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Work injuries and exposures in children and young adults: review and recommendations for action.

Child labor, the penultimate form of cheap labor, is endemic in poor countries; it also occurs in affluent countries. Little information has been available on injuries, disease, and effects on growth and development in the tens of millions of children at risk. Preventive and control measures are eliminating the gross abuses, tracing and banning hazardous exposures to toxic agents, eliminating risks of injuries and ergonomic strain, providing health services for working children through the primary health care network, and developing international failsafe design standards for tools and work systems, if these children must work. There is a need to train public health professionals, pediatricians, and maternal and child health care personnel in carrying out simple descriptive epidemiologic studies and setting up interventive programs. Eliminating the worst conditions and controlling hazards where there is no imminent alternative to child labor are suggested as the basis for a two-pronged strategy for protecting children who are forced to work.

Accidents, Occupational↗

Work-related injuries in minors.

Since 1938, federal child labor laws have restricted employment of persons under 18 years old, in part to protect them from hazardous occupations. Workers' compensation claims reported to the Supplementary Data System of the Bureau of Labor Statistics were examined to define the current status of occupational injuries among minors. Data tapes from 1980 to 1983 were searched to identify all current claims for injuries and illnesses occurring in 1980 in persons under age 18. Injury rates were calculated using information about employment in 1979 available from the 1980 census. In the 24 states included in this study, 23,823 claims were reported for persons less than 18 years old. Of these claims, approximately 10% were from persons under age 16. Rates of injuries in 16- and 17 year olds were 12.6 per 100 full-time male workers and 6.6 per 100 full-time female workers. Serious injuries included fractures, dislocations, and amputations, accounting for 5.8%, 0.7%, and 0.6% of cases, respectively. California, the only state that coded whether injuries resulted in fatalities, reported 12 deaths in this age group. Machines and vehicles, many of which are restricted under child labor laws, accounted for 8.3% and 5.8% of claims. These data suggest that persons under age 18 years are not adequately protected from occupational injury. Further attention and, possibly, new preventive strategies are needed.

Accidents, Occupational↗

Workrelated risks and health problems of working children in urban Istanbul, Turkey.

The purpose of this cross-sectional study was to identify the work-related risks and health problems of working children. The sample included 167 working boys. These boys were chosen from schools giving occupational education in the industrial part of Istanbul. A questionnaire and worksite assessment checklists, developed by the researchers, were used as data gathering tools. Data were collected from the boys' schools and workplaces. From this data, it was found that 24.6% of the boys were jewelers, 32.3% were car mechanics and 43.1% were hairdressers. Findings revealed that 30.5% of the boys, who were engaged in child labor, were poor and dropped out of school to assist their families. Boys, whose mean age was 17.6 +/- 1.2, had been working since they were 13 yr old. The boys were also found to work 66.4 h a week, which was an unexpectedly high result considering the 35 hours limitation set by the laws of Turkey for working children. As for work-related risks, chemical risks for boys working as hairdressers (p<0.01), and using sharp tools and accidents for boys working as car mechanics were more common than the other groups (p<0.001, p<0.001). Boys working as hairdressers mostly had respiratory system problems, skin problems, and headache (p<0.001, p<0.001, p<0.001). Those working as car mechanics had nose/throat problems, and musculoskeletal system problems (p<0.001, p<0.01). Among those working as jewelers, eye-related problems were common (p<0.001). It was concluded from the findings of the present study that child labor creates an unhealthy environment for children.

Adolescent↗

Health hazards to children in agriculture.

Children comprise a significant portion of the agricultural workforce and are exposed to many workplace hazards, including farm machinery, pesticides, poor field sanitation, unsafe transportation, and fatigue from doing physically demanding work for long periods. Migrant farmworker children face the additional hazard of substandard or nonexistent housing in the fields. Children account for a disproportionate share of agricultural workplace fatalities and disabling injuries, with more than 300 deaths and 27,000 injuries per year. The most common cause of fatal and nonfatal injury among children in agriculture is farm machinery, with tractors accounting for the greatest number. Remedies to the problems of child labor must take into account family economics and the need for child care. Labor law reform and rigorous enforcement of existing laws and of workplace health and safety requirements are vital to better protect the children and adults working in agriculture.

Accident Prevention↗

Epidemiology and prevention of injuries among adolescent workers in the United States.

In the United States, most adolescents are employed at some time during their teen years. Provisions of the Fair Labor Standards Act, the nation's child labor law, address some of the risks of adolescent employment; however, > 70 teenage workers are estimated to die from work-related injuries each year, with greater risk among males, whites, and older adolescents. Furthermore, the nonfatal work-related injuries of the > or = 64,000 teens who receive emergency department care each year are believed to significantly undercount actual injuries. Many of these nonfatal injuries are severe, with 15%-45% leading to work restriction or permanent disabilities. Significant methodological issues limit the ability of existing surveillance systems to monitor youth worker injury. Risk factor and intervention research is very limited, but does suggest the role of some worker characteristics, management practices, and training issues. However, these factors need more careful study. This review considers existing information about occupational injuries among adolescents and identifies needs for research and policy attention.

Accidents, Occupational↗

Growth and nutritional status of male adolescent laborers in Ankara, Turkey.

Undernutrition, pathogenic agents, and poor living conditions are of primary importance in the evaluation of adverse environmental conditions' effects on human growth; but child labor (an equally significant factor, especially in underdeveloped countries) is generally overlooked or ignored. The aim of this study is to focus on this subject and clarify the effects of labor on the physical growth and nutritional status of child and adolescent laborers. In this study, the height and weight of 532 male adolescent laborers aged 13.5-18.5 years and their non-laboring peers (n = 451) (the control group) were measured by standard anthropometric techniques and equipment. The individuals of both groups come from lower socioeconomic strata and share similar living conditions. Data were transformed to z-scores, using the US Center for Disease Control and Prevention's 2000 growth charts. The analyses show that the z-scores for height-for-age, weight-for-age, and body mass index (BMI)-for-age were negative in both groups. The z-scores of laborers' height-for-age and weight-for-age values lie below the controls', but there is no significant difference between the two groups' BMI-for-age scores. In the laboring group, the percentages of stunting (-2 SD of height-for-age), underweight (-2 SD of weight-for-age), and wasting (-2 SD of BMI-for-age) were 14.3, 2.6, and 0.2, respectively. These values suggest that malnutrition is not a common problem among adolescent laborers living in Ankara; but laboring is an important cause of faltering in growth, particularly in linear growth, in less or underdeveloped economic environments.

Adolescent↗

The effectiveness of NGO campaigning: lessons from practice.

This article looks at the lessons learned in reviewing two long-running international campaigns, one to promote breast-feeding in Ghana, and the other against the use of child labor in the carpet industry in India. In particular, it focuses on understanding the nature of campaigns and what makes them effective. It asserts that campaigns are not linear or mechanistic, but need to be understood as passing through various stages and requiring different kinds of action at different levels and at different times. The variety of work and skills thus required makes it vital that the various organizations involved collaborate with each other. In particular, grassroots mobilization has a role that is often forgotten in bringing about sustained policy change.

Africa↗

Child and adolescent labor: factors, legal aspects, and social repercussions

Children and youth are currently one of the population segments most heavily jeopardized by the worsening of social, economic, and cultural problems in Brazil. Factors such as lack of government support for a sound, universally accessible school system, income concentration, low wages, unemployment, and family dysfunction have direct impacts on the life histories of children and adolescents, forcing them to join the labor market early, where their rights as 'citizens with special developmental conditions' are routinely ignored. This article aims to provide support for the eradication of child labor and the adaptation of adolescent labor to the terms of the pertinent Brazilian legislation. To this end, the article reviews the Federal Constitution, Consolidated Labor Laws, and Statute for Children and Adolescents to analyze situations in which work activities may or may not be allowed for children and adolescents, settling possible points of disagreement between the three legal texts and analyzing their social aspects.

Journal Article↗

Deaths at work among children and adolescents.

OBJECTIVE: To identify and describe all nonmilitary on-the-job injury fatalities in North Carolina among persons younger than 20 years over 10 years, with special attention to potential violations of the Fair Labor Standards Act. DESIGN AND SETTING: Historical, population-based case series, with cases identified by the computerized files of the North Carolina Office of the Chief Medical Examiner. CASES: Persons younger than 20 years who died of injuries received on the job in North Carolina between January 1, 1980, and December 31, 1989. RESULTS: We identified 71 cases. Decedents ranged in age from 11 to 19 years, with 41% aged 17 years or younger. Cases were disproportionately male (90%), white (80%), and injured during June, July, and August (44%). Farm or field was the most frequent place of injury (27%). More than 50% of injuries involved a motorized vehicle, frequently a tractor. Similar to studies in adults, homicide was the leading cause of fatal occupational injury for females. At the time of injury, 86% of workers younger than 18 years were involved in activities that appeared to violate the Fair Labor Standards Act of 1938. CONCLUSIONS: This study raises questions about the adequacy of federal child labor policies as minors continue to work under conditions that place them at risk for fatal injuries.

Accidents, Occupational↗

[Street child work in Latin American capitals].

OBJECTIVE: To identify the age, sex, mobility, education, work activity, working hours, street dwelling, and social security coverage in a group of children working in the streets in capital cities in Latin America. MATERIAL AND METHODS: Cross sectional study. A questionnaire was applied to 972 children working in the streets of Bogotá, Guatemala City, Mexico City, Quito and San Salvador. RESULTS: A total of 63.3% subjects were boys; 39% were children from displaced families; 18% lived in the streets; 62% worked more than 40 hours per week; 19% were covered by the social security system, and 32% were street vendors. The behavior of variables differed significantly by city. CONCLUSION: Child labor in the streets is a dangerous activity characterized by long working hours and exposure to risk factors. Child work has different characteristics in each of the cities studied, which suggests that the solution to the problem must be designed on a case by case basis.

Adolescent↗

Labor supply behavior of prospective and new mothers.

Utilizing unique data generated from the National Longitudinal Surveys of Young Women, this paper examines the labor force participation of young mothers in the months immediately preceding and following the birth of the first child. Labor supply behavior at this point in the life cycle is described in greater detail than has hitherto been available. In addition, we analyze the independent effect of several factors of interest on the probability that a young woman will be in the labor force during various intervals surrounding the first birth.

Adolescent↗

Foreign aid, international organizations, and the world's children.

Recent improvement in child mortality has taken place in all regions of the world. In developing countries, major remaining causes are neonatal problems, diarrheal diseases, vaccine-preventable diseases, and respiratory diseases. Foreign aid has come in many forms, among them individual persons, nongovernmental organizations, national governments, and international agencies. Governmental involvement in health activities abroad can advance foreign policy interests as well as help protect a country's citizens against existing and potential disease foci. Intergovernmental health agencies, regional and worldwide, have been in existence only in this century; the World Health Organization is barely 50 years old and suffers from US delinquency in paying its dues. Child labor has health aspects in industrialized as well as in developing countries. The United Nations Convention on the Rights of the Child has significant implications for health. Despite broad support, including that of the American Academy of Pediatrics, the United States has not ratified the convention, the only nation in the world beside Somalia not to do so.

Child↗

The unwritten story of women's role in the birth of occupational health and safety legislation.

Women's role in the formation of trade unions and development of collective bargaining, as well as in labor's historical struggle to improve day-to-day working conditions, has been conspicuously underplayed, if not ignored. Yet, when one reviews the history of the reduction of working hours, prohibition of child labor, elimination of homework in tenement slums, reform of factory legislation, and investigations into accidents precipitating early workers' compensation legislation, the literature is rich with women's investigative reports and studies on unhealthy and unsafe working conditions. This was the case from the late 19th century in North America up until the 1950s and the Cold War. The women's movement and political activities requiring factory reforms then seemed to go underground, re-emerging in full force during the 1960s. Women's involvement in the environmental movement, especially in the United States, has been significant in politicizing occupational health as well. Their efforts led to the 1970 passage of the U.S. Occupational Health and Safety Act.

Canada↗

"A sudden and terrible revelation": motherhood and infant mortality in France, 1858-1874.

In 1874, legislators in France passed a law regulating the wet-nursing industry. Citing recent medical research into the causes and social costs of high infant mortality, the law's supporters met little opposition, despite the fact that the law challenged the tradition of paternal authority and familial autonomy that had been inscribed in French law since the promulgation of the Civil Code of 1804. Extending state power into the familial realm required a concerted effort by reformers, who concentrated on two issues: maternal responsibility for newborn infants and the social costs of early death. Because working women in urban areas used wet-nurses to preserve their wage-earning capacity, reformers capitalized on widespread opposition to women's labor outside the home. The law met little opposition in part because the issues of paternal authority had already been thoroughly debated several months earlier in the child labor law of 1874.

Breast Feeding↗

Youth, race, and labor: working kids and historical ambivalence in twentieth century America.

As a society, we share assumptions that exhibit a profound historical ambivalence regarding young people at work. On the one hand, we all acknowledge that there is something socially and morally reprehensible about forcing children to toil. Many of us see child labor as a vestigial remnant of the harshest aspects of the Industrial Revolution. On the other hand, we also continue to see work as a sign of the moral and social health of a community and hence, we see employment among the young as a stabilizing and redemptive activity. Especially when addressing the nation's poor, urban and African-American populations, youth unemployment is almost universally understood as a root cause of social unrest and community breakdown. This paper outlines some of the historical arguments about children in the work force and raises the question about the national resolve to seriously address this issue.

Child↗