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[Mortality of silicosis patients among migrant workers].

Migrant workers known in Japanese as "dekasegi" refer to workers who migrate seasonally from their town of residence to areas where work is readily available. The eastern part of Toyama Prefecture is well known as a source of migrant workers who engage in jobs associated with dust exposure such as tunnel projects. Most of these workers suffered from silicosis. A total of 695 migrant workers suffering from silicosis who had underwent health screening between 1977 and 1982 were followed until the end of 1983. For cases of death, the cause and date of death were individually confirmed on the basis of death certificates. Based on these data, the person-years of risk and cause-specific mortality rates were calculated. The mean person-years of risk per person was 4.7. During this period of observation, there were 75 deaths among these silicosis patients, giving a mortality rate of 23.0 per 1,000 person-years of risk. When classified by the Japanese roentgenographic category of pneumoconiosis, the mortality rate was 10.5 for category 1, 21.3 for category 2, 38.6 for category 3 and 49.3 for category 4. The mortality rates of categories 3 and 4 were significantly higher than those of categories 1 and 2. The highest cause-specific mortality rate among silicosis patients per 1,000 person-years was 5.2 for malignant neoplasms followed by 3.7 for pulmonary tuberculosis, 3.1 for both cardiovascular diseases and pneumoconiosis, and 2.8 for pneumonia and bronchitis. High mortality rates in the 50-69 age group were found among silicosis patients belonging to categories 3 and 4. By cause of death, the mortality rates of all malignant neoplasms (especially lung cancer), pulmonary tuberculosis, and cerebrovascular diseases were relatively high in this age group. In the 70-89 age group, the mortality rate of those belonging to categories 2, 3 and 4 was high and by cause of death the mortality rates of pneumoconiosis, pulmonary tuberculosis, all malignant neoplasms (especially lung cancer), cardiovascular diseases and pneumonia and bronchitis were high. The mortality rates of silicosis patients with abnormal findings in %VC, FEV1% and AaDO2 by pulmonary function tests tended to be higher than those of silicosis patients without such abnormalities.

Adult↗

Vision care for migrant workers.

Migrant vision care, although encompassing only a small percentage of the population, presents a unique opportunity to the profession through the schools and practitioners. The need for care has been shown through several demonstration projects; viable practice modes have been developed that offer cost-effective care to this population.

Delivery of Health Care↗

Setting norms in the United Nations system: the draft convention on the protection of the rights of all migrant workers and their families in relation to ILO in standards on migrant workers.

The author reviews the U.N.'s draft proposal concerning the rights of migrant workers and their families. "This article examines the nature and scope of obligations under the United Nations Convention and contrasts them with existing international standards. In the light of the elaboration of the U.N. Convention, the conditions of future normative activities to limit negative consequences of a proliferation of instruments and supervisory mechanisms are outlined." Consideration is given to human and trade union rights, employment, social security, living and working conditions, workers' families, expulsion, and conditions of international migration. (SUMMARY IN FRE AND SPA)

Demography↗

[Healthcare for migrant workers in Israel].

An estimated 300.000 migrant workers are currently living in Israel, which is about 5% of the general population. More then half of this population is undocumented and have very limited access to public health care. Due to the financial difficulties within the Israel's public health system, the entity is unable to deal with the needs of migrant workers. Hence, when these migrant workers need inpatient care, hospitals have to bear the costs and this situation creates a divergence between medical and economic considerations. The open clinic of "Physicians for Human Rights", which is operated by volunteer physicians and nurses, is able to provide medical aid for mild and transient illnesses, but not for chronic diseases. Israeli physicians are regularly confronted with ethical issues, regarding the therapy they would like to provide to undocumented migrant workers, but are unable to do so. In Europe, undocumented migrant workers have better access to public health care than in Israel. The Israeli public health system should permit all migrant workers to insure themselves at affordable prices, or another inexpensive insurance system should be created for them.

Costs and Cost Analysis↗

[Social psychiatry of migrant workers (author's transl)].

A review of literature about psychic illness in migrant workers (with special reference to the situation in Europe) is presented, including the problems of incidence and prevalence, course of the illness, typical syndromes and treatment. Results concerning incidence and prevalence of psychic disease in migrant workers are contradictory and partly--for methodological reasons--of questionable quality. It cannot be take for granted, that migrant workers suffer more often from psychiatric disturbances than either of the two possible control groups: the populations of the emigration or immigration countries respectively. There are two high risk periods for migrants: shortly after the migration and after a longer period in the guest country. Differences between the migrant's culture and that of the immigration context (language, mythical beliefs, illness behavior) influence the manifestations of psychiatric syndromes. The following syndromes are typical for migrant workers: paranoid reactions, hypochondric-depressive syndromes, psychosomatic conditions and sexual neurosis. Special attention requests the treatment of migrant workers with psychiatric problems; the aspects of psychotherapy, accompanying social measures and the return as therapeutic measure are discussed. In the second part, a general frame of reference for the sociological analysis of the problem of migrant workers is presented. Reasons for the mass immigration of foreign workers to the industrialized countries of central Europe were the demand of labor force and the large gap in socio-economic development between the countries. In the immigration context, the foreign workers find themselves in the lowest social strata and numerous problems accumulate there. Empirical evidence for different sociological explanations of mental illnes of migrant workers ist presented: hypotheses of social selection vs. social causation (low socio-economic status, goal-striving-stress, culture-shock theory, theory of culture change and isolation hypothesis).

Adjustment Disorders↗

A preliminary study of the mental health of young migrant workers in Shenzhen.

The aim of this study is to examine the mental health status of young migrant workers in Shenzhen. Using the Symptoms Check List-90 (SCL-90), Eysenck Personality Questionnaire, Social Support Scale and Mental Health Questionnaire for Laborers, 371 migrant workers who came from inland areas of China and 100 local workers were investigated. The SCL-90 profile of migrant workers was also compared to the SCL-90 norms provided by general people in China. The SCL-90 results showed that the total scores, the average scores of the positive symptoms, the three factor scores of obsessionality, interpersonal sensitivity and phobia in migrant workers were significantly higher than those in the local workers. According to the multivariate analysis, the amount of contribution to mental health, in descending order, was neuroticism, psychological pressure, income, home sickness, marital or love problems, extroversion and introversion, living conditions and social status. The mental health status of young migrant workers in Shenzhen was poorer than that of their local counterparts, as well as people in China on the SCL-90. It is recommended that mental health workers should help migrant workers adjust to the new urban environment by providing psychological counseling and other relevant treatment facilities.

Acculturation↗

Child psychiatric disorders and family dysfunction in migrant workers' and military families.

Migrant adaptation was studied in children and families of French soldiers and of Greek and Turkish migrant workers in West Berlin. In addition, a German control group was investigated. All four samples were matched with regard to sex and age of the children. Psychiatric morbidity differed significantly between the migrant groups. Disturbed parental behaviour and impaired maternal health clearly correlated with psychiatric disturbance in the children in samples. Cultural rather than socioeconomic factors seemed to be most influential with regard to psychosocial adaptation.

Child↗

[A study on awareness of sexually-transmitted disease/acquired immunodeficiency syndrome and related factors among migrant workers in Hangzhou City, Zhejiang Province of China].

OBJECTIVE: To understand awareness on transmission routes of sexually transmitted diseases and acquired immunodeficiency syndrome (STD/AIDS) among migrant workers in Hangzhou City, Zhejiang Province. METHODS: A cross-sectional study was conducted in migrant workers in Hangzhou with self-administered anonymous questionnaire to collect their demographic information and awareness on STD/AIDS. All the data were analyzed by SPSS 11.0 software. RESULTS: A total of 3 001 subjects were interviewed. Most of them have already had some knowledge about STD/AIDS, but not complete. There were 556 (18.8%) migrant workers did not understand that condom could prevent from STD, and 759 did not know if it could do. There were 357 (11.9%) workers did not know AIDS could be prevented, and 746 (24.9%) thought that AIDS could be cured. There were 637 workers did not know that correct use of condom could reduce occurrence of AIDS, and 725 of them thought AIDS could be infected by hands-shaking and hugging with patients of AIDS. There existed statistically significant difference in awareness on STD/AIDS between men and women, workers with varied marital status and education levels. CONCLUSIONS: Awareness on STD/AIDS in migrant workers was smattering, allowing of not optimistic. Community-based health education on knowledge about STD/AIDS should be strengthened among high-risk migrant workers with varied channels to improve their awareness.

Acquired Immunodeficiency Syndrome↗

Food habits and nutritional status of agricultural migrant workers in Southern Brazil.

A new class of migrant workers, commonly known as "Boia-Frias", is rapidly growing in the periurban slumbs (favelas) of Brazil. In 1978 a collaborative study was undertaken to assess the food habits and nutritional status of 100 migrant worker families of Vila Recreio, a typical Boia-Fria settlement near Ribeirao Preto in the state of Sao Paulo. The findings of this survey revealed that the traditional diet of Boia-Frias is nutritionally inadequate both in quality and quantity. Their rice and bean-based diet lacks sufficient variety because of the infrequent use of fresh fruits and vegetables, which are available locally, and of supplemental amounts of protein-rich foods of animal origin. Empty-calorie foods such as carbonated drinks and alcoholic beverages are consumed freely; and starchy foods, traditionally used in the North and Northeast of Brazil, are used commonly as weaning foods. Although dietary practices of pregnant and lactating women are poor, breast-feeding is still practiced by most mothers. The biochemical analysis of blood samples did not indicate major subclinical deficiencies except low hematological values and low plasma vitamin A concentrations in about 25% of the population examined. Plasma cholesterol and plasma vitamin E values were found to be normal. However, anthropometric examinations revealed clear signs of malnutrition and/or undernourishment, which likely impairs their capacity for physical work and adversely affects their overall health.

Adult↗

HIV-related characteristics of migrant workers in rural South Carolina.

After finding human immunodeficiency virus (HIV) infection in a migrant worker named as a syphilis contact, the South Carolina Department of Health and Environmental Control offered HIV counseling and testing and syphilis screening to migrant workers in the surrounding two-county area. In addition, a brief questionnaire was administered to document demographics and risk behavior. Of the 265 workers aged 16 and older in 15 migrant camps, 198 (75%) consented to the survey and testing. Of the 198 tested, 85% were male and 75% single. The median age was 39, with a range of 16 to 69 years. Twenty-five (13%) were HIV antibody positive, and 32 (16%) had reactive serologic tests for syphilis. Of the 166 workers who reported the frequency of condom use, 77 (46%) indicated they never use condoms. We conclude that there is a relatively high rate of HIV infection in these rural South Carolina migrant workers, whose behavior puts them at risk for HIV infection and other sexually transmitted diseases.

Adolescent↗

"No TEBA...forget TEBA": the plight of Malawian ex-migrant workers to South Africa, 1988-1994.

"This article is about the process of socioeconomic transformation in rural Malawi. It examines the survival strategies and enterprising spirit of Malawian migrant workers and their households. It argues that the strategies of these people often went beyond survival in the provision of basic necessities.... In March 1988, the South African Chamber of Mines stopped a century-old tradition of recruiting migrant workers from Malawi. This has arrested and put to a halt a process of accumulation taking place in the households of the returned migrant workers in the rural economy. Thus, the effects of the retrenchment of the workers will spread from the migrant and his family through the economic and social wellspring of all sectors of rural communities and their commercial lives."

Africa↗

[Migrant workers: evolution of the Israel health system approach to the new social issue].

The immigration of workers from poor countries to Israel began in earnest in 1993, and by 2003 their number had reached 250,000, the majority without work permits. In this article we describe the evolution of the Israeli approach to providing health services to migrant workers, noting particularly the swings between exclusion and inclusion, ranging from providing only the most minimal services to providing a complete health services package. The National Insurance Institute was the first to provide benefits to documented migrant workers, mandating compensation benefits for those injured at work or in terrorist incidents. The health care sector provided an ever-increasing package of health benefits for documented migrant workers, culminating in the Foreign Workers Law of 2000 obligating employers to insure workers with a health package similar to that of Israeli citizens. The provision of health services to undocumented migrant workers and their families arose more gradually, but ultimately included the full range of mother and child preventive health services, school health services, provision of ambulatory medical care by volunteer physicians members of human rights organization, the possibility of enrolling their children at a reduced premium in Meuchedet Health Fund, free diagnostic and treatment services for tuberculosis and sexually transmitted diseases, free antiretroviral treatment of HIV-positive pregnant women, and, finally, the ability to obtain gas masks for a token deposit prior to the Iraq War of 2003

Delivery of Health Care↗

Determination of the prevalence of lymphatic filariasis among migrant workers in Kuwait by detecting circulating filarial antigen.

The main objective of this study was to determine the prevalence of filarial infection among migrant workers in Kuwait. The study was conducted from April 2000 to November 2003. A total of 1050 migrant workers (>90 % from the Indian subcontinent) from filarial endemic countries and 260 individuals residing in Kuwait as controls (50 healthy Kuwaiti blood donors, 50 microfilaria-negative individuals from endemic areas and 160 patients with other parasitic infections) were screened for filarial infection. All specimens were tested for microfilaraemia by microscopy of nucleopore-filtered blood (NFB) and detection of circulating filarial antigen (CFA) by an immunochromatographic test (ICT) and the TropBio assay. The overall prevalence of filarial antigenaemia was 18.3 % (192 individuals) using the ICT and 20.3 % (213 individuals) using the TropBio assay. Thirty-two cases (3 %) of Wuchereria bancrofti were detected by microscopy and the mean microfilaria count in these cases was 816 microfilariae ml(-1). CFA was detected only in two of the 260 control subjects. Statistical analysis to calculate the sensitivity, specificity and prevalence of infection was carried out using maximum-likelihood statistical methods. The overall sensitivity and specificity of the ICT and TropBio assay to detect CFA were comparable. Compared with NFB microscopy, the sensitivity of the ICT was 93.8 % and specificity ranged from 84 to 100 %. The sensitivity and specificity of the TropBio assay were 90.1 and 100 %, respectively. However, the ICT failed to detect CFA in two cases with a microfilarial load of <20 microfilariae ml(-1). In conclusion, the prevalence of filarial infection among the migrant workers in Kuwait was 18.3 % as determined by the ICT.

Adolescent↗

[Age of migrant workers: ethnic resources and double disadvantage].

As a result of migrant-movement in Western Europe increasing numbers of aged people of foreign origin are being registered. In the FRG a large number of these are migrant workers. Initial reports confirm the same observations made in the USA that in old age an increased withdrawal into ethnic enclaves takes place. An additional phenomenon observed in the Europe study population is the desire to return to their native country among the aged immigrants. A return however, is usually not realized. This creates a dilemma which often characterizes the situation of older migrant workers. The specifics of the ageing process and the age situation of ethnic old people can only be researched in a synthesis of migration and gerontological research. Findings from both fields must be analyzed in order to develop adequate provisions in help-for-the-aged program dedicated to this specific aged population.

Adaptation, Psychological↗

Women migrant workers' vulnerability to HIV infection in Hong Kong.

Research on population mobility and HIV/AIDS risk among migrant populations is quite limited, and research on migrant women workers' vulnerability is further limited. Hong Kong, the Special Administrative Region of China, has currently about 200,000 women migrant workers working as domestic helps. This paper reports migrant women worker's access to AIDS-related health information and health care facilities, perceptions about vulnerability, and risk behaviour profile. Data was collected through a pre-tested questionnaire from a random sample of 2,010 women migrant workers. A majority of the migrant women workers (63.6%) have been living and working in Hong Kong for between 4-10 years. Fifty-four per cent of the respondents felt that being a female they were vulnerable to HIV infection. Overall, the knowledge regarding HIV/AIDS and its route of transmission is inadequate amongst the migrant women workers in Hong Kong. It appears that AIDS-related information education and communication needs of women migrants workers are not met by the current HIV prevention and care activities in Hong Kong. The study indicates that migrant women workers who experienced sexual violence (9%) in Hong Kong perceive themselves to be 'at risk' of HIV infection. Seventy per cent of the respondents reported that they have felt discriminated against in Hong Kong, of which 42% felt discriminated against in Hong Kong hospitals. Addressing discrimination in health care settings is an essential element of AIDS prevention. The discussion urges researchers and policy makers to pay more attention to the vulnerability of migrant women workers.

Adolescent↗

Perceptions of health hazards in the narratives of Italian migrant workers at an Australian asbestos mine (1943-1966).

This article reconstructs how workers perceived asbestos hazards, using narratives from a group of migrant workers at the crocidolite mine of Wittenoom Gorge, Western Australia. The mine employed about 7000 workers over the entire period of its operation from 1943 to 1966-relying heavily on migrant workers. The exposure to asbestos dust caused a huge number of occupational respiratory diseases in workers, leading Wittenoom later to be labelled as a modern industrial disaster. Fieldwork involved 137 interviews with Italians who had worked at Wittenoom. They constituted 18% of the mine's work-force and were employed as miners or millers between 1951 and 1966. We interviewed workers who had returned to Italy, relatives of Italian workers now deceased, and workers who had settled in Australia. The results confirm the seriousness of the occupational exposure to asbestos and the weaknesses of the health surveillance program. Although workers were given no health-related information, they felt they were at risk and left the job as soon as possible. From the early 1950s onward, some of the workers became aware of a long-term connection between work at Wittenoom and lung illnesses that required hospitalisation and caused deaths. However, up to the early 1960s, workers at the mine were led to believe that the respiratory disease spreading among them was tuberculosis.

Adult↗

Technology evaluation of a USA-Mexico health information system for epidemiological surveillance of Mexican migrant workers.

From 1994 through 1996, federal, state, and nongovernmental organizations in Mexico and in the United States of America developed and piloted a Binational Health Information System for Epidemiological Surveillance of Mexican migrant workers. The system allowed data exchange for epidemiological surveillance between the state of Guanajuato in Mexico and the Commonwealth (state) of Pennsylvania in the United States, for case detection, prevention, and treatment, through shared contact investigation and case management of communicable diseases. The target population consisted of migrant workers traveling between Guanajuato and Pennsylvania to work mainly in the mushroom industry, and their sexual partners in their Mexican communities of origin. Computerized migrant health information modules were set up in Guanajuato and in Pennsylvania. Patient information and epidemiological surveillance data were encrypted and communicated electronically between the modules, using the WONDER communications system of the U.S. Centers for Disease Control and Prevention. Evaluation of the Guanajuato-Pennsylvania Binational Health Information System showed that major barriers to binational epidemiological surveillance and control are: a) lack of communication binationally; b) interrupted medical care due to migration; c) inconsistent diagnosis and treatment criteria between the two countries; d) lack of referral clinical records from one country to the other; and e) deficient legal regulations concerning binational clinical data transfer. To our knowledge, this is the first project that has successfully demonstrated the technological feasibility of a binational disease control system linking a state in the interior of one country with a state in the interior of another country, rather than just states in the border region. The project also advanced the understanding of health service organizational issues that facilitate or hinder communication, outreach, disease prevention, and organization of health care services for migrant workers in both Mexico and the United States. Despite the unprecedented success and potential bilateral benefits demonstrated by this project, serious structural and organizational deficits in the public health systems of both countries must be addressed before epidemiological surveillance can be achieved binationally.

Information Systems↗