title: Health and safety implications of recruitment payments in migrant construction workers.
abstract: BACKGROUND
  The Middle East construction sector is heavily reliant on a migrant workforce that predominantly originates from South Asia. It is common practice for migrant construction workers to pay a local labour recruiter the equivalent of one or more years' prospective overseas salary to secure employment, work and travel permits and transportation. The occupational health and safety implications of these financial arrangements remain unexplored.
  
  
  OBJECTIVE
  To examine associations between payment to a labour recruiter, perceived general health and worksite accidents among migrant construction workers in the Middle East.
  
  
  METHODS
  A questionnaire was completed by a convenience sample of predominantly Indian migrant construction workers drawn from a large construction project. The relationship between payment and risk of poor health and workplace accidents was assessed using multivariate logistic regression models (crude and adjusted for socio-demographic and occupational factors).
  
  
  RESULTS
  There were 651 participants. The majority (58%) of migrant construction workers had paid a labour recruiter and ~40% had experienced a worksite accident. Between 3% (labourers) and 9% (foremen) perceived their health to be poor. Labourers and skilled workers who had paid a labour recruiter were significantly more likely to have experienced a worksite accident in the previous 12 months. Skilled workers, but not labourers and foremen, who had paid a labour recruiter were at increased risk of poor health.
  
  
  CONCLUSIONS
  The mechanisms linking labour recruiter payments to adverse safety and health outcomes warrant investigation with a view to developing interventions to erode these links.
authors.affiliation: Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG8 1BB, UK.
authors.forename: H A
authors.initials: HA
authors.lastname: Hassan
authors.affiliation: Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG8 1BB, UK. jonathan.houdmont@nottingham.ac.uk.
authors.forename: J
authors.initials: J
authors.lastname: Houdmont
mesh_terms: D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D003132:Commerce; D060389:Construction Industry; D004651:Employment / Q000191:economics*; D006304:Health Status; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008877:Middle East; D016272:Occupational Health; D010560:Personnel Selection / Q000191:economics*; D011446:Prospective Studies; D012449:Safety; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D055815:Young Adult
keywords: Accidents; economic stress; health; labour recruiters; migrant construction workers; safety.