International Students and work-hazard exposure: Are we managing their risks?

Recent changes in Canada and Australia allow international students to increase the hours they work outside their studies. 

Previously, international students in Canada were permitted to work only 20 hours per week outside their school programs; that limit has been temporarily removed until December 31, 2023.  Australia moved earlier and lifted a similar cap until June 30, 2023.  In the US, an on-campus 20-hour restriction exists during sessions with additional hours during breaks and specific exceptions for certain groups and circumstances. Demand for workers means more students working more hours in more sectors in the economy.

Clearly, the easing of restrictions on work hours is intended to alleviate labour shortages, particularly in the service sector.  That said, many students work in many other sectors of the economy.  In my own experience, I have met international students working in construction, manufacturing, transportation, warehousing, and healthcare.

Increased Hours = Increased Risk

With unlimited hours on top of studies and on-campus work (often part of their studies), international students are exposed to more hazards.  Recall that risk is the chance or probability of harm from a work-related hazard.  That increased risk is greater than you might expect.

First, the risk of injury and occupational disease is related to exposure.  For most jobs, one can think of exposure in terms of hours exposed to the hazards present in the workplace.  Increased hours alone account for increased risk in the population of international students who engage in employment.  Holding the number of international students constant and increasing their exposure to work hazards through increased hours, increases the likelihood of occupational injury and disease.

Fatigue and Risk

A second factor can increase the risk beyond a straight linear relationship.  The fatigue – risk relationship is an accepted fact.  NIOSH-CDD writes:

Fatigue can slow down reaction times. Reduce attention or concentration, limit short-term memory and impair judgement…High levels of fatigue can affect any worker in any occupation or industry with serious consequences for worker safety and health. 

[See https://www.cdc.gov/niosh/topics/fatigue/default.html ]

Published studies rarely focus on non-work sources of fatigue outside of commuting time and breaks between shifts.  Study time, family needs and other factors can add to fatigue and increase risk.  Some industries have modeled hazards and fatigue related risks [for example, see Transport Canada, Fatigue Risk Management System for the Canadian Aviation Industry - Introduction to Fatigue Audit Tools - TP 14577 available at https://tc.canada.ca/en/aviation/publications/fatigue-risk-management-system-canadian-aviation-industry-introduction-fatigue-audit-tools-tp-14577 ]

Models and studies of enhanced risk facing resident and foreign students are lacking but the implication of existing knowledge is that the added hours of exposure to potential harms may disproportionately increase risk of injury or disease.

International Student Population

The population of foreign students is not trivial. Australia, Canada, and the US are three of the top five destination countries for foreign international students, accounting for more than 2 million of the estimated 5.6 million international students world wide. 

Rank	Country	International student population (2020)
1	USA	1,075,496
2	UK	551,495
3	Canada	503,270
4	China	492,185
5	Australia	463,643
		3,086,089

 

[see https://studee.com/guides/10-most-popular-countries-for-international-students/ ]

These are significant numbers.  Policy changes expanding hours increase the potential labour supply of this population’s in terms of allowed work opportunities may be needed to address demand for labour in the economy.  Current labour market shortages are evident in many jurisdictions.  Along with inflation, rental housing shortages and increased costs for transportation and study materials (particularly technology), international students may have a greater motivation to take advantage of greater opportunities for employment. 

Stock, Flow and Foreign Student Population Measures

International students pose a challenge for those charged with designing health, safety and workers’ compensation awareness programs for them.  At any given time, the population of international students can vary.  Most courses of study span a calendar year or more.  Study visas may be valid for or across multiple years, but students may enter and leave the jurisdiction as part of their studies or simply to return home for part of any given year. This is the “flow” of international students.

Unlike refugees and new immigrants (definitionally,  permanent or extended-stay residents including asylum seekers) or temporary foreign workers (individuals contracted for periods of greater than a year or returning on a seasonal basis), foreign students are generally in the jurisdiction for shorter periods (not permanently).  At any given time, the population or “stock” of foreign students may exceed the “flow” or count of new arrivals. 

Once a cohort of new immigrants or temporary foreign workers is oriented to health and safety or workers’ compensation in the jurisdiction, they are often considered part of the resident population in terms of knowledge and awareness programs.  With foreign students, the “stock” is ever changing and the challenge of raising awareness, building trust, and informing them of their rights and obligations never wains.

Experience and expectations

Workplace culture is not universal.  Attitudes and beliefs regarding workplace health and safety vary widely.  Experiences and understandings about workplace health and safety and workers’ compensation also vary by country.  It is not reasonable to assume all international students bring the same understanding to the workplace.

Consider the following: 

Canada's top 10 international student source countries (by number of study permit holders on Dec. 31, 2021)
India	217,410
China	105,265
France	26,630
Iran	16,900
Vietnam	16,285
South Korea	15,805
Philippines	15,545
United States	14,325
Nigeria	13,745
Mexico	11,550

[ See https://www.cicnews.com/2022/03/canada-welcomed-450000-new-international-students-in-2021-an-all-time-record-0323762.html#gs.fl1tae ]

 

 

US: Number of international students studying in the US in 2020/21, by country of origin
China	317,299
India	167,582
South Korea	39,491
Canada	25,143
Saudi Arabia	21,933
Vietnam	21,631
Taiwan	19,673
Brazil	14,000
Mexico	12,986
Nigeria	12,860

https://www.statista.com/statistics/233880/international-students-in-the-us-by-country-of-origin/

Australia: Number of international students studying Australian courses January-July 2022
China	141,567
India	86,782
Nepal	51,579
Vietnam	19,932
Indonesia	14,865
Malaysia	14,135
Thailand	14,015
Brazil	13,963
Philippines	13,703
Colombia	13,661

 [ See https://www.education.gov.au/international-education-data-and-research/international-student-numbers-country-state-and-territory ]

With the possible exception of international students from Canada, the US and Australia studying away from home in one of the other countries in this grouping, foreign students will have no prior understanding of the jurisdictional authorities responsible for workplace health, safety and workers’ compensation. I could find no study contrasting the a priori understanding of international students regarding workplace laws, duties, and responsibilities.  While resident citizens will have some understanding from their indirect exposure through media, family, and community, it is unlikely that all foreign international students will bring an equivalent common understanding with them.

International students should not be “lumped in” with strategies designed for other temporary foreign workers.  Most temporary foreign workers are required by their visas to work for specific employers; international students may be employed in multiple sectors by multiple employers and may change employers frequently. This adds a further challenge for those seeking to increase protections for and gain the trust of international students and those who employ them. 

Are workers’ comp and OH&S adapting

Workers’ compensation agencies and prevention organizations are not always quick to react to changes in the demographics of their target populations.  International students are a special demographic segment of their target population. 

As noted, Canada, the US and Australia differ from other countries in who has jurisdiction over workplace health, safety and workers’ compensation laws.  Most countries in the world that have social security arrangements for work injuries have national programs.  While efforts to increase the knowledge of residents on workers’ compensation and occupational health and safety  through advertising and inclusion in high school curricula in Canada, the US and Australia; similar awareness programs and educational curricula may not exist in the home countries of many international students.  Failure to adequately inform international students may lead to their injury, potential under-reporting of hazards, and suppression of workplace rights. 

So, what are authorities responsible for workplace health, safety and compensation doing to address this change?  How are they working to communicate worker rights to this unique population, helping their employers understand risks, and making others in the workplaces more aware to foreign student issues?

To be clear, this is not just a question of language.  Nearly all international students are required to have official language proficiency just to qualify for admission as students.  Understanding, trust, access, and support go beyond translating brochures and webpages.  If you can find a workers’ compensation authority or OH&S doing a great job gaining the trust of foreign students, let me know.  I could find no public-facing statements or studies on this issue.  Foreign students need to know that their status and right to work are not at risk by engaging with health and safety agencies or filing a workers’ compensation claim.

I also found little in the way of data on the risk differences (if any) faced by international students.  Do they experience similar levels of injury or risk as resident workers remains an unanswered question.  Few workers’ compensation jurisdictions identify international students in their data –a necessary categorization if we are to determine work-injury risk, claims rates, or establish the likelihood of under-reporting of workplace injury in this population.

Taking action to help protect international students and serve them requires action by workers’ compensation and prevention authorities.  These actions include:

•       Collecting data on international student injuries

•       Interacting with specific international student groups

•       Determining where international students are working and being injured

•       Educating international students and their employers on their rights and building trust

•       Actively seeking to minimize under-reporting of workplace injury, illness and disease involving international students

•       Comparative research on risk, frequency, severity, and outcomes of injured international students vs. resident student workers

Societally, we want and need international students more than every.  They can be a resource that will help level the gaps in our labour force and skill needs. Takin intentional and robust steps to understand and address their needs is more important now than at any point in the past.   

What comes after the pandemic’s peak? Six trends, three predictions and one sure thing

    The end of the COVID-19 pandemic is not here—not even close.  In many jurisdictions, second-wave peaks in new infections, hospitalizations and deaths are yet to come.  The possibility of a third wave looms as new, more infectious variants emerge.

    The workers’ compensation impacts are only just beginning to be felt.  Direct COVID-19 work-related illness, disability, and death claims are rising in number; psychological injury claims for front-line healthcare and other essential workers are also on the rise.   The disparities across jurisdictions in claim acceptance rates, timeliness, and benefits are becoming more evident.  Non COVID-19 cases are suffering delays in treatment and economic disruptions are resulting in longer periods of disability until a return to work is possible.  Longer claim durations can contribute to worse outcomes for workers and costs for employers.

    Hygiene, safety plans, and personal protective equipment issues have grown in priority for occupational safety and health inspectorates and prevention agencies.  Inspectors themselves are working in difficult times and with unfamiliar risks.  Keeping themselves safe while ensuring protections are in place for workers and others in the workplace is a markedly changed objective in the altered reality of 2021. For industry and labour services providing OH&S education and promotion, COVID-19-specific messaging is one challenge; reaching intended audiences without seminars and conferences is another.

    The COVID-19 pandemic is behind some emerging workplace trends that will impact the workplace for years to come.  No one knows for sure where these trends will lead; some predictions are possible based on past experiences and current trajectories.  One thing’s for sure, this is not the last time something like the COVID-19 pandemic will impact our workplaces.

Six Trends

1.       Working from home is now mainstream… for some:  The proportion of workers working from home some or all of the time has increased and will continue to be a significant segment of the workforce. During the pandemic, garages and attics have become office spaces and dining room tables commandeered as workstations.  Many workers who once lived close to the office to avoid the long daily commute have opted for the larger residential spaces offered in the suburbs and rural areas and are commuting less often to the corporate. Workplaces have adapted but the new arrangements may test traditional boundaries for occupational safety and health and workers’ compensation.  How much say, if any, should an employer have over ergonomics, ventilation, or safety of a home office?  Is the commute from the home office to the corporate office a work journey? What protocols do you need to investigate work injuries and workers’ compensation claims in the home workplace? The questions are growing as the work-from home trend continues.

2.       Impermanent workplaces and shared workspaces are increasing: “The Workplace” used to be synonymous with a specific location under the control of the employer.  There were always exceptions; truck drivers take their workplace with them and field technicians have workplaces in every site they visit.  We used to joke that the local coffee shop was the “corporate office” for many small companies.  I know of firms that have no corporate offices at all; they work virtually most of the time and rent office spaces or hotel rooms as needed.  Fully equipped office spaces complete with highspeed internet, secure teleconference services, boardrooms and even coffee service are available by the hour, day, or week as needed.  Individually incorporated professionals such as massage therapists and psychologists share independently run office space and even some support staff.  Virtual, asynchronous or simultaneous use of workspaces blur the lines of accountability and even liability.  Who has responsibility of health and safety issues?  Will there be an increase in third party claim considerations?  The reconceptualization of the workplace will continue and become a more significant concern.

3.       Mask-wearing is becoming a social norm…in most of the world:  As someone who [used to] spend a lot of time in airports, on airplanes and traveling on public transit, I was somewhat used to seeing a few face masks on my fellow travelers and in lecture or seminar audiences. There was not a lot of science about the efficacy of mask wearing as a means of infection control but that has changed.  For the coronavirus that causes COVID-19, the scientific evidence is now conclusive:  masks are effective in preventing the spread of this disease, more so in protecting others than the wearer but with some protection for the wearer.  That trend towards normalizing mask-wearing in public spaces and private workplaces will continue.  When this pandemic wanes, daily mask wearing will be more common and more accepted.  Should mask wearing become mandatory in certain workplaces or situations?  Should masks be an employer-supplied piece of PPE?  What mask standards should apply to which workplaces?  

4.       Work environments are being built, rebuilt, and retrofitted with infection control in mind [not top of mind, but in mind]:  Those plexiglass barriers you see everywhere are not all temporary.  Ventilation systems with advanced virus and bacteria killing technology are not just a passing fad.  Lighting systems with safe UV frequencies may not be commonplace but are being retrofitted in some places and designed in new builds.  Even the hastily installed take-out windows in many restaurants are likely to persist.  New HVAC and air conditioning systems that kill bacteria and destroy viruses are now in the marketplace.  The hastily installed barriers on some production lines are likely to persist and there is a good chance that the next iteration of design will integrate these and other new features to protect workers and others in the workplace.  Will improvements in the built environment be enough?  Will there be standards that create an even playing field or will this trend fade under cost pressures?

5.       “Burnout”, mental injury, stress—real consequences of the pandemic—are taking an increasing toll:  For decades, workers’ compensation has been slow to accept any aspect of work as causative of mental injury or illness.  With the high toll of mental exhaustion, breakdown and even suicide among caregivers, the underlying work-related causes are impossible to ignore.  Healthcare workers are the most obvious victims, but others suffer mental injuries including depression, mental exhaustion, and post-traumatic stress disorder (PTSD).  Workers’ compensation legislators and policymakers are adapting.  While some are doing so by exception, executive order, or limited presumptions, others are applying existing policies, setting new procedures that will persist and apply more broadly. What will the policy landscape look like after the pandemic passes?  Will the growing acceptance of mental injury translate into greater numbers of claims?  Will the responsibilities employers have for prevention of mental injury change or become more prominent? 

6.       Disruptions/distortions in labour markets and the economy continue:  When the pandemic began, the distorted market for PPE, nasal swabs and even toilet paper quickly dominated news coverage.  Supply chains took time to adjust.  Manufacturers shifted from making car parts to respirators and from distilling vodka to producing hand sanitizer. The shift toward online commerce and home delivery exploded during the pandemic, accelerating a trend in play before the pandemic. Storefronts on main streets are shuttered but massive distribution centres are burgeoning.  Nothing happens instantly and the lag-time resulted in shortages—including shortages of trained and qualified people.  Knowing what is needed in terms of labour is far different from having the people and skills available.  Medical professionals from nurses to respiratory technicians were already in short supply in many areas and still are just as demand for these skills rose.  Shortages of qualified personnel are making the decision between staffing COVID-19 testing programs, contract-tracing operations or vaccination centres a real challenge.  Which should be the priority?  How will workers’ compensation deal with the distortions caused by overtime, bonuses and incentives in the COVID-19 period.  Will disability or earnings-loss policies–already a difficult area—have to change to adequately reflect loss in case of injury or illness?  How will those suffering long-term physical or psychological effects of this pandemic be identified, supported and accommodated in a shifting and uncertain labour market be accommodated?

Three Predictions

1.       “Immunity passports” will be a common requirement… for a while:  If you are of a certain age, immunization travel documents like these may be familiar.  Commercial airline staff and merchant mariners had to have them; other travelers were advised to carry.  These were essential for entry into certain countries.  Proof of immunization will be a requirement again just as proof of a negative COVID-19 test is now a requirement for many air travelers. “Immunity passports” may be formally discouraged by certain governments, considered by others, and debated in journals.  Regardless of governmental views or what you call them, functional immunity passports will be required in many workplaces. Whether they take the form of a printed book, electronic record, or wallet card, workplaces are going to have a need to know who has been vaccinated and who might be at elevated risk if they are not.  There will be questions about an employer’s right to require vaccinations or a workers’ right to refuse vaccination.  Workers and other persons (such as passengers seeking to board a cruise ship) will be required to present evidence of their immunity either by vaccination or another means.  In the ramp up to universal vaccination, there will be challenges.  If a single vaccination series provides long-term immunity, if the virus does not mutate too quickly, or if the virus is extinguished for lack of susceptible individuals, the need for immunity passports will vanish… but those are a lot of ifs. 

2.       Presenteeism will persist…with risks:  For years, efforts to reduce absenteeism in the workplace have focused on the outcome with little differentiation in strategy for disease.  The laudable goal of an early and safe return to work following an injury blended with the idea that anyone with any reason for being absent should make the effort to return to work as soon as possible.  The systems in place to penalize absenteeism and reward or applaud staying at work do not differentiate well between injury and illness due to infectious diseases.  The resulting presenteeism in the COVID-19 case is the source of many workplace outbreaks, particularly in congregate settings (prisons, care homes) and production lines (poultry and meat processing plants). The general duty of employers to protect workers from illness has not been well understood, promoted or enforced. The nexus between work and illness is often obscured in the case of disease but that is changing.  DNA sequencing and contact tracing make the “work-relatedness” of infection clear in many instances.  COVID-19 has taught us the need for a different strategy when it comes to workplace disease.  Presenteeism will continue but its drivers and circumstances will get closer review.  It may not mean universal paid sick leave but the incentives and penalties regarding illness in many workplaces will have to be re-examined and managed differently.

3.       Disaster Management, Business Continuity, Contingency and Succession Planning will be ascendent … for a while:  There are lessons to be learned from this pandemic. Will we learn them?  There is a good chance we will, but a strong likelihood the lessons learned will fade.  It will take time and research dollars to parse knowledge from the COVID-19 experience, but it will also take organization will translate that knowledge into plans and actions.  That will happen… in some organizations… for a while.  For a time, business continuity planning will be in the ascendency.  Stockpiles of PPE will be replenished and kept up to date; responsibility and accountability will be assigned at a high level; plans, policies and procedures for various outbreaks and pandemics will be developed and revised; and outbreak and pandemic scenarios will be incorporated into contingency plans…until they are not.  One lesson we learned from this pandemic is that despite the warnings in environmental scans and the near misses of H1H1, SARS, and other diseases, any heightened awareness wanes.  Costs rise, responsibility fragments, budgets get cut.  Disaster management and business continuity planning priorities get diluted and marginalized to job description lines just before “other related duties”. I don’t see that changing in the longer term.

One sure thing

    This is not the last pandemic.  This pandemic is not “the big one”. 

    Do not confuse statements like “this is a once in a hundred-year event” with the idea that a pandemic happens just once in a century.  We may be a day, a month, or a year away from the emergence of another, even more infectious disease, and an even more devastating pandemic.  Will we be ready for the next pandemic if it is as infectious as measles and as deadly to children as COVID-19 has been to the elderly?

    COVID-19 exposed our lack of preparedness.  Our failings are not due to a lack of imagination.  Every corporate planning exercise I was involved in over the last few decades listed the risk and even assessed the impact. Unfortunately, the immediacy of other threats often narrow leadership focus and divert organizational resources. Expertise is lost in the name of streamlining, budgets tightened, and stockpiles depleted or aged out of usefulness. 

    The human and economic costs of this pandemic are consequences of our past failures to consistently invest in science, plan for pandemics, and expend resources in preparation for what we know is coming.  

    Another pandemic is inevitable. Being ready for one is a choice.  Hopefully, a choice workplaces are willing to make.