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农民工与本地工人之间的全因死亡率和特定原因死亡率差异:丹麦一项基于人群的队列研究。

All-cause and cause-specific mortality differences between migrant workers and local workers: a population-based cohort study in Denmark.

作者信息

Lau Karen, Mkoma George F, Kreshpaj Bertina, Kiss Ligia, Zimmerman Cathy, Norredam Marie, Hargreaves Sally

机构信息

Migrant Health Research Group, Institute for Infection and Immunity, City St. George's, University of London and the Consortium for Migrant Worker Health, London, United Kingdom.

Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.

出版信息

Eur J Public Health. 2025 Aug 1;35(4):672-679. doi: 10.1093/eurpub/ckaf058.

Abstract

Migrants are prone to poor working conditions in high-risk industries, yet little is known about their mortality risk compared to local-born workers. This study compares all-cause and cause-specific mortality between foreign-born and local-born workers, and identifies at-risk foreign-born workers. A nationwide register-based cohort study was performed using data on migrant workers obtaining residence permits in Denmark during 2015-22. Comparison group comprised Danish-born workers matched by age and sex. Survival analysis using extended Cox model was used to estimate all-cause and cause-specific mortality. Subgroup analysis was conducted by region of birth, economic sector, and occupation. Male migrant workers from Central Europe, Eastern Europe, and Central Asia had higher risk of all-cause mortality than Danish-born workers (HR = 1.30 [95% CI: 1.09-1.54]), attributed to accident deaths (HR = 1.64 [1.06-2.53]), whereas migrants from other regions had lower risk. Migrant workers from these regions were more likely to work in high-risk economic sectors and occupations, such as agriculture and construction. When stratified by economic sector and by occupation, among the elementary occupations, migrant workers from these regions still had a higher risk of all-cause mortality (HR = 1.70 [1.10-2.64]) and accident mortality (HR = 1.51 [1.22-1.85]) than Danish-born workers. Migrant workers from Central Europe, Eastern Europe, and Central Asia are more likely to die from accidents than Danish-born workers. This increased risk was partially explained by their higher representation in at-risk sectors and occupations. There is a need to better understand the structural determinants of health faced by these migrants, particularly in elementary occupations, to prevent avoidable deaths.

摘要

移民在高风险行业中容易面临恶劣的工作条件,但与本地出生的工人相比,他们的死亡风险却鲜为人知。本研究比较了外国出生和本地出生工人的全因死亡率和特定原因死亡率,并确定了有风险的外国出生工人。利用2015 - 2022年期间在丹麦获得居住许可的移民工人数据,进行了一项基于全国登记的队列研究。对照组由按年龄和性别匹配的丹麦出生工人组成。使用扩展Cox模型的生存分析来估计全因死亡率和特定原因死亡率。按出生地区、经济部门和职业进行亚组分析。来自中欧、东欧和中亚的男性移民工人的全因死亡风险高于丹麦出生的工人(风险比=1.30 [95%置信区间:1.09 - 1.54]),这归因于意外死亡(风险比=1.64 [1.06 - 2.53]),而来自其他地区的移民风险较低。来自这些地区的移民工人更有可能在高风险经济部门和职业中工作,如农业和建筑业。当按经济部门和职业分层时,在基础职业中,来自这些地区的移民工人的全因死亡风险(风险比=1.70 [1.10 - 2.64])和意外死亡风险(风险比=1.51 [1.22 - 1.85])仍高于丹麦出生的工人。来自中欧、东欧和中亚的移民工人比丹麦出生的工人更有可能死于意外。这种风险增加部分是由于他们在高风险部门和职业中的比例较高。有必要更好地了解这些移民所面临的健康结构决定因素,特别是在基础职业中,以预防可避免的死亡。

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