Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Terry Bunn, PhD

Committee Member

Svetla Slavova, PhD

Committee Member

David Mannino, MD


Background: Foreign-born workers may be more vulnerable to fatal and nonfatal work injuries. Available information on the differences that exist between foreign-born and U.S. native-born worker fatal injuries is scarce. This study aims to describe and characterize occupational fatal injuries in foreign-born and U.S. native-born workers in Kentucky.

Methods: A retrospective descriptive analysis of foreign-born vs. U.S. native-born worker fatalities was performed over a 14-year period from 2001-2014 using Kentucky Fatality Assessment and Control Evaluation (FACE) program worker fatality surveillance data.

Results: From 2001-2014, there were a total of 87 foreign-born and 1,361 native-born worker fatalities. The average age of foreign-born worker death was 38 year of age compared to 47 years of age in native-born workers. The majority of foreign-born workers were employed in the construction, services and transportation, warehousing and utilities industries at time of death. In contrast, native-born workers were primarily employed in transportation, warehousing and utilities and agriculture, forestry and fishing industries at time of death. The top external causes of fatal injury incurred by foreign-born workers were motor vehicle accidents, accidental falls, homicide and injury purposely inflicted by other persons and other accidents. The top external causes of fatal injury in native-born workers were motor vehicle traffic accidents, accidental falls and other accidents. Foreign-born workers were employed in the transportation and material moving and construction and extraction occupations compared to 3 transportation and material moving and management, business and financial occupations in native-born workers.

Conclusions: A large percentage of occupational fatalities occurred in the transportation industries and occupations, regardless of worker country of birth. Employers should establish and implement company driver safety programs and ensure that both native-born and foreign-born employees receive driver safety training in their appropriate language focused on defensive and safe driving. A proactive approach by employers using concurrent safety training and safety performance monitoring may reduce both native-born and foreign-born worker injuries and fatalities.

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