European employed population.

BACKGROUND: Aim of the study was to identify work organization features and workplace hazards associated with sickness presenteeism (SP) among European workers. METHODS: The study was conducted on data from the European Working Conditions Survey 2010 and included a study population of 30,279 employees. The relationship between work-related factors and SP was assessed through Poisson multivariate robust regression models, adjusting for significant (P < 0.05) individual and work-related characteristics. RESULTS: SP for at least 2 days in the previous year was reported by 35% of the workers. In fully adjusted model, several psychosocial (decision authority, skill discretion, reward, abuse; psychological, cognitive, and emotional demand), and organizational factors (shift work, working with clients, long work hours) were positively associated with SP, whereas job insecurity and exposure to physical factors (lifting or moving people, vibration) decreased SP risk. CONCLUSIONS: Our results support the importance of work-related factors, especially psychosocial exposures and organizational features, in determining workers' SP.

Job tenure and work injuries: a multivariate analysis of the relation with previous experience and differences by age.

BACKGROUND: One of the consequences of the increasing flexibility in contemporary labour markets is that individuals change jobs more frequently than in the past. Indeed, in many cases, through collecting a lot of contracts, individuals work in the same economic sector or even in the same company, doing the same job in the same way as existing colleagues. A very long literature has established that newly hired workers--whatever the contract type--are more likely to be injured than those with longer job tenures. The objectives of this paper are: 1) to study the relationship between job tenure and injury risk taking into account past experience as a possible confounder; and 2) to evaluate how the effects of past experience and job tenure are modified by age. METHODS: Using a longitudinal national database, we considered only job contracts starting in 1998-2003 held by men working as blue collars or apprentices in the non-agricultural private sector. We calculated injury rates stratified by job tenure and age. Multivariate analyses were adjusted for background variables and previous experience accrued in the same economic sector of the current job. RESULTS: In the study period 58,271 workers who had experienced 10,260 injuries were observed. These people worked on 115,277 contracts in the six years observed (1.98 contracts per worker). Injury rates decrease with job tenure; the trend is the same in each age group; young workers have both the highest injury rate (9.20; CI 95%: 8.95-9.45) and the highest decrease with job tenure. Previous experience is associated with a decreasing injury rate in all age groups and for all job tenures. Multivariate analyses show that, even after checking for previous experience, workers with job tenure of less than 6 months show always higher relative risks compared with job tenure > 2 years: relative risk is 41% higher among under-thirty workers; it is 22% higher among people over forty. Previous experience is protective against injury risk in workers over thirty: after checking for all other variables, relative risk is lower in workers who have accumulated more than 5 years of experience. CONCLUSIONS: In a context in which career fragmentation is increasing, workers find themselves more and more in the "high risk" period and only individuals who are able to build their career with similar jobs may mitigate the higher risks thanks to their past experience. If institutions don't adopt appropriate prevention policies, injury risk is likely to increase, especially among young people.

A new Italian surveillance system for occupational injuries: characteristics and initial results.

BACKGROUND: Occupational injuries research and surveillance is important for prevention and public health protection. A new occupational surveillance system based on linkage of work histories calculated from the Italian National Social Security Institute (INPS) and occupational injuries provided by the National Insurance Institute for Occupational Injuries (INAIL) was created and assessed. METHODS: It has been extracted a 1% sample of individuals from INPS. For each subject, a detailed description of the career has been compiled between 1985 and 2004, and matched on an individual basis to work injuries between 1994 and 2003. It has been calculated injury rates and risks by economic activity, gender, age, job tenure, country of birth, and firm size. RESULTS: The linkage success is very high both in engineering than in the construction sector. The comparison with Eurostat statistics is very positive. The injury risks calculated by job tenure, country of birth, and firm size are consistent with literature. The high injury rate for short work contracts remain unvaried also after controlling by age. CONCLUSIONS: It is finally possible to describe injuries based on some main characteristics of the recent changes in the labor market, such as precarization, ageing of workers, migration, that databases currently available in Italy do not allow. The sample is longitudinal and can contribute to describing the development of the phenomena over time. The Ministry of Health is completing procedures to extend the sample and to increase the health outcomes for which a follow-up is available.

[Life expectancy, strenuous work and pension system's fairness. First evidence from the Work Histories Italian Panel]. / Aspettative di vita, lavori usuranti ed equità del sistema previdenziale. Prime evidenze dal Work Histories Italian Panel.

OBJECTIVE: the study aims to estimate the differentials in life expectancy by income and work history in Italy during the 2000's, in order to evaluate the level of actuarial equity of the recent Italian retirement reform in computing benefits proportional to the contributions paid. DESIGN: retrospective cohort study. SETTING AND PARTICIPANTS: mortality follow up of a 1% sample of the Italian workforce employed or self employed in the private sector, retired between 1985 and 2003 (about 63,000 people), whose work history and income since 1985 is registered in the National Institute for Social Insurance (INPS) data base. MAIN OUTCOME MEASURE: mortality differentials computed through Cox model. RESULTS: social inequalities in survival in favour of the more advantaged categories of income and occupational classes are observed. CONCLUSION: the principle of actuarial equity assumes that life expectancy varies only according to age and birth cohort; nevertheless inequalities in life expectancy exist also along other dimensions, like income and occupational class: this means that the system is producing an opposite redistribution, from the careers more socially disadvantaged to the less disadvantaged ones.