Piecework, musculoskeletal pain and the impact of workplace psychosocial factors

Aim To investigate the impact of piecework on musculoskeletalpain and general health, and the influence of perceived workplacepsychosocial factors on any such associations, in a generalUK population. Methods A questionnaire was mailed to an age-stratified randomsample of 10 000 adults aged 18–75 in North Staffordshire,UK. Respondents reporting a current main job were asked if thisjob was paid by a piecework system. Health measures were (i)number of pain areas according to a body manikin and (ii) generalhealth (SF-12v2). Other measures included questions on occupationalhistory and psychosocial aspects of the work environment. Results The adjusted response was 54%. A total of 1193 respondentsreported a current main job, of whom 201 (17%) reported piecework.Pieceworkers were more likely to be older (P < 0.05), male(P < 0.001) and in lower socioeconomic groups (P < 0.001)than non-pieceworkers. Piecework was associated with perceptionsof a poor psychosocial working environment, more pain areas(P < 0.05), more elbow (P < 0.01), forearm (P < 0.001)and hand pain (P < 0.05), and a lower physical health score(SF-12v2; P < 0.01), but no difference in mental health score(P = 0.60), compared with non-pieceworkers. After controllingfor psychosocial factors, and socioeconomic group, the associationsbetween piecework and pain areas, or physical health, were nolonger statistically significant. Conclusions These results show that piecework was associatedwith poorer self-reported general physical health and more areasof pain, which may be attributed to low socioeconomic group,and workplace perceptions of little job control, high physicaldemand and little supervisor support.