Background  Immigrants continue to face challenges after entering the labor market and remain overrepresented in ‘3-D jobs’ (dirty, difficult, degrading). This study aims to investigate the differences in occupational injury due to accidents (OIA) among immigrants compared to native-born workers in Sweden, and to examine the role of migrant-specific and work factors in these differences.

Methods  This repeated cross-sectional study used nationwide registers including all gainfully employed individuals in 2004–2020 (average annual sample 4.5 million individuals). OIA was treated as a binary outcome and migrant status was categorized based on region of birth and reason for immigration. OIA odds were estimated using pooled logistic regression analyses, where the crude model was adjusted for sociodemographic factors, time since immigration, and work factors.

Results  First-generation immigrants (odds ratios [OR] 1.41; 95% confidence interval [CI] 1.40, 1.42) and second-generation immigrants (OR 1.10; 95% CI 1.09, 1.11) had higher odds of OIA than native-born workers. Among the first-generation immigrants, the strength of the association varied depending on region of birth and reason for immigration. Immigrating to Sweden for work reasons was associated with lower odds of OIA among first-generation immigrants (OR 0.62; 95% CI 0.61, 0.64). The elevated odds of OIA among immigrants relative to native-born workers remained after adjusting for important covariates.

Conclusions  The differences in OIA underscore the disparities among native-born and immigrant workers in Sweden. The current findings highlight the importance of addressing these issues to ensure a safe work environment for all.