Journal of Immigrant and Minority Health · 9 authors, 3 centres
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Migrant workers from low-income countries (LMICs) in Cypriot agriculture experience significantly higher occupational heat strain than native workers from high-income countries (HICs). This is driven by four factors: fewer unplanned breaks, higher work intensity, more insulating clothing, and smaller body surface area. The findings highlight the need for targeted heat mitigation policies to protect vulnerable migrant workers.
**Background:** Global warming increases occupational heat stress for agriculture workers, with migrant workers potentially at higher risk due to language barriers, limited training, and socioeconomic factors. Previous studies relied on self-reported data; this study objectively measured heat strain differences between migrant and native workers.
**Methods:** The study monitored 124 experienced, acclimatized agriculture workers across 17 farms in Cyprus from 2016 to 2019. Workers were grouped by country income: high-income (HICs, n=32, native Cypriots), upper-middle-income (UMICs, n=43, from Balkan countries), and lower-middle- and low-income (LMICs, n=49, from South-East Asia). Environmental conditions (WBGT, air temperature, humidity, solar radiation, wind speed) were recorded. Video recordings were used to analyze work intensity (W/m²), unplanned breaks (% of shift), clothing insulation (CLO), and body posture/speed. Predicted core body temperature (T_C) and time above 38°C (T_C^38) were calculated using the FAME Lab Predicted Heat Strain software. Statistical analyses included one-way ANOVA with Bonferroni post-hoc, Pearson correlations with GDP per capita, and risk ratios.
**Key Results:** Ambient conditions ranged from 14.6 to 32.5°C WBGT (average 24.8±4.2°C). Four main findings emerged: (1) LMIC workers took fewer unplanned breaks (9.5±0.8% of shift) vs. UMIC (11.5±0.7%) and HIC (12.8±1.1%) workers. (2) LMIC (198.0±17.8 W/m²) and UMIC (195.6±18.1 W/m²) workers had higher average work intensity than HIC workers (182.0±21.1 W/m²) (p<0.05). (3) LMIC workers wore more clothing (0.75±0.11 CLO) than UMIC (0.70±0.13 CLO) and HIC (0.66±0.16 CLO) workers (p<0.05). (4) LMIC (1.70±0.28 m²) and UMIC (1.82±0.21 m²) workers had smaller body surface area than HIC workers (1.97±0.24 m²) (p<0.05). Consequently, LMIC workers had significantly higher T_C (37.81±0.38°C) vs. UMIC (37.71±0.35°C) and HIC (37.60±0.29°C) (F(2,87)=11.84, p<0.001). LMIC workers faced a 52% (95% CI 3% to 125%) higher risk of T_C^38 compared to UMIC workers and an 80% (95% CI 10% to 193%) higher risk compared to HIC workers. LMIC workers spent 27.7±31.3% of shift above 38°C vs. 17.0±27.5% (UMIC) and 13.4±25.4% (HIC). GDP per capita was weakly correlated with unplanned breaks (r=0.232, p=0.01), work intensity (r=-0.327, p<0.001), and time above T_C^38 (r=-0.203, p=0.024).
**Clinical Implications:** Migrant workers from low-income countries are at substantially higher risk of heat strain due to modifiable factors (fewer breaks, higher intensity, more clothing) and non-modifiable factors (smaller body size). Interventions should include equitable task allocation, culturally appropriate clothing guidance, mandatory rest breaks, and heat-health training. Policy makers should establish regulations similar to Qatar's heat stress legislation, including health checks, shaded areas, and worker representation. The study's limitations include reliance on self-reported anthropometrics and focus on one Mediterranean country, but the consistent pattern across 17 farms suggests broader applicability.