BackgroundMigrants resident in Italy exceeded 5 million in 2015, representing 8.2% of the resident population. The study of the mechanisms that explain the differential health of migrant workers (as a whole and for specific nationalities) has been identified as a priority for research. The international literature has shown that migrant workers have a higher risk of total and fatal injury than natives, but some results are conflicting.The aim of this paper is to study the injury risk differentials between migrants, born in countries with strong migratory pressure (SMPC), and workers born in high income countries (HIC), taking into account individual and firm characteristics and job tenure. In addition to a comprehensive analysis of occupational safety among migrants, the study focuses on Moroccans, the largest community in Italy in the years of the analysis.MethodsUsing the Work History Italian Panel-Salute integrated database, only contracts of employment in the private sector, starting in the period between 2000 and 2005 and held by men, were selected. The analysis focused on economic sectors with an important foreign component: engineering, construction, wholesale and retail trade, transportation and storage. Injury rates were calculated using a definition of serious occupational injuries based on the type of injury. Incidence rate ratios (IRR) were calculated using a Poisson distribution for panel data taking into account time-dependent variables.ResultsInjury rates among SMPC workers were higher than for HIC workers in engineering (15.61 ‰ py vs. 8.92 ‰ py), but there were no significant differences in construction (11.21 vs. 10.09), transportation and storage (7.82 vs. 7.23) and the wholesale and retail sectors (4.06 vs. 4.67). Injury rates for Moroccans were higher than for both HIC and total migrant workers in all economic sectors considered. The multivariate analysis revealed an interaction effect of job tenure among both SMPC and Moroccan workers in the construction sector, while in the wholesale and retail trade sector an interaction effect of job tenure was only observed among Moroccan workers.ConclusionsMigrant workers have higher occupational injury rates than Italians in the engineering and construction sectors, after two years of experience within the job. Generally the risk differentials vary depending on the nationality and economic sector considered. The analysis of injury risk among migrant workers should be restricted to serious injuries; furthermore, job tenure must be taken into account.