Risk of occupational injuries among migrant workers: Research findings and practical implications from a field experience in Italian foundries

Background: Migrant workers (MWs) usually perform dirty, dangerous and demanding (“three-D”) jobs in poor working conditions, which are possible determinants of occupational safety inequalities (OSI) that, in turn, lead to increased risk of traumatic occupational injuries (TOI). Literature generally lacks of field studies analyzing OSI in risky sectors. Objectives: To present data from an intervention field study carried out during 2008-2011 in the context of a wider project for occupational health and safety in the Italian foundry industry. Methods: Data are reported from 35 foundries, 24 ferrous and 11 non-ferrous. A multifaceted intervention was carried out, with the main outcome of reduction in standardized TOI rates (incidence=TOI/workersx102, frequency=TOI/working hoursx105, severity=workdays lost-WDL/working hoursx103). An interrupted time series (ITS) analysis was performed, using generalized linear mixed-effects models. Results: A mean of 567 MWs/year were employed in the period 2003-2011, with an upward trend in the last few years (i.e.+60% from 2003 to 2011). MWs were blue collars, 98% males, mainly coming from North-West Africa (55%) and East Europe (25%), mean age 38.5 (range 19.6-62.9), mean duration of employment 7.3 years (range 0.2-28.8), accounting on average for 30% of both workforce (range 7-88%) and working hours (range 6-84%), mostly performing “three-D” tasks. In 2003-2011, 1115 TOI (e.g. burns, wounds, dislocations, strains, sprains, fractures, eye injuries), representing 33% of total injuries and 6322 WDL (25% of total) were registered in MWs. Before the intervention (2007), MWs displayed significantly higher TOI incidence rate (1.78, p=0.005) as compared to Italian workers (IWs). ITS analysis showed increasing trend of all TOI rates (incidence: +28%, p=0.045; frequency: +76%, p=0.026; severity: +47%, p=0.034) among MWs in the intervention/post period, opposite to the slope direction registered for IWs. Possible explanations regarding these findings attain to differences in job tasks, type of employment, health surveillance, education, compliance with safety procedures as compared to IWs. Conclusions: The study provides evidence of OSI among MWs in the foundry sector and highlights the need for dedicated interventions, with proactive role of occupational physicians and safety responsible, for the ultimate goal of healthy and safe integration of migrant workforce.