Occupational injury among migrant workers in China: a systematic review

Determinants and inequities in healthy working life expectancy in China

Many countries are raising the pension age to mitigate the challenges of population aging, but such a solution may ignore the disparities in health and working conditions across populations. Using large-scale longitudinal data from China, this study provides estimates of healthy working life expectancy (HWLE), defined as the average number of years expected to be spent healthy and in work from age 50 years, and highlights substantial inequities in HWLE by gender, socioeconomic status and geographical region. The HWLE from age 50 years was, on average, 6.87 (95% confidence interval: 6.70 to 7.04) years in China. Hypertension was the leading chronic condition for people working unhealthily (5.67 years for men and 4.85 years for women), and arthritis contributed the largest differences in unhealthy working years across people by occupation (agricultural laborer versus enterprise employee, 3.28 years). Moreover, adopting healthy lifestyles was associated with gains in HWLE (2.13 years for men and 1.61 years for women). Our findings suggest that increasing the pension age through a 'one-size-fits-all' approach may not effectively meet the goal of extending working lives. Inclusive initiatives aimed at targeted populations to promote health or work conditions and to facilitate the pension system will be essential to improve HWLE by reducing inequities.

The Impact of Stressors on Depressive Symptoms Among Youth Myanmar Migrant Workers in Thailand: A Cross-Sectional Study

Background

Many youths suffer from depressive symptoms globally, especially youth migrant workers who are more vulnerable to depressive symptoms than non-migrant youths. Given the extensive literature reviewed, little is known about the impact of stressors on depressive symptoms among young migrant populations. Therefore, this study aimed to investigate the impact of stressors on depressive symptoms among young Myanmar migrants in Thailand.

Methods

This cross-sectional analytical study was conducted between August and December 2023, using self-administered questionnaires. The sample size was 165 young migrant workers in Myanmar by simple random sampling. The exclusion criteria were participants who had serious physical illness or acute mental illness, and unwillingness to participate in the study. Sociodemographic characteristics, Rosenberg Self-Esteem Scale, and CESD (The Center for Epidemiological Studies-Depressive symptoms) were included in the questionnaires. Chi-square and Fisher exact tests were used for descriptive statistics. Hierarchical linear regression analysis was used to examine the association between stressors, self-esteem, coping behavior, and depressive symptoms.

Results

It was found that 47.9% of young Myanmar migrant workers had experienced depressive symptoms. Depressive symptoms was associated with four variables: workplace stressors (β = 0.525, p <0.001), security stressors (β = 0.181, p <0.01), living stressors (β = 0.126, p <0.05), and self-esteem (β = -0.135, p <0.05).

Conclusion

According to hierarchical linear regression analysis, workplace, security, and living stressors significantly increased depressive symptoms scores, whereas self-esteem decreased depressive symptoms scores among young 165 Myanmar migrant workers. Therefore, policymakers should be encouraged to establish preventive measures against specific stressors. In addition, many young migrant workers have been found to experience depressive symptoms. Mental health care should be prioritized and made accessible to this vulnerable and risky group.

Long-Term Disability Outcomes for Migrants (and Non-migrants) 12 Years Post-injury: Results from the Prospective Outcomes of Injury Study in New Zealand

To understand, and identify predictors of, long-term post-injury (i.e. 12 years post-injury) disability outcomes for migrants and non-migrants. This 12-year longitudinal study followed participants with entitlement claim injuries registered with New Zealand's universal no-fault injury insurer between 2007 and 2009. Information was collected about migrant status, other sociodemographic, health and disability characteristics, and injury characteristics. Disability outcome information was collected 12 years later. Of 1543 people interviewed 12 years post-injury, 1497 had disability and migrant status data available; 20% were migrants (n = 301). Migrants reporting inadequate pre-injury household income or those who perceived their injury as a threat to life at the time of injury were more likely to experience disability 12 years post-injury (aRR 2.08; 95% CI 1.09-4.03, aRR 2.93; 95%CI 1.17-6.69, respectively). Hospitalised injured migrants were significantly less likely to have long-term disability (aRR 0.18; 95%CI 0.04-0.55) than those not hospitalised. We found sociodemographic and injury-related characteristics were independently associated with long-term disability among migrants. We highlight that some characteristics, ascertained early in the injury pathway, predict risk of long-term disability. Early post-injury interventions focused on improving disability outcomes for migrants may also have long-term impacts.

The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A Systematic Review

China's internal migrants suffer from marginalised housing conditions, poor neighbourhood environments and residential segregation, which may have significant implications on health and well-being. Echoing recent calls for interdisciplinary research on migrant health and well-being, this study examines the associations and mechanisms of the impact of the residential environment on the health and well-being of Chinese migrants. We found that most of the relevant studies supported the "healthy migration effect", but the phenomenon was only applicable to migrants' self-reported physical health rather than mental health. The subjective well-being of migrants is lower than that of urban migrants. There is a debate between the effectiveness of residential environmental improvements and the ineffectiveness of residential environmental improvements in terms of the impact of the neighbourhood environment on migrants' health and well-being. Housing conditions and the neighbourhood's physical and social environment can enhance migrants' health and well-being by strengthening place attachment and social cohesion, building localised social capital and gaining neighbourhood social support. Residential segregation on the neighbourhood scale affects the health outcomes of migrant populations through the mechanism of relative deprivation. Our studies build a vivid and comprehensive picture of research to understand migration, urban life and health and well-being.

Highly Educated Immigrant Workers' Perspectives of Occupational Health and Safety and Work Conditions That Challenge Work Safety

This study explored the perspectives of new immigrant workers regarding occupational health and safety and workplace conditions that increase workers' vulnerability to sustaining injury or illness. Using an interpretive research approach and semi-structured qualitative interviews, 42 new immigrant workers from a range of industries operating in two cities in a province in Canada were interviewed. Seventy-nine percent of the workers were highly qualified. A constant comparative approach was used to identify key themes across the workers' experiences. The findings revealed that new immigrant workers have an incomplete understanding of occupational health and safety. In many workplaces, poor job training, little worker support, lack of power in the workplace, and a poor workplace safety culture make it difficult for workers to acquire occupational health and safety information and to implement safe work practices. This study proposes workplace policies and practices that will improve worker occupational health and safety awareness and make workplaces safer for new immigrant workers.

Injury analysis of teachers' occupational accidents

BACKGROUND

Occupational accidents among teachers are a cause of concern because of their consequences regarding several parts of the body, such as the neck, back, or extremities; however, the number of studies on this issue is limited.

OBJECTIVE

To analyze the possible effects of different variables (gender, age, nationality, experience, sector, day of the week, traffic accidents) associated with occupational injuries suffered by teachers.

METHODS

All teachers' accidents recorded in Spain (136,702) from 2003 to 2018 were analyzed. Odds ratios with a 95% confidence interval were calculated.

RESULTS

For injured female workers, being younger than 45, in her first month of experience, in a public school, without risk assessment, and in a traffic accident are the most important factors related to suffering a neck injury. In the case of injured male workers, to be older than 45, in a private school, and no traffic accidents are the factors detected influence suffering an injury in lower extremities.

CONCLUSIONS

Institutions and schools should pay special attention to the highest-risk profiles. Results obtained can be a very useful tool for the design and implementation of specific occupational health and safety strategies adapted to the more vulnerable workers in each kind of injury.

Public and Commercial Medical Insurance Enrollment Rates of Rural-to-Urban Migrants in China

Objectives: Large-scale rural-to-urban migration of China has provoked heated discussion about the health of migrants and whether they have equal access to the health resources. This article aimed to compare the public and commercial medical insurance enrollment rates between temporary, permanent migrants and urban natives. Methods: Average marginal effects (AME) of the weighted logistic regression models using 2017 China General Social Survey from 2,068 urban natives, 1,285 temporary migrants, and 1,295 permanent migrants. Results: After controlling for the demographic and socio-economic characteristics, our results show that while the temporary and permanent migrants have a similar public insurance enrollment rate compared with the urban natives, both temporary and permanent migrants have significantly lower commercial insurance enrollment rates (7.5 and 5.3%, respectively) compared with the urban natives. Conclusions: The results highlight significant institutional barriers preventing the temporary migrants from gaining access to public medical insurance and the adverse impact of disadvantaged socio-economic backgrounds on the access of temporary migrants to both public and commercial insurance.

Occupational Health Problems among Seasonal and Migrant Farmworkers in Ethiopia: A Cross-Sectional Study

Background

Migrant and seasonal farmworkers are at increased risk for occupational fatalities and injuries. Although such employment-related geographical mobility is receiving increasing attention, there is limited evidence about occupational health problems among seasonal farmworkers. Therefore, this study aims to investigate occupational health problems among seasonal and migrant farmworkers in Ethiopia.

Methods

A cross-sectional study design was employed from October to December 2019 among seasonal and migrant farmworkers. The study was carried out in two sites of Amhara regional state, northwest Ethiopia. A cluster sampling technique was used to recruit 990 study participants. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20 to identify factors associated with injuries. The significance level was obtained at 95% CI and p-value ≤0.05.

Results

In this study, the period prevalence of work-related injury among seasonal and migrant farmworkers was 32.5% (95% CI: 29.7, 35.9). Being unemployed before migration (AOR = 2.22, 95% CI: 1.26, 3.91), working for >8 h/day (AOR = 1.62, 95% CI: 1.16, 2.27), stress (AOR = 1.38, 95% CI: 1.02, 1.88) and thermal discomfort (AOR = 1.48, 95% CI: 1.09, 1.98) were the significant risk factors for work-related injury. In addition, nearly two-third (60.9%) of the study participants have shown three or more heat-related illness symptoms. Moreover, the prevalence of work-related stress among seasonal and migrant farmworkers was 67.6% (95% CI: 64.6, 70.7).

Conclusion

Occupational health problems among seasonal and migrant farmworkers in northwest Ethiopia remain a major public health problem. Hence, implementing tailored preventive measures like training on health and safety, and hazard control measures would be supremely important to minimize the risk.

Health service use and health outcomes among international migrant workers compared with non-migrant workers: A systematic review and meta-analysis

OBJECTIVES

The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers.

METHODS

A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration.

RESULTS

Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512).

CONCLUSIONS

Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.

Influences of Migrant Construction Workers' Environmental Risk Perception on their Physical and Mental Health: Evidence from China

Employing Chinese General Social Survey 2013 data (N = 678), this study examines the influences of migrant construction workers' environmental risk perception (ERP) on their physical and mental health. The ERP of migrant construction workers is characterized by six dimensions: perceptions of air pollution, industrial waste pollution and noise pollution at working sites, and perceptions of domestic waste pollution, water pollution and food pollution at living sites. The results indicate that migrant construction workers with stronger ERP have better physical and mental health. The results also suggest the influences of ERP on the physical and mental health of migrant construction workers with different gender and age (<50 and ≥50 years) are heterogeneous. Perceptions of industrial waste pollution, noise pollution and domestic waste pollution significantly affect female workers' physical health, but not that of male workers. The six dimensions of ERP all significantly influence male workers' mental health, while except for domestic waste pollution perception, the other perceptions do not influence that of female workers. Perceptions of air pollution, domestic waste pollution, and water pollution significantly influence physical health of workers aged 50 and above, while those of ERP do not work on that of workers younger than 50. Perception of food pollution significantly influences mental health of workers younger than 50, but not that of workers aged 50 and above. The seemingly unrelated regression shows the results in this paper are robust.

Decomposing differences in depressive symptoms between older rural-to-urban migrant workers and their counterparts in mainland China

Background

There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie’s decomposition was used to parse out differences into observed and unobserved components.

Results

After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie’s decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents.

Conclusions

Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers’ depressive symptoms.

Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: a systematic review and policy gap analysis

BACKGROUND

More than 90% of the Chinese population was covered by its three basic social health insurances. However, the Chinese rural-to-urban migrant workers (RUMWs), accounting for about one-fifth of China's total population, seem to be put on a disadvantaged position under the current health insurance schemes. The purpose of this study is to identify the current barriers and to provide policy suggestions to the ineffective health insurance coverage of RUMWs in China.

METHODS

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total, 70 articles were reviewed.

RESULTS

(1) Chinese RUMWs have high work mobility and low job stability; (2) Barriers faced by RUMWs in obtaining effective health insurance coverage are primarily due to the reluctance of employers to provide insurance for all employees and the disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers.

CONCLUSION

It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW's characteristics to meet their primary health needs, (4) strengthening supervision of employers, and (5) providing more vocational training and other support to increase RUMW's job stability.

Job stress and depressive symptoms among migrant workers in Macau: A moderated mediation model of self-esteem and perceived social support

Damaged self-esteem can explain the negative effects of various job stresses on depressive symptoms of migrant workers. Social support may threaten workers' self-esteem in highly stressful environments, and in turn worsen their mental health. This study aimed to examine the indirect role of self-esteem in the relationship between job stress and depressive symptoms among migrant workers in Macau and whether this indirect effect is modified by social support. A sample of 900 mainland Chinese migrant workers was recruited into the study. Job stress, social support, self-esteem, and depressive symptoms were measured. Conditional process analysis was used to examine the proposed moderated mediation model. Job stress was associated with depressive symptoms through lower self-esteem. The indirect effect of job stress on depressive symptoms via decreased self-esteem was significant among migrant workers with higher levels of social support, but not among migrant workers with lower levels of social support. Our findings suggest that when migrant workers perceive a high level of social support, job stress is more likely to threaten their self-esteem and in turn increase their risk for depression. Future efforts aimed at promoting the mental health of migrant workers need to tailor interventions to avoid the threatening effect of social support on self-esteem in job environments with high stress.

Discourse on culture in research on immigrant and migrant workers' health

BACKGROUND

Health and safety researchers and practitioners have proposed that cultural differences help explain inequalities between foreign and native-born workers. While cultural explanations for inequalities have long been debated in other fields, there exists little critique of cultural discourses in occupational health.

METHODS

This article examines and discusses the discourse on culture in 107 articles on immigrant or migrant workers' health published between 2011 and 2015. For each article, passages on culture were identified and analysed for both the context and the manner in which culture was discussed.

RESULTS

The discourse on culture was found to be generally simplistic, individualistic, and uncritical, intentionally or unintentionally supporting the worldview that workers' "otherness" is both cause of inequalities and target for interventions.

CONCLUSION

The article argues that empirical, theoretical and interdisciplinary work is needed to document the mechanisms and pathways that underlie health and safety inequalities by foreign-born status.

Migrant Workers and Physical Health: An Umbrella Review

Migrants are mainly employed in “3D jobs” which are dirty, dangerous, and difficult, are characterized by monotony and intense rhythms, and are found in sectors with higher risks such as construction, heavy industry, and agriculture. The aim of this study is to construct a systematic review in order to identify the main occupational risks and occupational diseases of this category. Research included articles published from 2013 to 2018 on major online databases (PubMed, Cochrane Library, and Scopus), which were obtained using a combination of keywords (migrant workers, expatriates, physical health, diseases, illnesses, travel, travelers, work, and occupational medicine). The online search included 1109 references. We excluded 977 studies because they were unrelated to physical health and another 64 due to duplication. There were 68 articles which were analyzed, including six reviews and 62 original articles. The main risks which emerged are developing infectious diseases, metabolic cardiovascular diseases and manifesting a lower quality of life, in particular due to difficulties in accessing local health services. It will be crucial to implement the role of occupational medicine in order to introduce multilevel interventions designed to prevent work-related injuries and illnesses, and to promote healthier working environments.

Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors

AIMS

Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers.

METHODS

A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs.

RESULTS

The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70).

CONCLUSIONS

CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.

Should the poor have no medicines to cure? A study on the association between social class and social security among the rural migrant workers in urban China

Background

The rampant urbanization and medical marketization in China have resulted in increased vulnerabilities to health and socioeconomic disparities among the rural migrant workers in urban China. In the Chinese context, the socioeconomic characteristics of rural migrant workers have attracted considerable research attention in the recent past years. However, to date, no previous studies have explored the association between the socioeconomic factors and social security among the rural migrant workers in urban China. This study aims to explore the association between socioeconomic inequity and social security inequity and the subsequent associations with medical inequity and reimbursement rejection.

Methods

Data from a regionally representative sample of 2009 Survey of Migrant Workers in Pearl River Delta in China were used for analyses. Multiple logistic regressions were used to analyze the impacts of socioeconomic factors on the eight dimensions of social security (sick pay, paid leave, maternity pay, medical insurance, pension insurance, occupational injury insurance, unemployment insurance, and maternity insurance) and the impacts of social security on medical reimbursement rejection. The zero-inflated negative binomial regression model (ZINB regression) was adopted to explore the relationship between socioeconomic factors and hospital visits among the rural migrant workers with social security.

Results

The study population consisted of 848 rural migrant workers with high income who were young and middle-aged, low-educated, and covered by social security. Reimbursement rejection and abusive supervision for the rural migrant workers were observed. Logistic regression analysis showed that there were significant associations between socioeconomic factors and social security. ZINB regression showed that there were significant associations between socioeconomic factors and hospital visits among the rural migrant workers. Also, several dimensions of social security had significant associations with reimbursement rejections.

Conclusions

This study showed that social security inequity, medical inequity, and reimbursement inequity happened to the rural migrant workers simultaneously. Future policy should strengthen health justice and enterprises’ medical responsibilities to the employed rural migrant workers.

Electronic supplementary material

The online version of this article (10.1186/s12939-017-0692-x) contains supplementary material, which is available to authorized users.

Labour Trafficking among Men and Boys in the Greater Mekong Subregion: Exploitation, Violence, Occupational Health Risks and Injuries

Background

Men comprise nearly two-thirds of trafficked and forced labourers in common low-skilled labour sectors including fishing, agriculture and factory work. Yet, most evidence on human trafficking has focused on women and girls trafficked for sex work, with scant research on trafficked men and boys.

Methods

We analyse survey data from the largest systematic consecutive sample of trafficked people collected to date to describe the prevalence of violence, occupational health risks and injuries and associated factors. Participants were labour-trafficked men and boys using post-trafficking support services in Thailand, Cambodia and Vietnam.

Findings

Data are presented on 446 males aged 10–58. Men and boys were mainly trafficked for fishing (61.7%), manufacturing (19.1%) and begging (5.2%). Fishermen worked extensive hours (mean 18.8 hours/day, SD 5.9) and factory workers worked on average 11.9 hours/day (SD 2.9). 35.5% of male survivors had been injured while trafficked; 29.4% received no personal protective equipment (e.g. gloves). The most commonly reported injuries among all males were deep cuts (61.8%) and skin injuries (36.7%), injuries for which fewer than one-quarter reported receiving medical care. Six fishermen lost body parts, none of whom received medical care. Most males (80.5%) had no or very few rest breaks. One-third (37.8%) experienced severe violence. Work-related injuries were associated with severe violence (AOR 3.44, CI:1.63–7.26), being in the fishing sector, (AOR 4.12, CI:2.39–7.09) and threats (AOR 2.77, CI:1.62–4.75). Experiencing any violence was associated with threats (AOR 26.86, CI:14.0–51.23), being in the fishing sector (AOR 18.53, CI:8.74–39.28) and fluency in language of destination country (AOR 0.39, CI:0.20–0.75).

Conclusion

This study highlights the abuse and extreme occupational hazards suffered by trafficked men and boys. Occupational health and safety interventions are urgently needed to protect male migrant labourers working in high-risk sectors, particularly fishing.

Transient risk factors for acute occupational hand injuries among metal manufacturing workers: A case-crossover study in southern China

BACKGROUND

Acute occupational hand injuries are a common occurrence in China's metal manufacturing industries. This study aimed to explore the transient risk factors for acute occupational hand injuries among metal manufacturing workers.

METHODS

A case-crossover study was conducted from October 2013 through December 2013 in Zhongshan city, southern China. Face-to-face interviews were used to collect information on the occurrence of 12 transient risk factors during the "hazard" period (a 60-min period prior to occupational hand injury) and a "control" period (the week before the injury).

RESULTS

One hundred ninety-four qualified acute occupational hand injury cases (139 male, 55 female) were enrolled in this study, with a mean age of 35.5 (standard deviation [SD] 10.4) years. The most common (64.9%) type of work was punching, and the most common injures were crushes and fractures (28.8 and 23.7%, respectively). Of these cases, 62.9% were regarded as severe or major. Among the 12 transient risk factors, 11 ones were significantly associated with acute occupational hand injuries occurring during the hazard period: "replacing sharp knives" (IRR = 14.38, 95%CI 11.43-18.08), "using malfunctioning machinery" (IRR = 30.59, 95%CI 17.84-52.48), "using different tools" (IRR = 10.96, 95%CI 4.77-25.17), "using different machines" (IRR = 5.20, 95%CI 2.25-12.00), "performing unusual work tasks" (IRR = 24.38, 95%CI 14.11-42.15), "working overtime" (IRR = 13.40, 95%CI 7.70-23.29), "performing a task with a different method" (IRR = 56.41, 95%CI 23.61-134.81), "being in a bad mood" (IRR = 108.11, 95%CI 55.10-211.11), "feeling ill" (RR = 12.27, 95%CI 4.95-30.43), "rushing" (IRR = 5.16, 95%CI 2.49-10.70), and "not wearing gloves" (IRR = 1.63, 95%CI 1.23-2.15).

CONCLUSIONS

Our study suggested that multiple transient risk factors were responsible for the acute occupational hand injuries in China's metal manufacturing industries. Am. J. Ind. Med. 59:832-840, 2016. © 2016 Wiley Periodicals, Inc.

Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

Objectives

China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China.

Methods

The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores.

Results

After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence. Community health center/community health station users reported significantly better experience in the community orientation domain. Township health center/rural health station users expressed significantly better experience in the ongoing care domain. There were no statistically significant differences across settings in the ongoing care, comprehensiveness (services provided), and family-centeredness domains. Multiple linear regression models showed that factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P<0.001).

Conclusions

This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care.