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52 ProfessionalSafety JUNE 2014 www.asse.org
The U.S. workforce is undergoing dramatic
demographic shifts that are likely to continue
in the coming decades. Increasing participa-
tion of men and women in previously gender-seg-
regated fields (Sarkar, 2002), the aging workforce
(National Research Council, 2012) and the inte-
gration of 2.4 million soldiers who have
served in Iraq and Afghanistan since
2011 (Waterstone, 2010) are just a few
characteristics of the emerging diverse
workplace.
Perhaps most noticeable is the coun-
try’s growing ethnic diversity as a result
of immigration and higher birthrates; this
trend has prompted estimates that no
ethnic or racial majority will exist in the
U.S. by 2042 (Johnson & Lichter, 2010).
Each group brings unique experiences,
assets and challenges to the workplace
in general and occupational safety and
health in particular. Effectively respond-
ing to this diversity will be increasingly
important for public- and private-sector
institutions alike.
Immigrants & the Workforce
Immigration is a key contributor to
these demographic shifts. The Pew Research Cen-
ter’s Hispanic Trends Project (formerly the Pew
Hispanic Center) estimates that immigrants will
make up roughly 23% of adults of
working age in 2050, up from 15%
in 2005 (Passel & Cohn, 2008). It
is also predicted that immigrants
and their children, from all regions
of the globe, will make up 83%
of the growth in the working age
population of the U.S. during this
same time period (Congressional
Budget Office, 2005). Immigra-
tion from Latin America to the
U.S. has grown dramatically over
the past 2 decades and will figure
prominently in these numbers.
Currently, about 18 million Latino
immigrants live in the U.S. (Bata-
lova & Terrazas, 2010).
This growth has been accompanied by geograph-
ic expansion into nontraditional settlement areas
such as the Midwest and Southeast regions of the
U.S. as immigration patterns responded to job op-
portunities (Gouveia & Saenz, 2000; Pew Research
Center, 2005). This rapid and unanticipated growth
in both traditional settlement areas and areas with-
out bilingual infrastructure or a history of a Latino
community present unique challenges and oppor-
tunities for immigrants, employers, safety profes-
sionals and institutions charged with promoting
occupational safety and health (OSH).
Occupational Health Disparities
The growth and expansion of the Latino immi-
grant population has been accompanied by increased
occupational health disparities for Latino immigrant
workers. These workers suffer significantly higher
rates of workplace mortalities (5.0 per 100,000) than
all workers (4.0), non-Latino white workers (4.0) or
non-Latino black workers (3.7) (Cierpich, Styles,
Harrison, et al., 2008) (Figure 1, p. 54).
Considered alone, Latino immigrants to the U.S.
have a workplace fatality rate of 5.9 per 100,000
IN BRIEF
•Companies must face
certain challenges in inte-
grating employees from an
increasingly diverse work-
force to remain effective,
competitive and safe.
•
These challenges include
knowledge, language, cul-
ture and structural realities
such as unfamiliarity with
materials, institutional cul-
ture and wrong-sized PPE.
•
While focused on Latino
immigrants to the U.S., the
approaches discussed can
inform efforts with workers
from various backgrounds.
Michael A. Flynn, M.A., is a social scientist with NIOSH’s Training Research
and Evaluation Branch in Cincinnati, OH, where he is project officer for a research
program focused on better understanding and improving the occupational health
of immigrant workers. Flynn is also assistant coordinator for NIOSH’s Priority
Populations and Health Disparities Program. Before joining NIOSH, he worked
for nongovernmental organizations in Guatemala, Mexico and the U.S. Flynn
holds a graduate degree in anthropology from University of Cincinnati and is
a Research Fellow of the Consortium for Multicultural Psychology Research at
Michigan State University.
Safety Management
Peer-Reviewed
Diverse
Safety & the
Diverse Workforce
Lessons From NIOSH’s Work
With Latino Immigrants
By Michael A. Flynn
COMSTOCKIMAGES/STOCKBYTE/THINKSTOCK
www.asse.org JUNE 2014 ProfessionalSafety 53
person-years, which is almost 50% higher than the
rate for all workers (4.0) and even greater when
compared to Latino workers born in the U.S. (3.5)
(Figure 2, p. 55). During the same period, two-thirds
of work-related deaths among Latinos were among
foreign-born individuals, up from just more than
half in 1992. These data suggest that immigrant
workers may be the driving force behind the elevat-
ed rates of workplace injuries and illnesses among
Latinos in the U.S.
The direct and indirect cost of occupational injury
and illness in the U.S. increased from $146 billion
(or $217 billion in inflation-adjusted dollars) in 1992
to $250 billion in 2007 (Leigh, 2011). This economic
burden is similar to that of cancer and greater than
that of diabetes, coronary heart disease or stroke.
During 2007, workers’ compensation benefits cov-
ered less than 25% ($55 billion) of these costs, leav-
ing injured workers and society as a whole to absorb
these additional costs (Leigh, 2011). If OSH dispari-
ties are not reduced or eliminated for Latino immi-
grant workers, the cost to society will increase as
their participation in the workforce grows over time.
To remain effective, competitive and safe, orga-
nizations must ensure that they have the internal
capacity to successfully integrate employees from an
increasingly diverse workforce. This article discuss-
es the immigrant work experience based on recent
NIOSH research with Latino immigrant workers
across the U.S. It identifies challenges that OSH
professionals and organizations face as they work to
promote OSH among immigrant workers as well as
some general strategies for solutions. While the pri-
mary focus is the Latino immigrant workforce, the
general themes and approaches are broad enough to
inform efforts with other workforce groups as well.
Promoting Occupational Health
Among Immigrant Workers
An essential first step in improving OSH among
any group of workers is to understand the factors
that contribute to their injuries. The noted demo-
graphic changes will not only require workers to
integrate and adapt to the worksite, but will also
require institutions to adapt and change. There-
fore, it is important to focus on the diverse perspec-
tives, backgrounds and experiences of all workers
as well as those of the organization (Koonce, 2001).
Knowledge as a Barrier to Safety
Understanding how to work safely is crucial in
avoiding occupational injuries and illnesses. Upon
arrival to the U.S., immigrant workers often take
jobs in industries in which they did not work previ-
ously (Eggerth, DeLaney, Flynn, et al., 2012). They
are often unfamiliar with the machines, chemicals
and materials present nor the hazards associated
with them. Even immigrants who worked in the
same industry often find different materials and
procedures in the U.S.
For example, residential home construction in
Mexico often relies on cinder blocks and cement,
whereas materials such as wood and drywall are
more common in many areas of the U.S. Finally,
the regulatory structure and veracity of regulation
enforcement in the U.S. may differ greatly from
that of their home country (Flynn, Check, Eggerth,
et al., 2013).
Therefore, even if workers are aware of the safe-
ty regulations governing their work, they may not
know how to address an unsafe situation.
As a result, providing effective safety training
is an essential practice. However, concerns have
been raised about the quality of training that im-
migrant workers receive. Brown (2003) found that
many Spanish-language safety materials were of
poor quality. In addition, immigrant workers fre-
quently report not receiving any safety training on
the job in the U.S. (Gany, Dobslaw, Ramirez, et al.,
2011; O’Connor, Loomis, Runyan, et al., 2005).
Therefore, determining effective ways to provide
safety training to immigrant workers is an essential
step in combating occupational health disparities
(O’Connor, Flynn, Weinstock, et al., 2011). Such
efforts must go beyond simple translations of ex-
isting English-language materials, and the for-
mat, content and messages should be customized
for the target audience as well (Brunette, 2005).
O’Connor, et al. (2005), provide a general overview
To remain
effective,
competitive
and safe,
organiza-
tions must
ensure that
they have
the internal
capacity to
successfully
integrate
employees
from an
increas-
ingly diverse
workforce.
54 ProfessionalSafety JUNE 2014 www.asse.org
of tailoring safety training along with an overview
to approaches, techniques and best practices from
the training literature.
Language as a Barrier to Safety
Language differences between immigrant work-
ers and their supervisors and coworkers are one
of the most frequently cited challenges companies
face in promoting safety among immigrant work-
ers (Gany, et al., 2011). This is particularly common
in areas of the U.S. that have little to no bilingual
infrastructure (Gouveia & Saenz, 2000; Pew His-
panic Center, 2005).
A common practice in companies with no bi-
lingual staff is for the manager to identify the best
English speaker among the immigrant workers
and have him/her translate for the other workers.
This can lead to miscommunication if the employ-
ee is not as competent in English as the supervi-
sor believes. Additionally, it puts this employee in
a position to mediate the relationship between the
supervisor and the other workers, which could be
exploited for personal gain by communicating one
thing to the manager and another to coworkers
(O’Connor, et al., 2011).
Developing a bilingual capacity within an orga-
nization, either through training or hiring, will be-
come increasingly important in economic sectors
with high immigrant participation such as the con-
struction and service sectors. One way to address
this is for companies to provide English classes to
immigrant workers. While this is a laudable effort,
anecdotal evidence suggests that U.S-born work-
ers may perceive this as immigrants receiving spe-
cial treatment.
An alternate model is to pro-
vide both English and Spanish
classes so that all workers have
the opportunity to improve
their communication skills and
even their economic situation if
proficiency with a second lan-
guage is rewarded by a salary
increase or a promotion. The
shared struggle of learning an-
other language may also help
break down barriers within the
workforce as coworkers, both
immigrant and U.S.-born, see
each other tackle the chal-
lenges of learning another lan-
guage. Indeed, classes could
be structured in such a way
that students could practice
with each other, which could
also foster increased contact
between workers of different
backgrounds.
Workers’ Culture
as a Barrier to Safety
While the ability to com-
municate is essential, fixation
on language can cause other
important cultural differences to be overshadowed.
In the context of OSH and immigration, culture can
be generally understood as a system of shared be-
liefs and behaviors, either brought from home or
that develop after arrival that impact how groups
of workers perceive, understand, adapt to and ad-
dress work-related safety concerns.
Cultural factors that may affect safety at work
include how immigrants understand work and
their relationship to their coworkers and employ-
ers; how these understandings compare to their
native-country experiences; how they perceive the
dangers at work relative to other risks they face
each day; how they adapt to workplace dangers;
and how these understandings are similar and dif-
ferent from other groups of workers.
A study of a small group of Latino immigrant
workers in Chicago, IL, documents how these
workers’ behaviors reflect a culture that placed a
high value on hard work and being perceived as
such by their employer (Gomberg-Munoz, 2010).
These workers were observed making overt dem-
onstrations of their productivity to curry favor with
employers and cultivate a reputation as better em-
ployees, which led to a competitive edge in the
labor market relative to U.S.-born workers. This
study also describes the various tactics the group
used to ensure that team members maintained a
high productivity level. While this strategy may
prove effective in securing employment, it can lead
to an increased risk of injury over time.
Employers seeking to create a safe work environ-
ment must recognize these evolving value systems
and adaptations so they can be addressed during
training or in one-on-one interactions. A common
Figure 1
Number of Fatal Work Injuries
for Latinos, 1997-2011
Note. Data from 2001 exclude fatal work injuries resulting from the Sept. 11 terrorist aacks. Reprinted
from “Census of Fatal Occupational Injuries Charts, 1992-2012 (revised data),” by Bureau of Labor
Statistics, U.S. Department of Labor, 2013, p. 11.
11
Number of fatal work injuries involving Hispanic or Latino workers, 1997-2011
NOTE: Data from 2001 exclude fatal work injuries resulting from the September 11 terr orist attacks.
SOURCE: U.S. Bureau of Labor Statistics, U.S. Department of Labor, 2013.
Fatal work injuries involving Hispanic or Latino workers increased in 2011 after four consecutive
years of decline. Sixty-eight percent of fatally-injured Hispanic or Latino workers in 2011 were born
outside of the United States.
379 405 468 494 572 578 520 596 638 667 634
503 429 441 512
279 302 262
321
323 263 274
306 285 323 303
301
284 266
237
0
200
400
600
800
1,000
1,200
Foreign born Native born
658 707 730
815
895 841 794
902
990
923 937
804
713
Number of fatal work injuries
707 749
www.asse.org JUNE 2014 ProfessionalSafety 55
mistake made by U.S.-born
managers is to overlook the
significant diversity that ex-
ists in the Latino immigrant
community (Eggerth & Fly-
nn, 2010). Differences such
as one’s country of origin,
ethnicity or race, primary lan-
guage (Spanish or a pre-Co-
lumbian language), previous
work experience, time in the
U.S. and level of formal edu-
cation are among the many
factors that contribute to di-
versity in the Latino immi-
grant community and impact
how immigrant workers re-
late to their coworkers (both
immigrant and U.S.-born),
their employers and work-
place safety. These differences
can play a critical role in how
workers respond to hazards
and must be accounted for in
training content, format and
messages (Brunette, 2005;
O’Connor, et al., 2011).
It is also important to con-
sider these factors in per-
sonnel decisions. Often, it is
assumed that bilingual individuals hired as safety
professionals or supervisors will easily relate to
and be effective with the monolingual employees
because they speak the same language. While lan-
guage skills are essential for effective communica-
tion, it is important to account for factors such as
social position, personality and experience when
hiring supervisors or safety professionals (Eggerth
& Flynn, 2010). The ability to speak a language
does not mean that an individual has the people
skills or technical knowledge necessary to be an ef-
fective leader. Finding qualified individuals can be
difficult, especially in areas of the country with a
limited number of bilingual individuals in the labor
market. Companies must take care to not become
overconfident that they have solved their language
problem simply by hiring one bilingual individual.
Institutional Culture as a Barrier to Safety
Another common mistake is focusing on an im-
migrant’s culture without examining or accounting
for the organizational culture or that of workers
from the dominant group. The scope of this article
does not allow for a detailed discussion of areas
such as organizational culture, diversity and safety
culture. Suffice it to say that organizations must
develop an understanding of their specific culture
and the degree to which relying on “the way we
do things here” may inadvertently exclude workers
from different backgrounds.
Germane questions may include: What value
does management place on safety? Is this consis-
tently enforced in times of both high and low pro-
ductivity? How is this communicated to employees?
How might limited English proficiency affect this
communication? What formal and informal chan-
nels are used to address safety concerns? Are these
open to all workers? How might a cultural disposi-
tion to nonconfrontation with authority affect im-
portant safety information flowing from workers to
supervisors and managers?
Understanding and overcoming cultural barriers
to safety requires sensitivity to employees’ different
cultural backgrounds, knowledge of the organiza-
tional culture, and an appreciation of where these
may hinder or facilitate a common understanding
and practice.
Structural Realities as a Barrier to Safety
Effective communication and improved cultural
understanding are not the only factors involved in
improving safety for a diverse workforce. Structural
realities can contribute to occupational health dis-
parities for immigrant workers as well. Structural
realities often refer to laws, policies and practices,
such as large macroeconomic trends like globaliza-
tion (Siqueira, Gaydos, Monforton, et al., 2013);
systemic discrimination such as racism (Krieger,
2010; Krieger, Waterman, Hartman, et al., 2006);
and industry practices, such as a growing reliance
on temporary workers (Landsbergis, Grzywacz &
LaMontagne, 2014). These realities contextualize
the work experience and affect the likelihood or
ability of workers or specific groups of workers to
raise safety concerns.
Likewise, macroeconomic trends and industry
practices also contextualize and influence the safe-
ty practices and choices of individual companies
Figure 2
Fatal Injuries for Foreign-Born Workers,
by Country or Region of Birth, 2011
Note. Percentages may not add to 100 due to rounding. Reprinted from “Census of Fatal Occupational
Injuries Charts, 1992-2012 (revised data),” by Bureau of Labor Statistics, U.S. Department of Labor,
2013, p. 12.
Fatal injuries involving foreign-born workers,
by country or region of birth, 2011
Total= 843
SOURCE: U.S. Bureau of Labor Statistics, U.S. Department of Labor, 2013.
NOTE: Percentages may no t add to 100 due to ro unding.
Mexico
41%
Asia
18%
Central America,
except Mexico
11%
Europe
10%
Caribbean
10%
South America
4%
Africa
3%
Canada
2% Australia and Oceania
1%
Workers born in Mexico accounted for the largest portion (41 percent) of foreign-born workers
who died from work-related injuries in the United States in 2011.
12
56 ProfessionalSafety JUNE 2014 www.asse.org
(NIOSH, 2008). While it is beyond the scope of this
article to discuss how specific trends, policies and
social attitudes may contribute to or hinder OSH,
safety professionals must understand how these
structural realities contribute to individual and or-
ganizational behavior.
By definition, eliminating structural barriers of-
ten requires changes in policies and practices at
levels (e.g., industry, federal government, inter-
national regulatory body) beyond that of the in-
dividual worker or organization. While individual
workers or organizations can advocate over time
for structural change to eliminate barriers to safety,
they often can take short-term actions to mitigate
the effects of structural barriers on safety.
One such example relates to proper-fitting safety
equipment for diverse workers. Many PPE speci-
fications in the U.S. are based on measurements
taken from military male recruits in the U.S. during
the 1950s to 1970s (Spahr, Kau, Hsiao, et al., 2003).
These data do not account for the range of body
shapes and sizes of the modern civilian workforce
and, consequently, structurally exclude many work-
ers in today’s economy. This decreases the ability to
achieve good PPE fits for women, nonwhites and
individuals with unique body sizes or shapes (Hsiao,
Friess, Bradtmiller, et al., 2009). This is problematic
because poor fit not only reduces the PPE’s ability
to protect the worker as designed, it may also cause
a worker to reduce or eliminate its use because the
gear is perceived to be either ineffective or uncom-
fortable (Goldenhar & Sweeney, 1996).
Current initiatives are focused on developing
better methods to collect anthropometric data and
ensure that datasets used to design PPE are more
inclusive. For example, researchers are involved in
improving the fit of respirators and fall protection
harnesses for a wider range of body shapes (Hsiao,
2013; Zhuang, Benson & Viscusi, 2010). While more
must be done to update anthropometric data sets
and PPE for the modern workforce, NIOSH’s for-
mative research suggests that alternative-sized PPE
(e.g., designed for women, unisex) may be more
widely available than previously thought. However,
poor advertising to those with purchasing authority
and restrictive (e.g., bulk) purchasing policies with-
in organizations often prevent these options from
reaching workers (DeLaney, 2012).
Updating the anthropometric databases and
creating better-fitting PPE for a wider range of
workers is essential in improving safety among the
diverse workforce. However, this will take time. In
the meantime, a company can investigate available
alternative-sized PPE and examine how it might
adapt purchasing procedures to make such gear
more accessible to the workforce.
Case Study
In 2009, NIOSH researchers initiated a project to
develop an ergonomic awareness and work-relat-
ed musculoskeletal disorder (WMSD) prevention
publication for residential building contractors and
workers. Based on an extensive literature review and
numerous visits to residential building sites, NIOSH
researchers planned to develop a publication simi-
lar to “Simple Solutions: Ergonomics for Construc-
tion Workers” (NIOSH Publication No. 2007-122),
which addresses WMSD risks related to multiple
body regions and construction activities, including
system installation, material component assembly
and manual material handling. Focus groups were
conducted in English and Spanish, respectively,
with native born and immigrant residential building
workers representing multiple trades to understand
their perspectives on WMSD risks and prevention
and their preference for communication materials.
Findings from the focus groups suggested that
building workers in both groups were more like-
ly to recognize the risk of low back injury during
manual material handling than other potential
WMSD risks. Participants in both groups described
favoring publications with more illustrations and
limited text and technical explanations (Albers &
Cato, 2011). Differences between the two groups
were apparent when describing potential interven-
tions for WMSD risks, as immigrant workers were
more likely to suggest worker training and work
rules, rather than substituting tools and equipment
for labor or utilizing different building materials.
Since the publication was intended to provide
information about actionable interventions, the re-
search team decided to limit the focus to the area
that participants clearly recognized as problematic.
The document published was “Simple Solutions for
Home Building Workers: A Basic Guide for Prevent-
ing Manual Material Handling Injuries” [NIOSH
Publication No. 2013-111 and 2013-111(Sp2013)].
Conclusion
Promoting OSH requires practical and theoretical
tools that directly address diversity and inform nec-
essary adaptations to current practices to make them
more responsive to a diverse workforce. Organiza-
tions and safety professionals will increasingly be
called on to develop and implement safety programs
that account for this diversity. To effectively promote
OSH among workers, a company must understand
the diversity that currently exists in the workforce
and how workers approach on-the-job safety.
Essential to this process is developing a more
precise understanding of the workforce and an ap-
preciation for the diversity that exists within groups
of workers such as Latino immigrants. Translating
these diverse perspectives into tailored practices
and interventions will help ensure that different
levels of knowledge and cultural perspectives are
specifically addressed in trainings.
Efforts to create institutional capacity to effec-
tively work with a diverse workforce require both
short- and long-term planning. This capacity will
be developed through targeted hiring as well as
internal training. Finding inclusive ways to build
institutional capacity by promoting a common
destiny may be more effective than providing ad-
ditional training for some groups of workers so that
they fit in. This may be especially true if incentives
are attached to skill building such a developing
proficiency in another language.
Efforts
to create
institutional
capacity to
effectively
work with
a diverse
workforce
require both
short- and
long-term
planning.
www.asse.org JUNE 2014 ProfessionalSafety 57
Structural barriers to safety are difficult to ad-
dress and will likely require that an organization
seeks long-term solutions while also addressing
short-term effects. Effectively addressing the di-
versity that currently exists in an organization will
not only provide a foundation for integrating those
workers but can also build institutional capacity
that will enable an organization to more easily in-
tegrate diverse groups of workers in the future.
PS
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Disclaimer
The find-
ings and
conclusions
in this article
are those of
the author
and do not
necessar-
ily represent
the views of
NIOSH.
