P015 Estimating occupational attributable disease burden in migrant and transient workers now and in the future: an example in construction

Abstract

Introduction To date, migrant workers have generally been excluded from disease burden estimates. However, changing employment patterns, worldwide and in the European context, suggest occupational disease in these workers may become an increasingly important consideration. We have extended our attributable fraction (AF) methodology to provide estimates, theoretical at this stage, of the disease burden experienced by migrant workers in a country hosting large numbers of non-residents in this industry. Methods Proportions of migrant workers exposed were estimated using the data available, generally limited, on numbers of non-residents employed, plus estimates of staff and population turnover based on average contract lengths for non-resident workers and working time limits. Life expectancy was based on the host country’s resident rates rather than the local rates in migrants’ countries of origin. Where available, exposure-response relative risk estimates allowed for migrants’ shorter exposure durations. The host country’s underlying disease rates were applied to the migrant worker population estimates to give attributable disease numbers. Results Based on theoretical data for a country employing migrant workers in the construction industry, where between 1980 and 2015 migrant worker numbers were assumed to have increased more than ten-fold, we estimated that 13% of cancers attributable to working in construction were in migrant workers, a share projected to rise in the future as migrants who have ever been exposed in the host country age and increase in number with high turnover. In contrast, two-thirds of the estimated prevalent non-malignant respiratory diseases were in migrants. Conclusions We present a method to estimate occupational disease burden in migrant workers, a group who have been overlooked in the past due to temporary employment status and short residency. The method allows fair comparison to be made between the experience of work-related disease in migrant and resident workers.