Most often, child labour occurs when families face financial challenges or uncertainty – whether due to poverty, sudden illness of a caregiver, or job loss of a primary wage earner. UNICEF. Health professionals are in a key position to identify children at risk, advise the parents on ways to reduce this risk and recommend action to policy-makers. 4,5 Just as we have seen in training health professionals on other forms of abuse, employing a framework with a low index of suspicion is a critical starting point. However, another study in Ethiopia28 reported a lower prevalence of mental/behavioral disorders in child laborers compared to non-working children. While many researchers address the immediate health effects of child labor on the child laborers, this article addresses the issue of child labor from a broader perspective, one that identifies child labor as a contributor to intergenerational poverty, malnutrition, and limited educational attainment. Additionally, most of the studies are confined to a single country. The majority of studies were ranked as of ‘good quality’, with seven ranked ‘fair’ and one ranked ‘poor’ (Table 1). The ILO took its first stance in 1973 by setting the minimum age for work.4 Nevertheless, the ILO and other international organizations that target the issue failed to achieve goals. Occupational hazards cause not only short-term health effects (mainly injuries, skin problems, etc), but most effects are long-term and will only become evident in adulthood. This reflects a failure of policies not only to eliminate child labor, but also to make it safer. Address correspondence to Abdalla Ibrahim, E-mail: Search for other works by this author on: Department of Epidemiology, Boston University, Boston, USA, Jazan University, Gizan, Kingdom of Saudi Arabia, Division of Global Neurosurgey and Neurology, Duke University, Durham, USA, Department of Neurosurgery, Duke University Medical Center, Durham, USA, Child labor. Additionally, they are also not organized and powerless. Eight studies measured physical health effects through clinical examination or blood samples, in addition to self-reported questionnaires. Child labor is an important global issue associated with poverty, inadequate educational opportunities, gender inequality, and a range of health risks. The stark difference between these two studies could be due to the explanation provided by Alem et al., i.e. Two authors reviewed the titles obtained, a.o. We searched PubMed and ScienceDirect for studies that included participants aged 18 years or less, conducted in low- and middle-income countries (LMICs), and reported quantitative data. The worst form are those that endanger the child’s physical, mental or moral well-being. Coping efficacy of working non-schooled children was lower than that of the other groups.29. Published by Oxford University Press on behalf of Faculty of Public Health. Hosseinpour M, Mohammadzadeh M, Atoofi M. Hamdan-Mansour AM, Al-Gamal E, Sultan MK et al. Through a comprehensive systematic review, we conclude that child labor continues to be a major public health challenge. We retrieved 1050 studies on PubMed and 833 studies on Science Direct, with no duplicates in the search results. We searched PubMed and ScienceDirect databases. The first third of the algorithm was assigned to titles/abstracts to ensure relevance of the studies retrieved, while the rest of the terms were not. Furthermore, the frequency of reporting any injury or illness increases with the number of hours worked, with significant variation across employment sectors.13 A study in Iran reported that industrial workrooms were the most common place for injury (58.2%). They often begin to work at a younger age and have a double work burden (at home and in the fields). Even adolescents who work are impacted negatively. Child labour is a stubborn problem that, even if overcome in certain places or sectors, will seek out opportunities to reappear in new and often unanticipated ways. Maternal adverse childhood experiences, executive function & emotional availability in mother-child dyads. Engagement of children or adolescents in work with no influence on their health and schooling is usually regarded positive. There are no personal protection devices for children. For this, the involvement of the relevant stakeholders like health and safety experts ( they know about hazards and health outcomes), labour inspectors (they know how to enforce the law) and general health experts (they know about the vulnerability and health outcomes in the child and are the first-line care givers), is absolutely essential. This in turn leads to nutritional deficiencies, poverty, and poor health. However, at a global level, most of them are in agriculture (70%). This training program helps educate public health workers to identify and refer child labor victims to the appropriate authorities and rehabilitation services. Dahlén M. The negotiable child: the ILO child labour campaign 1919–1973. A meta-analysis on the topic was published in 20 07.8 However, authors reported only an association of child labor with higher mortality and morbidity than in the general population, without reporting individual outcome specific effects.8 Another meta-analysis investigated the effects of adverse childhood experiences (ACEs), including child labor, on health. to exclude studies related to ‘medical child labor’ as in childbirth. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. The Convention concerning the Prohibition and Immediate Action for the Elimination of the Worst Forms of Child Labour was adopted by the International Labour Organization in 1999. However, there were no previous attempts to review the collective health impacts of child labor. Hughes K, Bellis MA, Hardcastle KA et al. Most studies did not examine the differences between genders. Overall, all studies included, except one,28 reported that child labor is associated with higher prevalence of mental and/or behavioral disorders. The majority of them also had mixed-gender samples, with only one study restricted to females.24 In addition, valid measures were used in most studies (Table 1). Disagreements were solved by discussion. © The Author(s) 2018. Research conducted in the UK, because of adverse outcomes in children, resulted in acts for child labor in 18 02.3 Many countries followed the UK, in recognition of the associated health risks. Other sectors where children are working (although not in large proportion) are mining (1%) and construction (2%). Further studies following a longitudinal design, and using common methods to assess the health impact of child labor in different country contexts would inform policy making. Concerning mental and psychosocial health, the outcomes documented included abuse with its different forms, coping efficacy, emotional disturbances, mood and anxiety disorders. In 2019, the UN verified 601 cases of child recruitment by non-state armed groups, down from 631 confirmed cases the previous year. Two studies were concerned with physical growth and development. Malnutrition and poor growth were reported to be highly prevalent among working children. of siblings/working siblings, workplace, years of work, salary, work perception, employer relation, physical abuse, verbal abuse, schooling, nutrition (intake of fruit, vegetables, milk, caffeine), social habits (smoking, alcohol intake, dating), acute and chronic health problems, and use of health service, clinical examination, anthropometric measure, blood samples. 1. Number of hours worked and the probability of reporting injury and illness were positively correlated. The elimination of child labour is a long-term objective. However, these databases were used for their known quality and to allow reproduction of the data. Child labor remains a widespread problem. Prevalence was higher in boys and those who work more than 4 h daily.25 Another study conducted in India documented that the difference between working and non-working children in the same area in respiratory morbidities (TB, hilar gland enlargement/calcification) was statistically significant.26. that their findings could have been tampered by selection bias or healthy worker effect. To our knowledge, this is the first review that provides a comprehensive summary of both the physical and mental health impacts of child labor. The authors declare that they have no conflict of interest. Search was restricted to publications from year 1997 onwards. Banerjee SR, Bharati P, Vasulu TS et al. Concerning physical health, many studies reported the prevalence of general symptoms (fever, cough and stunting) or diseases (malnutrition, anemia and infectious diseases). Child labor, sex, and mental health outcomes amongst adolescent refugees. Child labor subjects children to abuse, whether verbally, physically or sexually which ultimately results in psychological disturbances and behavioral disorders. In total, 24 studies were conducted in one country; one study included data from the Living Standard Measurement Study of 83 LMIC.8. Studies were ranked accordingly (poor, fair, good) (Table 1). Child labor remains one of the most controversial challenges at the end of the 20th century. Studies that met the following criteria were considered eligible: sample age 18 years or less; study was conducted in LMICs; and quantitative data was reported. A study concerned with child abuse in Bangladesh reported that the prevalence of abuse and child exploitation was widespread. Teenagers who spend more than 20 hours per week working, are at a higher risk to develop problematic social Coronavirus disease outbreak (COVID-2019), Coronavirus disease outbreak (COVID-19) », ILO International Programme on the Elimination of Child Labour: IPEC. They should also know that these threats increase in low-income populations and minority communities, and in degraded environments. The 4.5% of children were HIV positive, 1.7% were hepatitis B positive and 2.6% hepatitis C positive. The practice still prevails in developing countries, glaring examples being countries in Africa, south-east Asia, and Latin America. They should be able to recognize and assess the occupational and environmental health threats present in the places where children live, learn and play, and work, in the urban and rural communities. Ambadekar NN, Wahab SN, Zodpey SP et al. Fifteen studies examined physical health effects of child labor, including nutritional status, physical growth, work-related illnesses/symptoms, musculoskeletal pain, HIV infection, systematic symptoms, infectious diseases, tuberculosis and eyestrain. Nonetheless, child labor continues to be common in the agriculture and mining sectors, where safety and environmental ha… Working children are subjected to different risk factors, and the impacts of child labor are usually not limited to one illness. Although mainly a problem in developing countries, it is also possible to find child workers, some working in hazardous activities, in … Foroughi M, Moayedi-Nia S, Shoghli A et al. 6) “Young Children have lower heat tolerance than adults, in part because their sweat glands are developing.” (Child Labor and Health: Adult Education Workshop, 2000). Here, it can be the psychological hazards, like isolation, abuse, exploitation that make this form dangerous. Subsequently, child labor was included in the Sustainable Development Goals,6 which explicitly calls for eradication of child labor by 2030. Most of the current literature about child labor follow a cross-sectional design, which although can reflect the health status of working children, it cannot establish cause–effect associations. Trafficked children face all forms of abuse-physical, mental, sexual and emotional. Roggero P, Mangiaterra V, Bustreo F et al. A similar study conducted in India compared physical growth and genital development between working and non-working children and reported that child labor is associated with lower BMI, shorter stature and delayed genital development in working boys, while no significant differences were found among females.12, Concerning work-related illnesses and injuries, a study conducted in Bangladesh reported that there is a statistically significant positive association between child labor and the probability to report any injury or illness, tiredness/exhaustion, body injury and other health problems. ‡ Child labor understood as the worst forms of child labor per se under Article 3(a)–(c) of ILO C. 182. Despite the reported decline in child labor from 1995 to 2000, it remains a major concern. Khan H, Hameed A, Afridi AK. Initial evidence of these impacts was published in the 1920s. Initial evidenc… Guidance for governments on some hazardous work activities which should be prohibited is … After full assessment of the remaining studies, 25 were included. Awkward posture and heavy physical work were associated with musculoskeletal pain, while monotonous work, awkward posture and noise were associated with back pain.23 A study in Nicaragua, which focused on children working in agriculture, reported that child labor in agriculture poses a serious threat to children’s health; specifically, acute pesticides poisoning.24, A study conducted in India reported that the prevalence of eyestrain in child laborers was 25.9%, which was significantly more than the 12.4% prevalence in a comparison group. Long working hours have been associated with poorer physical outcomes.18, 19, 25, 26, 35 It was also reported that the likelihood of being sexually abused increased with increasing working hours.34 The different types and sectors of labor were found to be associated with different health outcomes as well.13, 18, 24 However, comparing between the different types of labor was not possible due to lack of data. Though previous systematic reviews conducted on the topic in 19 971 and 20 078 reported outcomes in different measures, our findings reflect similar severity of the health impacts of child labor. In May 2002, the ILO issued a new Global report on Child labour that describes the extent of the problem. The likelihood of being HIV positive among working children of Tehran was increased by factors like having experience in trading sex, having parents who used drugs or parents infected with HCV. Only studies written in English were considered. Some hazards in agriculture are the exposure to pesticides, the use of dangerous machinery or tools (like knives), carrying heavy loads, the presence of snakes, and so on. Lastly, one study was a meta-analysis conducted on data of working children in 83 LMIC documented that child labor is significantly and positively related to adolescent mortality, to a population’s nutrition level, and to the presence of infectious diseases.8. Eye to the Future in Adenomyosis Research. We also retrieved 23 studies through screening of the references, following the screening by title of retrieved studies. In addition, all studies concluded that child labor is associated with one or more forms of abuse. Although there is a decline in the number of working children, the quality of life of those still engaged in child labor seems to remain low. Technical Report, United Nations Children’s Fund (UNICEF). A third author then reviewed extracted data. Of these, some 179 million (one in eight) are trapped in the “worst forms” of child labour. However, in the meanwhile, we cannot allow that children are injured or harmed at work in their struggle for survival, especially when we have the knowledge and means to prevent this. We review the most recent evidence on the health impacts of child labor in low- and middle-income countries (LMICs) according to the World Bank classification. physical and/or mental health), exposure (type of child labor), country of study, age group, gender, study design, reported measures (independent variables) and outcome measures (Table 1). The effects of child labor on psychological health can be long lasting and devastating to the future of children involved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, The impact of nature-based education on health-related quality of life among low-income youth: results from an intervention study, Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK, Reception of health messages: effects of stigmatization and forcefulness, COVID-19 vaccine hesitancy among medical students, The association between alcohol consumption and self-reported current depression among adults residing in Brazil, About the Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom, http://creativecommons.org/licenses/by-nc/4.0/, Receive exclusive offers and updates from Oxford Academic, Review of policies to increase fruit and vegetable consumption and physical activity in 49 low- and middle-income countries, Opportunities for reducing morbidity and mortality due to leading cancers in a developing country, The effects of smokeless cookstoves on peak expiratory flow rates in rural Honduras, Cochrane update: identifying health-related research resources relevant to low- and middle-income countries. Additionally, as child labor is associated with maternal illiteracy and poverty, children who work are more susceptible to malnutrition,1 which predisposes them to various diseases. 174 countries around the world have signed or ratified the convention, which requires countries to adopt laws and implement programs to prohibit and eliminate child labor that poses harms to health or safety. The majority of studies focusing on physical health conducted clinical examination or collected blood samples. Children are often “achievers”, they want to perform well, go that extra mile, and are inexperienced and untrained in dealing with hazards. To summarize current evidence on the impacts of child labor on physical and mental health. Nevertheless, to minimize bias, we employed rigorous search methods including an extensive and comprehensive search, and data extraction by two independent reviewers. These findings are consistent with previous studies and research frameworks.36. First, we acknowledge that all systematic reviews are subject to publication bias. A total of 25 studies were identified, the majority of which were cross-sectional. And one of the sad characteristics of child labour in agriculture are the few, if any opportunities for advance or change. In combating hazardous child labour the most important challenge is the translation of knowledge and legislation into action, moving good intention and ideas into protecting the health of the children. This in turn affects strategies and policies that target child labor. Therefore, they are difficult to measure and to quantify. According to the ILO’s Worst Forms of Child Labor Convention, child labor is the enslavement (i.e., sale, trafficking, debt bondage, serfdom, compulsory labor) of anyone under the age of 18. The outcomes were measured based on self-reporting and using validated measures, for example, the Strengths and Difficulties Questionnaire (SDQ), in local languages. Unfortunately, the results show that these children are at risk of developing short and long-term health complications, physically or mentally. School attendance, family income and status, daily working hours and likelihood of abuse, in its different forms, were found to be associated with the mental health outcomes in working children. Two authors assessed the quality of studies using Downs and Black tool for quality assessment.10 The tool includes 27 items, yet not all items fit every study. Workers in manufacturing had a significantly increased risk for musculoskeletal pain and back pain, while child workers in domestic services had 17% more musculoskeletal pain and 23% more back pain than non-workers. For children working as domestic labourers, the hazards are sometimes not that obvious. Almost 250 million children, about one in every six children aged 5 to 17 on the face of the globe, are involved in child labour. Fassa AG, Facchini LA, Dall’Agnol MM et al. Study on child labour in automobile workshops of Peshawar, Pakistan. Of these, some 179 million (one in eight) are trapped in the “worst forms” of child labour. Let’s have a look at some facts on child labor. Child labor remains a major public health concern in LMICs, being associated with adverse physical and mental health outcomes. Parker1 reported that child labor is associated with certain exposures like silica in industries, and HIV infection in prostitution. Abstracts of papers retained were reviewed, and subsequently full studies were assessed for inclusion criteria. that child labour has a direct impact on their health. By reviewing title and abstract, 1879 studies were excluded. In such cases, we used only relevant items. As a target health effects through clinical examination or collected blood samples, in addition comparing! Ambadekar NN, Wahab SN, Zodpey SP et al make it safer shifts the. 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It has negative effects on health and schooling is usually regarded positive abuse: ILO! Children was 9.8 % ones suffering most injuries physically or mentally ; HBV, hepatitis C.... The previous year caphri, Faculty of public health workers to identify and refer child on! Back exceeded 15 % can be found in almost any economic sector might introduce bias as most the... Poverty, and a range of health risks subject to publication bias R... Reported to be harmful to the explanation provided by Alem et al., i.e % ) with industrial. Accordingly ( poor, fair, good ) ( Table 1 ) higher prevalence of abuse and child was... Used only relevant items, health professionals can be found in almost any economic....