Occupational health outcomes among international migrant workers
Authors: Kristine Husøy Onarheim, Dianne Egli-Gany, Wafa Aftab
Journal: The Lancet Global Health (2019)

The health of the 164 million migrant workers worldwide is understudied;1International Labour OrganizationILO global estimates on international migrant workers. International Labour Organization, Geneva2018Google Scholar only 6·2% of the literature on global migration published between 2000 and 2016 has examined the health of migrant workers.2Sweileh WM Wickramage K Pottie K et al.Bibliometric analysis of global migration health research in peer-reviewed literature (2000–2016).BMC Public Health. 2018; 18: 777Crossref PubMed Scopus (93) Google Scholar The important systematic review by Sally Hargreaves and colleagues (July, 2019),3Hargreaves S Rustage K Nellums LB et al.Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.Lancet Glob Health. 2019; 7: e872-e882Summary Full Text Full Text PDF PubMed Scopus (105) Google Scholar summarises the global prevalence of occupational morbidity in migrant workers and reports on employment sector, country of origin, country of employment, occupational health outcomes, and design of the studies included. The systematic review3Hargreaves S Rustage K Nellums LB et al.Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.Lancet Glob Health. 2019; 7: e872-e882Summary Full Text Full Text PDF PubMed Scopus (105) Google Scholar provides essential new knowledge of a neglected area, but it omits a major underlying determinant—gender. Understanding the role of gender in the occupational hazards of migrant workers is crucial. The International Labour Organization1International Labour OrganizationILO global estimates on international migrant workers. International Labour Organization, Geneva2018Google Scholar estimates that there are more male than female migrant workers globally, with the proportion of male migrant workers increasing from 55·7% in 2015 to 58·4% in 2018. At the national level, some countries (eg, Qatar) have even more skewed sex ratios, where four in five international migrant workers are male. The sex ratio of migrant workers reflects the gendered determinants of both migration and the division of labour. For low-skilled workers, men outnumber women in construction sectors, whereas women are more often employed as domestic household workers or in caregiving roles. "Certain occupational sectors could also be more representative of specific migrant groups (eg, employment of one sex or migrants from specific geographical regions), which might also be predictors of occupational risk or specific outcomes", state Hargreaves and colleagues3Hargreaves S Rustage K Nellums LB et al.Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.Lancet Glob Health. 2019; 7: e872-e882Summary Full Text Full Text PDF PubMed Scopus (105) Google Scholar in their Discussion. The ways in which gender influences the health of international migrant workers warrants more attention; a minimum requirement would be to present sex-disaggregated data. In the information for authors' page, The Lancet Global Health4The LancetInformation for authors.https://www.thelancet.com/pb/assets/raw/Lancet/authors/tlgh-info-for-authors.pdfDate: 2019Date accessed: June 3, 2019Google Scholar recommends that authors, "where possible, report the sex and/or gender of study participants", and it also explains that, "separate reporting of data by demographic variables, such as age and sex, facilitates pooling of data for subgroups across studies and should be routine, unless inappropriate". These recommendations reflect the Sex and Gender Equity in Research (SAGER) guidelines.5Heidari S Babor TF De Castro P et al.Sex and gender equity in research: rationale for the SAGER guidelines and recommended use.Res Integr Peer Rev. 2016; 1: 2Crossref PubMed Google Scholar For Hargreaves and colleagues,3Hargreaves S Rustage K Nellums LB et al.Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.Lancet Glob Health. 2019; 7: e872-e882Summary Full Text Full Text PDF PubMed Scopus (105) Google Scholar this would have meant including the sex-disaggregated data in their analysis and interpretation. If the analysis and presentation of sex-disaggregated data was not possible, its absence could have been mentioned as a limitation of the systematic review and as a consideration for future research. There seems to be a long way to go before gender-responsive analyses are standard practice. Such analyses are urgently warranted for improving the health of migrants who often work in highly gendered occupations. The recognition of gender and global health by researchers, funders, and journals is welcome, but it needs to be put into practice; the SAGER guidelines should not only be endorsed, they should also be implemented. We declare no competing interests. All authors are affiliated to the Sexual Health Policy for Migrants and Refugees project (208712/Z/17/Z) project and report funds by VolkswagenStiftung, Riksbankens Jubileumsfond, and Wellcome Trust. Occupational health outcomes among international migrant workers: a systematic review and meta-analysisInternational 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. Full-Text PDF Open AccessOccupational health outcomes among international migrant workersIn their systematic review and meta-analysis, Sally Hargreaves and colleagues1 investigated the 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. The findings could help governments, policy makers, and businesses to enforce and improve occupational health and safety measures. However, after carefully checking the data in figure 2,1 we identified several issues that should be highlighted. Full-Text PDF Open AccessOccupational health outcomes among international migrant workers – Author's replyWe thank Kristine Husøy Onarheim and colleagues for raising the role of gender in the occupational hazards of migrant workers, and how gender influences health. We would like to strongly emphasise that, to date, female migrant workers remain invisible to society and to researchers. As such, the rights and protection of migrant women (and girls) are commonly ignored in discussions about occupational health. Our study1 should serve to show that disaggregating results by gender will remain impossible until female workers are fully recognised by labour structures and by researchers. Full-Text PDF Open Access