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Occupational health outcomes among international migrant workers: a systematic review and meta-analysis

Hargreaves, S; Rustage, K; Nellums, LB; McAlpine, A; Pocock, N; Devakumar, D; Aldridge, RW; Abubakar, I; Kristensen, KL; Himmels, JW; et al. Hargreaves, S; Rustage, K; Nellums, LB; McAlpine, A; Pocock, N; Devakumar, D; Aldridge, RW; Abubakar, I; Kristensen, KL; Himmels, JW; Friedland, JS; Zimmerman, C (2019) Occupational health outcomes among international migrant workers: a systematic review and meta-analysis. Lancet Global Health, 7 (7). e872-e882. ISSN 2214-109X https://doi.org/10.1016/S2214-109X(19)30204-9
SGUL Authors: Hargreaves, Sally Nellums, Laura Bruff

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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.

Item Type: Article
Additional Information: © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Lancet Global Health
ISSN: 2214-109X
Dates:
DateEvent
July 2019Published
20 May 2019Published Online
29 March 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
209993/Z/17/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
URI: http://sgultest.da.ulcc.ac.uk/id/eprint/110861
Publisher's version: https://doi.org/10.1016/S2214-109X(19)30204-9

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