Occupational health outcomes among international migrant workers: a systematic review and meta-analysis
Open accessAbstract
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.
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Prior to the COVID-19 pandemic, mental health problems were already one of the most commonly reported work-related health problems among international migrant workers.
“Prior to the COVID-19 pandemic, mental health problems were already one of the most commonly reported work-related health problems among IMWs [9, 10].”
From Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial (2023) · cites this paper as [10]
The Results (page not available in our copy) say mental health problems were common among retail and service workers and report depression or stress in several other migrant-worker groups. The paper does not establish that mental health problems were among the most commonly reported work-related health problems across international migrant workers as a whole. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDespite the mental health burden, access to specialist health care is limited for international migrant workers.
“Despite this mental health burden, access to specialist health care is limited [10, 13].”
From Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial (2023) · cites this paper as [10]
The Introduction (page unavailable) says migrant workers often face barriers to health care, including limited insurance and restrictions on statutory care. The Results (page unavailable) also describe psychiatric morbidity. The paper does not establish the more specific claim that access to specialist health care is limited. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Hargreaves, S., Rustage, K., Nellums, L. B., McAlpine, A., Pocock, N., Devakumar, D., Aldridge, R. W., Abubakar, I., Kristensen, K. L., Himmels, J. W., Friedland, J. S., & Zimmerman, C.
- Affiliations
- St George's, University of London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- University College London (GB)
- University of Copenhagen (DK)
- Corresponding author
- Hargreaves, Sally
- ORCID
- Venue
- The Lancet Global Health
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 7
- Issue
- 7
- Pages
- e872-e882
- ISSN
- 2214-109X (ISSN-L)
- PMC
- PMC6565984
- OpenAlex
- W2945394191
- Cited by
- 364
- References
- 64
- Citations by year
- 2026: 44 · 2025: 55 · 2024: 63 · 2023: 42 · 2022: 67 · 2021: 55 · 2020: 29 · 2019: 8
- FWCI
- 10.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UNU Collections (United Nations University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- European Society of Clinical Microbiology and Infectious Diseases
- Rosetrees Trust
- Wellcome Trust (209993/Z/17/Z)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Social Sciences › Sociology and Political Science › Migration, Identity, and Health
- Social Sciences › Health › Occupational Health and Global Justice
- Keywords
- international migrant workers, occupational health, occupational injuries, occupational morbidity, occupational mortality, occupational safety, migrant health, occupational safety policy, health insurance coverage
- MeSH terms
- Female, Health Status, Humans, Male, Transients and Migrants, Databases, Factual, Occupational Health
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