Immigrant Worker Safety and Health

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workers in a fieldIn the United States, immigrant workers constitute a significant proportion of the workforce. In 2006, 15% of U.S. workers were foreign-born and at least 6.3 million were undocumented. Immigrant workers face a disproportionate risk for workplace injury and illness. This is due to a confluence of factors including an overrepresentation in the most hazardous industries including construction and agriculture. Additionally, workplace safety interventions often do not reach immigrant worker populations due to barriers created by social, cultural, and economic issues including language, literacy, and marginal economic status. Furthermore, immigrant workers often lack knowledge of their rights to workplace safety and are reluctant to pursue these rights.

All workers have an equal right to a safe and healthy workplace irrespective of their immigration status. The National Institute for Occupational Safety and Health (NIOSH) has initiated several targeted intramural and extramural programs aimed at identifying and eliminating safety and health hazards experienced by immigrant workers. Some examples include:

  • The NIOSH Fatality Assessment and Control Evaluation (FACE) program identifies and studies work-related injury deaths, with the goal of identifying effective prevention measures. Through on-site investigations, NIOSH and cooperating states collect detailed circumstances for select incident types, including deaths of Hispanic workers since 2002.
  • Targeted research programs focused on the construction and agricultural sectors, both of which employ a disproportionate share of immigrant workers.
  • An occupational health disparities program, which is conducting research on the causes and prevention of occupational health disparities including those experienced by immigrant workers.
  • A Spanish language website and translation of several NIOSH publications into Spanish.
  • A National Academy of Science workshop requested by NIOSH on steps to improve Spanish language occupational safety and health materials. The report of the workshop Safety is Seguridad: A Workshop Summary can be found at:
  • An innovative information and communication effort with the Spanish-language television network Telemundo and other partners, in which construction safety messages were incorporated dramatically into a widely watched prime-time series, and supplemented with a public service announcement and a special website.

In addition to the projects mentioned above, NIOSH has funded a number of research grants targeting immigrant workers. The most comprehensive grant program has been the Environmental Justice & Community-Based Participatory Research. This program is funded collaboratively with the National Institute for Environmental Health Sciences (NIEHS). The purpose of the program has been to enable workers and community residents to more actively participate in the full spectrum of research. To achieve this goal, the program was designed to bring together three partners: a community organization, an environmental health researcher and a health care professional to develop models and approaches to building communication, trust, and capacity with the final goal of increasing community participation in the research process. Through this program, NIOSH has funded 10 projects which target a wide range of immigrant worker communities across the country. Summaries of the NIOSH and NIEHS Environmental Justice projects can be found at:

At the Safety, Health and Social Justice for Immigrant Workers – Lessons from the NIOSH Environmental Justice Projects session of the 2008 American Public Health Association’s annual conference Public Health Without Borders (October 25-29), a panel will present the experiences from six of the environmental justice projects addressing safety and health concerns of immigrants working in farming, poultry processing, and restaurant and domestic work. Each presenter will provide insights about how notions of social justice are achieved through their work.

Through this session we hope to identify five major challenges to developing intervention studies targeting immigrant workers; discuss methods that can be used to promote improved social justice as part of safety and health intervention programs targeting immigrant workers; and define major strategies and obstacles to implementing successful community based interventions for occupational safety and health.

For those unable to attend the session, we would appreciate feedback through this blog. Specifically, what experience have others had with developing successful interventions for immigrant workers? Additionally, what types of materials are needed to better assist safety and health professional to provide information and training to foreign-born workers?

—Sherry Baron, MD, MPH

Dr. Baron is the Coordinator for Occupational Health Disparities at NIOSH

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18 comments on “Immigrant Worker Safety and Health”

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    Dr. Baron: I’ve not applied my research to immigrant workers, but I suspect I’d find the same gap as with whole of general industry. Premise is, “we don’t know safety.” Sounds silly to say that, but my research supports that. We all have differing mental models of what safety is, our roles in it and how to manage it. Immigrants will have their mental models of safety, and these can be surfaced, tested and changed. One of my clients had the epiphany, “How can we manage something we cannot define?”

    If every single worker/manager had the same mental model of safety, a like-minded vision, we essentially have that many minds, eyes, hands, working toward a common goal of seeking an acceptable level of control over risks and hazards in whatever we are doing. It only takes asking a few questions to start the change. I have a paper (editorial) on my hypothesis. Will send it if interested. Sent it earlier this year to some contacts at CDC.

    I am working in a workers compensation clinic. Many things I want to say:

    1.Urgently we must provide basic education to this people, English, reading, health, citizen behavior, etc…
    2.This people is used and abused for slavery trafficants.
    3.Many of them do not speak Spanish or English. They speak indian dialects from Central America.
    4.Many of them are not provided with protection equipment.
    5.Their workers compensation cases incredibly are resolved faster than any other group, may be because they don’t know the system, and how to abuse it, or they are not contaminated and keep their innocence.

    I provide health care for many undocumented individuals. These individuals are working in construction, the food industry and a few are drivers. There is little or no information available about work dangers and minimal concern about chronic illness such as diabetes, HTN or hepatitis. Like doctors, they use denial to deal with serious illnesses. Even when we give them medicines to take home, most of them do not continue the medicines, do not take advantage of the free city hospitals to obtain medical care (you have to miss a day’s work to go to the free clinic) the good thing is that most of my hispanic patients do not smoke.

    Sadly they will only take a disease seriously, if I say it can kill them. So I advise my fellow physicians to use this card wisely during the care of their hispanic population…example..don’t drink, it will mess up your liver and kill you! The best thing is that the patients have been teaching us spanish, so my co-worker and I can do the rudimentry history by ourselves!

    The situation you’re addressing is not unlike food production systems on a global scale. Developed world (e.g. U.S.) pressure on developing countries to provide any product in any season at as low a cost as possible can generate investments in staying competitive versus protecting workers. Laborers in developing countries may be readily available, at low cost, and encounter low levels of concern when repercussions, e.g. harmful incidents, occur.

    I produced a video on this:

    Our recent work with Cargill, among others, gives me hope that this is being recognized. Cargill and McDonald’s, for example, are working with non-profits in Brazil and in Europe to enhance the environmental and labor-related conditions inherent in their production and sourcing systems. My take-away is the need for greater consciousness on the part of industry partners… Sometimes that takes “sousveillance” (monitoring from grass-roots levels) and the waving of red flags by non-profits and others to inspire partnerships that can lead to improvements.

    I read with great interest the scientific blog on Health and Safety of Immigrant workers. I happen to live and work in the Middle East—in a country under construction, with an expatriate workerforce of almost 1 million—70 percent of whom are in the construction business. As Health Advisor, it gets challenging at most times. I have Occupational and Public Health Background and am wondering what research programs one could get involved in, especially in this region. I am exploring getting back into Public Health and this area of immigrant workers in different countries seems particularly attractive. Would your organisation or your others links be interested in discussing such work now or in the future?

    Thank you for your interest. We will contact you directly to further discuss this important issue.

    Re Post #1 (Bill Montante): I’d like to see your article! I think this is a crucial issue: people’s mental models, which will affect how they understand (or misunderstand) whatever we try to tell them. This is in addition to any obvious language issues (and one’s linguistic competence in another language is often more limited than one realizes.) We public health professionals have our own culture, with our own mental models, and we sometimes assume that these are universal. Even among other native English speakers, this may not be the case. This of course is part of the communication problem…

    The situation you’re addressing is not unlike food production systems on a global scale. Developed world (e.g., U.S.) pressure on developing countries to provide any product in any season at as low a cost as possible can generate investments in staying competitive versus protecting workers.

    I also agree that Immigrant worker safety is a topic that deserves a great deal of attention and acknowledge that the efforts mentioned are an important step towards the betterment of this population. Based on my experience working with immigrant workers, and results of related studies on the topic, however, I would like to offer and see if any work has been done in immigrant outreach through more direct contact methods such as the use of community areas and leaders. I do agree with all the suggested forms in addressing the issue but would like to inquire more about the use of members of the community to inform, educate, and promote immigrant workers into using these resources.

    As your research has shown, there are many resources available to immigrant workers that are not used. I do agree that these resources are partially neglected because of lack of knowledge but it is also very important to pay attention of the fear that many people face regarding these resources. Many workers fear a repercussion from their employers, loss of wages, or the possibility of being deported to their home countries. Harari, Davis, and Heisler studied health care experiences for recent Latino Immigrants and among their results, is the importance of utilizing closer community contact to overcome language barriers and worker isolation in the community (2008). In the aforementioned study, it’s stated that the reason why many immigrants in the Midwest area did not seek health care services was because they were “unaware of services provided” but finally used health care resources after receiving information and assistance “from others in the community.”

    Immigrant workers’ degree of acculturation will also determine how much they seek public health resources. Recent Latino Immigrants, those with less community involvement, are less likely to use preventive services than their more acculturated peers (Jaramillo et al 2009). While serving as an interpreter for various immigrant workers I found a constant trend: many knew about some rights and resources available to them when suffering an accident at work but did not utilize these resources because of lack of information. Even though they received information about workers compensation, for example, it was not until a family member or friend of the community offered to help that they would utilize worker’s compensation or other assistance. The same was seen while working as an ESOL instructor at my local college: many would see us as trusted members of their community and experienced in the field and would then ask us questions that they were too afraid to ask.

    Even though the suggested methods of Immigrant Worker outreach will do a good job providing information to some of these people, the use of the community and its members will help spread this information and relieve some of the fear that deprive workers from safety and health. Has this been another outreach effort considered to address the issue? If so, based on your work and past research, is this a feasible option and how effective has it been in promoting Immigrant Worker Safety?

    Thank you for your thoughtful comments and we agree completely with your suggestions about the importance of using community-based leaders. It is for that reason that we have funded a series of projects over the past five years that focus on using community based participatory research methods to build local community capacity and to use worker leaders to convey safety and health information. A few of the examples of this work can be found in the following document—I direct you to the projects at the link: Look specifically at the projects by Arcury, Quandt, Siqueira, Jayarama, Keifer, Shadbeh, Gute, Azaroff, and Bhatia. We have ongoing funding opportunities for community based participatory research projects and if you are interested I encourage you to apply.

    Thank you again for your comments.

    According to a 2004 article in the American Journal of Industrial Medicine, foreign-born Hispanic construction workers had an 80% greater fatality rate compared to Non-Hispanic construction workers. To me, that is a shocking statistic. I am unsure about the extent to which the fact that there are many more foreign-born Hispanic workers in this industry than US citizens is reflected in this analysis, or if this analysis reflects more of the cultural, language, and legal barriers that immigrant workers face. I think NIOSH’s billingual workplace safety communication efforts, such as the PSA through Telemundo and other popular Spanish language media are great; it is a way to reach the target audience away from their workplace, where they may feel intimidated due to language barriers or possible illegal alien status. In South Florida, we are seeing an influx of immigrant workers from Haiti and rural Central America. In rural Central American villages, Spanish is not always understood; there are still many languages indigenous to Mayan villages in use. Also, Haitian immigrants do not always speak English or Spanish. I would like to know if NIOSH plans on designing resources in Haitian Creole or if there are any plans to create a more visual safety training program that could be provided to speakers of languages other than English or Spanish. What do we know about current safety training practices with workers who don’t speak English or Spanish?

    Thank you in advance for your reply.

    Thank you for your thoughtful comments. We currently do not have any projects directed at Haitan immigrants. A project we funded from Tufts University, Assessing and Controlling Occupational Risks Among Immigrants in Somerville, MA, reports that its programs were successfully adopted by the Haitian Coalition.

    We have also funded a very innovative project directed at Mexican indigenous farm workers. This project has developed materials in both Spanish and indigenous languages such as Mixtec. You can find a brief description of the project at:

    They also published some articles about the projects—the citations are:

    1.1: Farquhar S, Shadbeh N, Samples J, Ventura S, Goff N. Occupational conditions and well-being of indigenous farmworkers. Am J Public Health. 2008 Nov;98(11):1956-9.
    2.2: Farquhar S, Samples J, Ventura S, Davis S, Abernathy M, McCauley L, Cuilwik N, Shadbeh N. Promoting the occupational health of indigenous farmworkers. J Immigr Minor Health. 2008 Jun;10(3):269-80.

    I found the article very interesting, treating the problems of the health immigrants workers. Many questions have no answers about the psychology and the social existence of this population who continue to live the real insecurity. There is an interesting article about the immigrants who live in France. The problems of the institutional situation has been treated in one article which has been written by the sociologist Abdel-Halim Berretima, member of the IRIS, EHESS, Paris. Thank you for this investigation about the immigrants who continue to suffer.

    I just found Immigrant Worker Safety and Health article is very interesting and very helpful.

    I manage a blog which focuses on the health and safety of low wage immigrant workers, and also on related issues of interest to these workers and their families.
    Go to: []

    Opportunity to Learn
    Just as I can point to lack on joy and motivation, I can point to adult learners that preferred to be guided. I can also point to situations where the instruction did not meet the initial needs articulated by the learners because the instruction itself changed the learner’s and their stated needs

    I´m an OSHA Trainer, Professional Civil Engineer living in Honduras, Central America. We’ve just completed a 2-yr span project involving construction of a major food processing plant in the industrial sector of the North Coast. We’ve debunked the myth of Occupational Safety having to do with social, cultural or income disparity. Most of the fellow team mates we worked with had minimum or none safety training at all. It was only trough an innovative approach towards safety, and a “mind-model” of complete safety culture, mutual respect, and above all, teamwork, which we succeded in having a ZERO-ACCIDENT project. I ascertained and strongly believe that laying out the rules of the game before personnel are deployed to their sited, having daily safety meetings, selfless strong leadership, and total safety commitment can occupational accidents be avoided and minimized to the least expression. In the end, it’s about culture and how everyone relates to one easy-to-understand goal: “All we want is for you, to go home safely, everyday”. All the information presented on this article and comments have been extremely helpful, and I’m looking forward to deploy all our knowledge towards an accident-free work environment for our fellow team mates.

    Do visit my blog:
    to watch our achievements to date.

    Regards, JPH

    Thanks for the article, my dad is a worker on the farms and they just got a lone worker alarm which i love, because i know if anything did happen to my dad or his coworkers someone will get there fast and help.

    more employers should have alarms

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Page last reviewed: March 17, 2017
Page last updated: March 17, 2017