Work injury risks in Oakland CA garment industry (2002)

This study is one of several independent studies by largely academic-based researchers on occupational risks of specific groups of workers. This one involves Asian garment workers in Oakland. It looks at injury risks and ergonomic solutions. An absorbing study, it is also exasperatingly flawed. Like the other studies (which I will introduce soon), this study reports that an extremely small portion of worker physical complaints result in workers comp claims. This is a very serious problem. But the authors fail to take into account the severity of the self-reported complaints. They appear not to have considered the very real possibility that many injuries also may have had non-occupational factors. They used no comparison group of workers. It is impossible to figure out if the work injury experience of these workers is materially worse than that of other garment workers. (I suspect it is.) The authors turned away multiple requests to discuss the study with me.
For the complete 26 page report go to We Spend Our Days Working In Pain
I have posted below the Executive Summary and Recommendations……
California sewing factories employ over 100,000 sewing machine operators, most of whom are Asian and Latina immigrants. Health and safety violations are common in the mostly small factories that employ these minimum wage workers. This report is based on the clinical findings and survey results from sewing machine operators seen at the Oakland-based Asian Immigrant Women Workers Clinic (AIWWC), a free clinic for garment workers sponsored by Asian Immigrant Women Advocates (AIWA) and the University of California San Francisco (UCSF). Findings include:

  • Garment workers are being injured on the job and are at substantial risk of permanent disability from their injuries. Ninety-nine percent of AIWWC patients had one or more diagnosed work-related conditions, including back, neck or shoulder sprains or strains. Ninety-four percent experienced pain severe enough to interfere with their daily activities.
  • Working conditions in garment factories are frequently substandard. Approximately 94% of patients reported one or more problems with their workstations including inadequate seating (90%), awkward bending and twisting (67%), breathing problems due to fabric dust (48%), less than adequate rest breaks (40%), and being yelled at by their bosses (36%).
  • Garment workers typically work over 40 hours per week for low pay and no benefits. Patients reported earnings of $6.32 an hour, 25% less than the poverty level for a family of four. Only 22% of patients had health insurance and only 12% reported paid sick leave.
  • The overall health status of garment workers is far worse than that of the general population. A total of 66% of the garment workers in this study reported “poor” or “fair” health. This is three to four times higher than the rate for women in California.
  • Garment workers have inadequate access to occupational health care, specialty treatment services and general preventive health care. Nearly one-third of these women had never been seen by a health care provider for their ongoing musculoskeletal problems. Only a small fraction had been treated by clinicians trained in recognizing and treating occupational health problems.
  • Garment workers are effectively prevented from using the Workers Compensation system. Ninety-seven percent of workers seen in the clinic were eligible to file for workers compensation for their injuries, but refused to do so primarily due to lack of knowledge about the system or because they feared reprisals on the job.
  • Musculoskeletal injuries experienced by garment workers are preventable. Technology is not the problem. In many cases there are simple, cost-effective ergonomic solutions that would prevent the common musculoskeletal problems these workers experience.

The responsibility for improving health and safety conditions for garment workers rests with the apparel industry in California. However, improving the occupational health of garment workers and other low-wage immigrant workers must be made a priority by government agencies, community-based and worker organizations, public health officials, foundations and medical providers, as well as employers, if significant changes are to be made. We have identified the need for funding and policy changes to implement key recommendations in the following five areas:

  • Develop community-based occupational health clinics to provide basic treatment services statewide.
  • Increase the awareness and resouces of existing community health care providers to recognize and treat occupational health problems among low wage immigrant workers.
  • Fund research to identify other barriers that prevent low-wage immigrant workers from effectively using Workers Compensation and recommend actions to remove these barriers.


  • Fund grassroots leadership development and peer outreach and education programs to promote awareness of workplace health rights and occupational injury and illness prevention among low wage and immigrant workers.
  • Translate all pertinent Workers Compensation and worker health and safety materials into Spanish, Chinese, Vietnamese, Korean and other major languages spoken in California.


  • Provide safety grants to garment factories to upgrade equipment, redesign workflow and conduct worker training to reduce the number and severity of injuries on the job.
  • Develop models for proactive, community-based occupational health injury and illness prevention activities through education and outreach to these businesses and others that employ low-wage immigrant workers.


  • Ensure that all garment industry employers carry Workers Compensation insurance by requiring evidence of insurance before licenses are issued or renewed and by periodic comparisons with the insurance records kept by the Workers Compensation Rating Bureau of California.
  • Require minimal ergonomic standards (e.g., for adequate seating) in the Division of Labor Standard Enforcement (DLSE)licensing requirements for garment manufacturers. Include ergonomic and other risk factors on the checklist for enforcement of health and safety standards.
  • Identify and remove barriers that prevent low-wage immigrant workers from effectively using OSHA and other existing enforcement programs.


  • Fund research to identify the causes and implement practical and effective prevention of occupational injury and illness in the most vulnerable low-wage occupations.
  • Fund special surveillance studies to identify underreporting of injuries among garment workers and other occupations that employ primarily low-wage and immigrant workers.

Authors: Nan Lashuay, MA; Barbara J. Burgel, RN,MS,FAAN; Robert Harrison, MD,MPH; Leslie Israel, DO,MPH; Jacqueline Chan, MPH; Catherine Cusic, PA-C; Jane Chao Pun, RN, MS, NP; Ken Fong, BA; Young Shin, JD, MA.