|
1
|
Hargreaves S, Rustage K, Nellums LB, McAlpine A, Pocock N, Devakumar D, Aldridge RW, Abubakar I, Kristensen KL, Himmels JW, Friedland JS, Zimmerman C. Occupational health outcomes among international migrant workers: a systematic review and meta-analysis. Lancet Glob Health 2019; 7:e872-e882. [PMID: 31122905 PMCID: PMC6565984 DOI: 10.1016/s2214-109x(19)30204-9] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/25/2019] [Accepted: 03/29/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Globally, there are more than 150 million international migrant workers-individuals who are employed outside of their country of origin-comprising the largest international migrant group. A substantial number of migrants work in hazardous and exploitative environments, where they might be at considerable risk of injury and ill health. However, little data on occupational health outcomes of migrant workers exist, with which to inform global policy making and delivery of health services. METHODS For this systematic review and meta-analysis, we searched Embase, MEDLINE, Ovid Global Health, and PsychINFO databases for primary research published between Jan 1, 2008, and Jan 24, 2018, reporting occupational health outcomes among international migrant workers (defined as individuals who are or have been employed outside their country of origin), without language or geographical restrictions. We excluded studies containing mixed cohorts of migrants and native workers in which migrant data could not be disaggregated, and studies that did not explicitly report migrant status. The main outcome was prevalence of occupational health outcomes (defined as any injury, mortality, or physical or psychiatric morbidity due to an individual's work or workplace environment) among international migrant workers. Summary estimates were calculated using random-effects models. The study protocol has been registered with PROSPERO, number CRD42018099465. FINDINGS Of the 1218 studies identified by our search, 36 studies were included in our systematic review, and 18 studies were included in the meta-analysis. The systematic review included occupational health outcomes for 12 168 international migrant workers employed in 13 countries and territories, mostly employed in unskilled manual labour. Migrant workers originated from 25 low-income and middle-income countries, and worked in the following sectors: agriculture; domestic, retail, and service sectors; construction and trade; and manufacturing and processing. Migrant workers had various psychiatric and physical morbidities, and workplace accidents and injuries were relatively common. In the meta-analysis, among 7260 international migrant workers, the pooled prevalence of having at least one occupational morbidity was 47% (95% CI 29-64; I2=99·70%). Among 3890 migrant workers, the prevalence of having at least one injury or accident, including falls from heights, fractures and dislocations, ocular injuries, and cuts was 22% (7-37; I2=99·35%). INTERPRETATION International migrant workers are at considerable risk of work-related ill health and injury, and their health needs are critically overlooked in research and policy. Governments, policy makers, and businesses must enforce and improve occupational health and safety measures, which should be accompanied by accessible, affordable, and appropriate health care and insurance coverage to meet the care needs of this important working population. FUNDING Wellcome Trust.
Collapse
Affiliation(s)
- Sally Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK; Section of Infectious Diseases and Immunity, Imperial College London, London, UK.
| | - Kieran Rustage
- Institute for Infection and Immunity, St George's, University of London, London, UK; Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Laura B Nellums
- Institute for Infection and Immunity, St George's, University of London, London, UK; Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Alys McAlpine
- Gender, Violence and Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Nicola Pocock
- Gender, Violence and Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London
| | | | | | - Kristina L Kristensen
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Copenhagen, Denmark
| | - Jan W Himmels
- Institute for Infection and Immunity, St George's, University of London, London, UK; Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Jon S Friedland
- Institute for Infection and Immunity, St George's, University of London, London, UK; Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Cathy Zimmerman
- Gender, Violence and Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
|
2
|
Abstract
PURPOSE OF REVIEW Agriculture environments contain a variety of inflammatory aerosols that may increase risk for lung inflammation and disease in exposed individuals. In addition, epidemiological studies have also identified protective effects of rural environments and farming exposures. RECENT FINDINGS In this review, we will discuss recent literature published since 2016 that investigates the impact of differing agricultural exposures on respiratory health. Discussions include the impact of farming modernization, education, and personal protective equipment usage among workers, timing and duration in mediating lung health outcomes, and population studies investigating the association between exposure and risk for numerous lung diseases.
Collapse
|