Migrant workers prone to more work-related accidents but fewer diseases

The report ‘Work accidents and occupational diseases among migrant workers’ is the first study on the health and safety of non-EU workers. These workers report higher work accidents than Italian workers do because of their poor quality jobs, which are often undeclared or of a temporary nature. However, migrant workers report a lower level of occupational diseases than their Italian counterparts because of the so-called ‘healthy migrant worker effect’.

Profile of migrant workers

The National Confederal Assistance Centre (Istituto Nazionale Confederale di Assistenza, Inca-Cgil) is the social security assistance service of the largest Italian trade union, the General Confederation of Italian Workers (Confederazione Generale Italiana del Lavoro, Cgil). Inca-Cgil commissioned a report entitled Work accidents and occupational diseases among migrant workers (‘Il fenomeno infortunistico e tecnopatico nei lavoratori stranierii (in Italian, 117Kb PDF)’), which summarises the main results of available data sources on the health of migrant workers based on surveys carried out since 2000.

According to a report (in Italian, 151Kb PDF) by the Italian Workers’ Compensation Authority (Istituto Nazionale per l’assicurazione contro gli infortuni sul lavoro, Inail), which is the governmental insurance institution for occupational accidents, migrant workers represented 10% of all employees in 2005. These workers are most prevalent in the economic sectors of agriculture (21.6%), construction (17.5%), hotels and restaurants (about 50%) and services to households (65.5%); in the latter case, most of the workers are women. Thus, migrant workers are mainly found in industries characterised by ‘3-D jobs’ (dirty, dangerous and demanding), with the highest concentration in companies with fewer than 50 employees.

Furthermore, undeclared work is widespread, at 14.4% of the total active population among migrant men and 19.7% among migrant women (see the Italian contribution to the comparative report Employment and working conditions of migrant workers). This is due to the dominance of informal channels of recruitment in the Italian labour market: 77% of migrant workers find work through informal contacts, compared with 53% of Italian workers, according to the survey Isfol-Plus (Participation, Labour, Unemployment Survey) (in Italian) from the National Training Agency (Istituto per la Formazione dei Lavoratori, Isfol).

Health and accident rates

Migrants workers are on average younger than the native labour force and enjoy better health, which is consistent with the so-called ‘healthy migrant worker effect’. According to a report on migrant hospitalisation (in Italian, 214Kb PDF) from the National Institute of Health (Istituto Superiore di Sanità, ISS), this group records fewer days of hospitalisation, at 16.7 days per 1,000 persons compared with 20 days per 1,000 Italians. The primary reasons for migrants to go to hospital relate to pregnancy and accidents. However, data are incomplete because of the lack of surveillance systems. A survey on first aid activity (in Italian, 145Kb PDF) at the Hospital of Cesena, a northern medium-sized city, reveals that migrant men aged 18–49 years show slightly lower hospitalisation rates than native workers do but record higher use of first aid services, at 440 cases per 1,000 migrant men compared with 248 per 1,000 Italian men. Work accidents were one of the main causes of this demand for first aid, at 105 cases per 1,000 migrant men compared with 50 per 1,000 Italian men.

According to Inail, reported work accidents declined by 2.8% in 2005 compared with 2004, because, since 2005, workers from the new Member States (NMS) are no longer included among non-EU migrant workers. However, both undeclared work and fixed-term employment contracts affect both the completeness and accuracy of reporting, while mild accidents tend to be underreported. Nonetheless, work accident frequency rates are consistently higher than average for migrant workers, although the annual rates vary to a greater degree among this group because of other factors such as levels of inflow and the regularisation of illegal migrants (Table 1).

Table 1: Number of work accidents per 1,000 workers, according to country of origin
This table shows the number of work accidents per 1,000 workers among non-EU workers and for the total working population.
  2001 2002 2003 2004 2005
Non-EU workers 70.8 63.1 58.1 62.3 57.2
Total 47.4 45.3 43.9 43.1 41.6

Source: Calculations based on Inail 2005

Rate of occupational diseases

Work-related diseases show an overall increase, although less than the rate of growth of the migrant labour force; however, underreporting is higher in this group than for native workers. ‘Tabulated’ diseases – that is, those recognised by Inail as having an occupational cause – show a trend very close to non-EU labour force growth, with approximately stable prevalence rates. ‘Non-tabulated’ diseases – that is, diseases for which workers have to prove the causal link – also show a similar trend as the proportion of migrant employees; nonetheless, some musculoskeletal disorders, such as invertebral disk complaints and tendinitis, show a stronger increase (Table 2).

Table 2: Main reported occupational diseases among migrant workers, absolute values and % variation
This table outlines the main reported occupational diseases among migrant workers for 2001 to 2005, and notes the % variation between 2001 and 2005.
  2001 2002 2003 2004 2005 2001–2005 (% variation)
Tabulated diseases 229 207 217 221 135 -41.0
Hearing problems 100 89 86 94 51 -49.0
Skin diseases 56 49 61 56 41 -26.8
Asthma 8 13 12 12 12 50.0
Pleural maesothelioma 9 10 12 7 7 -22.2
Osteoarticular diseases 10 14 7 10 3 -70.0
Non-tabulated diseases 420 566 610 755 763 81.7
Hearing problems 141 117 124 173 183 29.8
Invertebral disk complaints 29 34 38 81 103 255.2
Tendinitis 39 50 50 76 95 143.6
Muscle and ligament diseases 31 22 32 35 54 74.2
Dermatitis and other eczemas 17 7 15 27 30 76.5
Non-determined 27 59 49 60 171 533.3
Total 676 832 876 1,036 1,069 58.1
Migrant employees 1,042 1,472 1,716 1,878 1,919 84.2

Source: Calculations based on Inail 2005

Table 3 summarises the share of certain work-related diseases reported by migrant workers as a proportion of the total work-related diseases reported to Inail. Hearing problems, bronchial asthma and skin diseases show a higher than average increase among non-EU workers. Thus, the poorer quality jobs that they do counterbalance their shorter career in the Italian labour market.

Table 3: Reported occupational diseases by migrant workers, % of total work-related diseases
This table outlines the share of certain occupational diseases reported between 2001 and 2005 by migrant workers, as a % of total work-related diseases. It also shows the % variation over the five-year period.
  2001 2002 2003 2004 2005 2001–2005 (% variation)
Tabulated diseases 2.4 2.7 3.5 4.1 3.8 58.9
Hearing problems 2.1 2.5 3.3 4.4 4.5 117.0
Skin diseases 5.4 5.9 9.2 9.5 10.6 95.6
Asthma 2.5 5.4 5.1 5.4 8.4 231.5
Pleural maesothelioma 1.4 1.5 1.8 1.1 1.1 -22.7
Osteoarticular diseases 2.7 3.9 2.5 4.5 1.9 -29.9
Non-tabulated diseases 2.4 3.4 3.5 3.9 4.3 80.0
Hearing problems 2.3 2.9 3.1 3.8 4.4 87.9
Tendinitis 3.4 4.1 3.6 4.2 4.4 27.9
Invertebral disk complaints 4.1 4.3 4.1 5.8 5.9 44.6
Non-determined 2.8 3.2 3.3 4.0 3.6 25.6
Total 2.4 3.1 3.5 4.0 4.1 70.8

Source: Calculations based on Inail 2005

Commentary

Although no systematic analysis exists on the health and safety of both non-EU and NMS migrant workers, the report highlights consistent results from the various pieces of evidence. However, the impact of both working and living conditions and their interaction has not yet been assessed.

Mario Giaccone, Fondazione Regionale Pietro Seveso

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