Sudden Adult Death Syndrome Takes Toll on Thai Workers in Israel

While the syndrome disproportionately affects East Asians, tough working conditions in Israel could be a factor, an NGO says.

Thai agricultural workers near Gaza, December 2016.
Eliyahu Hershkovitz

About 220 Thai agricultural workers have died in Israel over the past decade, about 40 percent of sudden adult death syndrome though it’s not clear if tough working conditions played a role.

Combining cases in which the cause of death is listed as sudden adult death syndrome and those where it is suspected (based on external exams in the absence of an autopsy), the syndrome can be attributed to 63 percent of deaths – a very high rate.

“The impression over time is that there is no one pushing to solve these fatal cases,” a source said. Over the past three years, autopsies were performed in only 20 percent of the cases attributed to the syndrome, the Health Ministry said.

“There is no one to tend to the [cases of the] dead workers,” one source said. “They’re barely of interest to anyone either in Israel or Thailand.”

The group Kav La’Oved, which helps migrant workers, expressed concerns about a possible link between the deaths and tough working conditions something the group said should concern the Israeli authorities.

Thais come to Israel to work as agricultural laborers through a bilateral agreement with Bangkok.

Most of the victims of sudden adult death syndrome, or Brugada syndrome, are healthy young men without a history of medical problems who die in their sleep.

The syndrome is particularly prevalent among East Asians. Some are found to have had heart arrhythmias, but it’s not clear if that is the cause of death or simply a side effect. People who witness the death sometimes say the victim suffered shortness of breath, a choking sensation, pressure in the chest and nightmares.

The syndrome is generally diagnosed after death by ruling out other causes. “It’s a subject that has not been researched in depth,” a source said.

“If someone decided to pursue it as it should be pursued, it’s very possible they’d find something new, and more importantly, maybe it would be found that the danger from the syndrome could be reduced through some kind of preventive measure. The truth is, they haven’t managed to unravel this disease, and it doesn’t appear anyone is in a hurry to do so.”

According to another source, even if the syndrome is genetic, “it’s impossible to rule out the environmental and workplace effects. Every case of death requires an in-depth investigation.”

After unusual deaths, Israel’s Abu Kabir Forensic Institute carries out autopsies at the request of the authorities. But with Thai laborers, in the absence of clear signs of violence, the police usually don’t request an autopsy.

An embassy can make a request or convey one from the deceased worker’s family, but that very rarely happens.

After the ministry looked into the matter last year, it recommended that Thai workers due to engage in strenuous farm labor receive an electrocardiogram as part of their physical in Bangkok.

The Thai Embassy told Haaretz it acts in accordance with Israeli law. When a Thai citizen dies in Israel, the embassy contacts the family and acts according to its wishes regarding an autopsy.

In 10 percent of cases, the cause of death among Thais in Israel is suicide.

Kav La’Oved said the high mortality rate among young people who were found fit before they reached Israel was a concern.