The health risks of informal waste workers in the Kathmandu Valley: a cross-sectional survey

• Published in: Public health (London) 2019-01, Vol.166, p.10-18
• Main Authors: Black, M., Karki, J., Lee, A.C.K., Makai, P., Baral, Y.R., Kritsotakis, E.I., Bernier, A., Fossier Heckmann, A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Country of origin; Cross-Sectional Studies; Data; Female; Gender; Health; Health care; Health care access; Health Knowledge, Attitudes, Practice; Health risks; Health status; Health Surveys; Hepatitis; Hepatitis B; Humans; Informal Sector; Informal waste workers; Injuries; Injury analysis; Male; Middle Aged; Nepal; Nepal - epidemiology; Occupational Diseases - epidemiology; Occupational health; Occupational Injuries - epidemiology; Occupational risks; Perception; Personal protective equipment; Personal Protective Equipment - statistics & numerical data; Policy making; Polls & surveys; Protective equipment; Public health; Recycling; Regression analysis; Risk assessment; Risk Factors; Risk perception; Safety equipment; Sampling; Signs and symptoms; Sociodemographics; Tetanus; Waste disposal sites; Waste Management; Wastes; Welfare; Workers; Young Adult
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2018.09.026

To describe the health and occupational risks of informal waste workers (IWWs) in the Kathmandu Valley and explore the factors associated with not using personal protective equipment (PPE). This is a cross-sectional survey of IWWs. Data were collected on the health and occupational risks of adult IWWs working on waste sites in the Kathmandu Valley and in the adjacent Nuwakot district, Nepal, in November 2017, through convenience sampling. Using a standardized health assessment questionnaire, face-to-face interviews were undertaken to record sociodemographic data, indicators of general and occupational health, data on healthcare access and use, physical risks, perception of occupational risks and use of PPE. Associations between use of PPE and gender, age, education, country of origin, injury and perception of occupational risks were examined using multivariate logistic regression analyses. In 1278 surveyed IWWs, prevalent physical risks included injuries (66.2% in the previous 12 months), and the main reported symptoms were respiratory in nature (69.9% in the previous 3 months). Most prevalent injuries were glass cuts (44.4%) and metal cuts (43.9%). Less than half of the IWWs (46.8%) had been vaccinated against tetanus and 7.5% against hepatitis B. The work was considered as ‘risky’ by 72.5% of IWWs, but 67.6% did not use PPE. Non-use of PPE was independently associated with male gender (odds ratio [OR] 2.19; P