In this study, the period prevalence of work-related injury among seasonal and migrant farm workers was high. A high proportion of study participants have shown heat-related illness symptoms. Extreme weakness, headache, profuse sweating, and fatigue were the commonest heat-related symptoms reported by the seasonal and migrant farm workers. Moreover, the prevalence of work-related stress among seasonal and migrant farm workers was very high. Being unemployed before migration, working for > 8 h/day, stress and thermal discomfort were the significant predictors for the work-related injury.
The finding of this study revealed that the lifetime prevalence of self-reported work-related injury among seasonal and migrant workers in Ethiopia was 32.5% (95% CI: 29.7, 35.9). Among the total of injured respondents, two-third 207 (66.9%) of them reported hand as the main part of the body affected. Moreover, 133 (43%) and 132 (42.7%) of injured respondents reported lower leg and head as part of the body affected respectively. Regarding the types of injury, 132 (42.7%) were head injury and 109 (35.3%) were cut. In addition, 122 (39.5%), 64 (20.7%) and 61 (19.7%) were abrasion, fracture and eye injury respectively. This finding suggests that seasonal and migrant farm workers are at high risk of work-related illnesses and injuries. This might be attributed to adverse occupational exposure to hazardous conditions and unsafe working environments [13, 29]. This result is supported by a study conducted across countries that stated that lack of provision of safety training and protective equipment, the use of unsafe farm machinery and poor health care access poses a significant risk for work-related injuries and fatalities [7, 17, 30–32]. Moreover, seasonal and migrant farm workers may take a greater risk on the job including work for less pay, working for longer hours and do not complain about unsafe working conditions fearing loss of jobs. These conditions put seasonal and migrant workers at increased risk of work-related injuries and fatalities [1, 7, 29].
Furthermore, this study result was higher than the study reported the prevalence of work-related injury among seasonal and migrant workers 3.3% in Turkey , 27% in binational health survey (USA, California)  and 23%in Hangzhou China . The possible reason might be a substantial number of migrants in this study work without adequate training and using protective equipment. Furthermore, they work in more hazardous, worse conditions and exploitive environments, where they might be at considerable risk of work-related injury than those countries. However, this finding was lower than the study that reported 73% among migrant farm workers , 38.3% among migrant workers in China districts  and 47% among international migrants . This might be due to the higher use of heavy agricultural machinery and major language/cultural barriers among migrants in those study areas compared to this study. Besides, poor access to health care, a high rate of adverse occupational exposures and working condition might attribute to the higher prevalence of work-related injury . The other possible reason might be migrant workers work in unsafe working conditions without complaining fearing loss of jobs or being deported.
This study also showed that the majority of seasonal and migrant farm workers suffered heat-related illnesses (HRI). This finding is also supported by a study conducted across countries. Which stated that uninterrupted strenuous job in a hot environment with a very few rest periods and lack of potable water contributes to a high incidence of heatstroke, heat exhaustion and heat cramps among farm workers [5, 9, 20, 21, 37, 38]. Another study also reported that farm workers are four times more likely to experience HRI than other industries workers as a result of high ambient temperatures . Moreover, according to a systematic review conducted agriculture has a mortality rate from HRI that is 20 times that of all other occupations . Lack of training, regular breaks, shade, and medical attention were reported as a risk factors for the high prevalence of HRI among seasonal and migrant workers .
Furthermore, in this study more than two-thirds of the study participants have experienced work-related stress. This result is supported by a study that reported migrant workers may experience high levels of stress that is attributed to a fast-paced work environment, precarious or insecure jobs and loss of protective socio-cultural factors such as social support, family ties, language and group identity [39–42].
This study showed that the employment status of migrants before departure from their home town was a significant predictor of the work-related injury. Seasonal and migrant farm workers who were unemployed at their home town before migrating had higher odds of experiencing work-related injuries when compared to respondents who were students at their home town before their departure. This result is also supported by a study done in Shanghai, which states that occupational injury was associated with less job experience . This might be explained by the concept of job-relevant knowledge gained over time. The more experienced workers had more constructive perspectives regarding safety practices than their inexperienced counterparts. Other possible reasons might be as they work longer years they become familiar and aware of hazards related to specific jobs .
In this study, working for more than 8 hours per day was associated with a high likelihood of experiencing work-related injuries. This study is in line with the study that reported long daily hours of work, which give rise to fatigue, increased the risk of work-related injuries [17, 24, 34, 45]. The possible reason for this might be long working hours may lead to fatigue, physical and mental stress which can possibly cause weariness, sleepiness, irritability, reduced alertness and impair judgment/decision making that increase the risk of physical injuries and susceptibility to accidents . Moreover, extended working hours may also involve prolonged exposure to potential health hazards.
According to this study, work-related stress was associated with high likelihood of sustaining work-related injuries. Respondents who had developed work-related stress had 1.38 times higher odds of experiencing work-related injuries than their counterparts. This finding was in line with the study that reported the demand for quick work often results in an increased risk of injury from psychological stress [47, 48]. The possible reason might be those stressed workers might be distracted, less focused, inattentive and in consequence lead to accidents and injuries. On the contrary, less stressed workers can manage the job demand and control imbalance in a better way and this could lessen the likelihood of experiencing a work-related injury.
Furthermore, heat stress was significantly associated with sustaining work-related injury. Respondents who perceived as there is heat stress risk had 1.48 times higher likelihood of experiencing work-related injuries when compared to those who were not perceived thermal discomfort. This result is supported by a study that reported work-place heat exposure can increase the risk of occupational injury [45, 49]. This might be due to the fact that elevation of core body temperature and dehydration have had negative behavioral effects in addition to physical impacts like fatigue, irritability, impaired judgment and vigilant decrement which could lead to an increased risk of accidents and injuries.
Though this study was able to provide important data on work-related injury and illnesses among seasonal and migrant farm workers, several limitations are noted. While we were able to investigate associations between work-related injury and important variables, causation could not be established, nor were audits of workstations and activities undertaken. Furthermore, the lack of accompanying physical examination to strengthen/verify the self-reported symptom was the limitation of this study. Also, the possibility of recall bias could not be ruled out since more serious and recent injuries or troubles remembered better than a less serious and older one. But we have tried to minimize the effect by honestly explaining the objective and significances of the study to the study participants and by using structured questionnaire for assessing work-related injury and illnesses. Despite these limitations, we feel the study provides a reasonably accurate assessment of work-related injury and associated risk factors among seasonal and migrant farm workers.