CHAPTER-I: INTRODUCTION

1.1 Background
Municipal solid waste is an outcome of economic productivity and consumption and includes
wastes from households, commercial establishments, institutions, markets, and industries and its
handling and disposal is a growing environmental and public health concern. Population growth
and economic development have brought increasing amounts of solid waste to urban areas. Solid
waste management encompasses a wide range of activities including, collecting garbage; sorting
recyclable materials; collection and processing of commercial and industrial waste. Risks occur
at every step in the process, from the point of collection at homes, during transportation and at
the sites of recycling or disposal. They are exposed to occupational health and accident risks
related to the content of the materials they handled, emissions from those materials, and the
equipments being used. In areas, infectious medical wastes and toxic industrial wastes are not
segregated from domestic waste, the waste collectors are exposed to a wide array of risks. As a
result of their exposure to multiple risk factors they suffer high rates of occupational health
problems.

Municipal solid waste (MSW) workers are highly exposed to health and environmental safety
risks due to exposure to heavy workloads, bio-aerosols, and volatile compounds, potential
hazardous or even infectious materials. Municipal solid waste workers are subject to
musculoskeletal, dermal, respiratory, and gastrointestinal problems (Poulsen et al. 1995 &
Englehardt et al. 1999).

Occupational safety and health (OSH)

Occupational safety and health (OSH) is generally defined as the science of the anticipation,
recognition, evaluation and control of hazards arising in or from the workplace that could impair
the health and well-being of workers, taking into account the possible impact on the surrounding
communities and the general environment. Occupational safety and health is a key element in
achieving sustained decent working conditions and strong preventive safety cultures.

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Occupational Health is the promotion and maintenance of the highest degree of physical, mental
and social well-being of workers in all occupations by preventing departures from health,
controlling risks and the adaptation of work to people, and people to their jobs (ILO / WHO,
1950). Sound health and healthy working conditions are the prerequisites to promote
development of society at all levels through increasing workers’ overall quality of life (Joshi &
Dahal, 2009).

Status of OSH in Nepal

The concept of OSH in Nepal is in its initial stage. It is started to talk in industrial sector but its
importance in other sectors is still needs to be justified. Despite various efforts, much still remain
to be done to establish sound OSH systems in the world of work. ILO estimates that more than
250 million workers meet occupational accidents and 160 million are suffering from
occupational diseases each year at the global level. Among them about 1.2 million workers die
annually caused by occupational diseases and accidents (ILO, 2001).

OSH is one of the major issues directly related to the workers’ rights. Almost all of the Nepali
labor force involves in informal sector and they are still unaware of the concept and importance
of OSH. As a result of continuous struggle of Nepali workers and trade unions as well as
Introduction solidarity from international centers of trade unions and supportive organizations
this issue is gradually coming in the limelight among Nepali working masses (Rimal, 2003).
From 1994 trade union confederations particularly General Federation of Nepalese Trade Unions
(GEFONT) has started awareness campaign on OSH taking the issue seriously. Still the issue is
one of the major agenda of GEFONT and have conducted several OSH training at the workplace
covering all 10 zones by the well trained personnel from different national and international
training institutions. Other confederations also have incorporated the issue in their programme
and activities. Government has also been working on the issue through the OSH Project under
Ministry of Labor and Transportation Management with the establishment of OSH Centre under

the financial and technical cooperation of ILO and Danida.

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1.2 Statement of Problem

The workers are subjected to direct exposure to waste that may cause severe health problems
among them. The major issue is the lack of segregation of organic, inorganic and hazardous
waste (e.g. discarded batteries, electronics, etc) at households before being left for the collection
by collection vehicles. From the generation of waste to its disposal, solid waste workers are
exposed to substantial levels of physical, chemical, and biological toxins. Current waste
management systems involve significant risk of contact with waste hazards. Thus, the workers
are directly in contact with the potential hazardous waste like broken pieces of glass, batteries,
and sharp discarded electronics. Also, the lack of use of personal protective equipment may pose
other health effects among the waste collectors. The prevention methods such as monitoring
exposures, personal protection, engineering controls, job education and training, and other
interventions are underutilized. To recognize and address occupational hazards encountered by
solid waste workers, it is necessary to discern potential safety concerns and their causes, as well
as their direct and/or indirect impacts on the various types of workers.

1.3 Research Question

 Which are the predominant occupational health risks among solid waste workers?
 What are possible solutions that can be implemented to reduce the occupational health
hazard rates among solid waste workers?
1.4 Objective

The general objective of the study is:

 To study the health issues and occupational safety of solid waste workers of KMC.

The specific objectives of the study are:

 To make inventory of the work related health issues among solid waste workers.
 To enumerate the use of PPEs during working hours.
1.5 Limitation of the Study
The study was done in single time observation basis. One day was not enough to scrutinize all
the occupational health and safety problems. Since the questionnaire was designed to assess the
scavengers’ attitude towards their profession might gave useful information about the impacts of
un-protective way of scavenging; it seemed that it did not provide enough evidence of the
scavengers’ actual hazards and risk to their profession.

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 CHAPTER-II: LITERATURE REVIEW

The US Bureau of Labor Statistics (1998) reported that US garbage collectors experienced 48.8
fatalities per 100,000 workers in 1996, and that garbage collection was the seventh riskiest
occupation in the US. Bastani (2014) reported that the occupation of refuse and recyclable
material collection was ranked as the 6th most dangerous job in the United States, with a rate of
27.1 deaths per 100,000 workers.

Pahren (1987), all waste workers, including those involved in collection, landfill, compost,
recycling, and incineration, often have direct contact or exposure to microorganisms, dusts, and
toxins such as leachate or stack gases emitted during various operations. Lundholm & Rylander
(1980), Sigsgaard (1994), Ivens (1997) several studies show evidence which relates respiratory
or gastro-intestinal disease amongst MSW workers to exposure of dust or microorganisms,
especially Gram negative bacteria and fungal spores. Several reports document a high frequency
of gastrointestinal (GI) problems among waste collectors. A study by Nielson et al. (1994) found
that garbage collectors may be exposed to the aerosols emitted from the refuse in garbage
disposal bags. Due to the high levels of bacteria and endo-toxin in the percolate from the waste,
these investigators linked workers' report of acute gastrointestinal symptoms (onset as quickly as
one half hour) to these exposures.

Rogoff stated that solid waste collection workers are potentially exposed to health,
environmental, and safety risks due to the weight of the waste to be collected and various
chemical and biological materials sometimes present in the waste stream. A 5-year research
program (entitled, Waste Collection & Recycling), supported by the Danish, EPA and Danish
Work Environment Services focused on occupational exposures and adverse health effects
related to the collection, sorting, and recycling of household waste (Midtgard & Poulsen 1997).
The published results of the project indicated high risks of respiratory and gastrointestinal
problems (Sigsgaard et al. 1994, Hansen et al. 1997 & Ivens et al. 1997).

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 CHAPTER-III: MATERIALS AND METHODS
3.1 Study Area
Sisdol Landfill Site lies 26 km north-west from Kathmandu Valley in Nuwakot District from
where around 450-500 tones of solid waste are being disposed of daily from 20 municipalities of
Kathmandu Valley. There is a transfer station in Teku to load the collected waste prior to the
final destination at Sisdol landfill. The study was conducted on Municipal Solid Waste workers
directly under the administration of Kathmandu Metropolitan City as well as others waste
workers who have been working their to run their normal life.

3.2 Research Process

The research procedure adopted for the study is presented below:

Literature Review

Research Problem
Identification

Setting of Objectives

Field Visit to Sisdol Landfill Site

Collection of Data

Data Analysis &

Interpretation

Report Writing

Fig 3.2.1: Flow chart of Research design

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3.3 Methods of Data Collection
3.3.1 Field Observation
A direct observation of the landfill site was made. The paper is based on the information
collected from the field survey. Observation was employed during the field visit to collect
primary data. During the observation of landfill site, the researcher was surprised to see
scavenger’s dirty and unhinging job. The researcher observed housing, fooding, water supply
and their working methods on the landfill site.

3.3.2 Key Informant Interview (KII)

The key informant interview was conducted with the Site In-Charge of the Sisdol Landfill Site to
gather overall information of the total number of workers working directly under KMC as well
as the other informal scavengers. The information relating to the number of workers directly
under KMC, the provisions of KMC regarding the occupational safety of solid waste workers,
information regarding the orientations and trainings being provided to the solid waste workers,
the participation of solid waste workers on trainings, the use of personnel protective equipments
and the monitoring by supervisors and so on, were the main focus of KII.

3.3.3 Questionnaire Survey to Scavengers

Questionnaires included questions related to their health problems. Information on variables such
as caste, age, sex, education, health, income, and occupational history are also gathered. Both
open-ended and closed questionnaire are included. In this study, in-depth interview was
undertaken with 67 respondents from study area (Sisdol) and recorded the information obtained
during the survey period. Key informant interview was used as a major means of collecting
relevant information regarding the scavengers and their job.

3.3.4 Sampling procedure

The findings of this study are primarily based on the information collected from 67 respondents
(Scavengers). The sample size (n) in the study area was determined by using formula (Arkin &
Colton, 1963; cited by Sharma, A. 2000) at 95% of confidence level. The sample size (n) of the

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household in the surveyed area was determined by,

Where,
n = Sample Size
N = Total Number of households
Z = confidence level (at 95% level, Z=1.96)
P = Estimated population proportion (0.05)
D = Error limit of 5% (0.05)

3.4 Analysis and Interpretation of Data

The data obtained through the survey and KII were processed and analyzed. The analysis was
done on the basis of available literatures.

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 CHAPTER-IV: RESULTS AND DISCUSSION

The following results were obtained from the survey of the solid waste workers at Sidol Landfill
Site.

4.1 Availability and Use of Personal Protection Equipments (PPEs)

To save the workers from the occupational diseases and accidents, proper use of personal
protection equipments are essential. But in the workplace, only 35.82% of the solid waste
workers were found to be using the PPEs which is shown through the bar diagram below:

70

60 64.18
50
% Respondents

40

30 35.82

20

10

0
Use Don’t Use

Fig 4.1: PPEs users in percentage

The survey revealed that most of the workers (64.18 % of respondents) didn’t use PPEs during
work. Also, they had little knowledge about the safety equipments which can prevent from
diseases and accidents at the workplace. Only few respondents were aware of the necessity of
safety equipments. PPEs include mask, gloves, boots, apron, etc.

From the survey and KII, it was revealed that KMC doesn’t provide PPEs. In spite of the PPEs,
the workers are provided monthly amount of Rs.1500 as personnel safety allowance to the
workers that were directly employed under KMC however other informal scavengers have to
manage themselves. The workers hadn’t used necessary safety equipments due to various
reasons. The major causes behind not using them were lack of awareness and felt-inconvenience
by the workers as reported by the workers themselves.

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4.2 Health Problems
From the survey, it was found that the large percent of the scavengers suffered from different
health problems. The types of injury/ illness reported by the workers during work were physical
injuries, poisoning, respiratory tract disease and allergies which is shown in bar diagram below:

90
80
70 77.6
% Respondents

60
50 61
40
30 41.8
20 28.4
10
0
Physical Respiratory Poisoining Allergies
Injuries Tract Diseases

Types of injury/ Illness

Fig 4.2: Percentage respondents and type of injury/illness

4.2.1 Physical Injuries

61% of the workers experienced physical injuries during work. Cuts, bruises and ruptures in the
body, back pain, joint pain, elbow injury, wrist pain and other physical pains and aches were
experienced by the solid waste workers as physical injuries.

Unsorted inorganic wastes and labor-intensive waste handling practices are the leading causes of
high rate of physical injuries. Poor protective measures and absence of first aid in time of injury
is intensifying the problem. Collectors and loaders use their feet to push spade into the pile of
garbage. Sometimes they wipe waste and put it in spade using feet or hand. While doing so, the
probability of cut, bruises and ruptures is high. Falling of broken glass and metals on one hand
can injure and the other hand uploading heavy load on trucks can develop dislocations and
physical ache to loaders.

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4.2.2 Respiratory Problems
41.8% of workers reported that they had respiratory problems. The RTI as said by the workers
themselves were tonsillitis, sinusitis and respiratory problems. The studies of Poulsen et al
(1995) in Geneva and Denmark, and Roy et al in USA present some examples of respiratory
tract related disease even in the developing countries.

4.2.3 Allergies

From the survey, it was found that 77.6 % of workers suffered from allergies due to work. Skin
rashes, itching, irritations, swelling lips or eyelids, eye irritations were few of the allergies
reported in the study. Since human and animal excreta are always present in municipal waste of
Kathmandu, handling such waste results in number of allergic reactions to waste workers
(Pandey 2004). Leach of waste-tips dissolved in the water or disease vectors and pathogens
transferred through clothes and body parts help to develop allergies. Allergic diseases are intense
due to poor protective measures, lack of enough water for proper sanitation and personal
hygiene.

4.2.4 Poisoning

From the survey, it was found that 28.4% respondents encountered poisoning due to the nature
of job to be performed. Garbage waiting for collection and wastes dumped in non- sanitary
dumping emit poisonous gases. Methane emitted from dumping site can cause poisoning (Birley
& Lock 1999). Numbers of poisoning problems can occur while handling rotten wastes.
Although the problems like headache, nausea, fatigues and fits might be the outcome of other
factors, they are perceived as symptoms of poisoning in this study, because the respondents
claim that when they go away from working sites, they feel normal again. Some waste workers
also believe that headaches are caused by intense heat during the sunny days and nausea and
fatigue are due to weakness.

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 CHAPTER-V: CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion

Solid waste management is the sole responsibility of each person. The problem of waste in urban
centers is one of the major concerns of sustainable development. Those involved from solid
waste collection to disposal, are directly exposed to the waste and pose the greatest risks to work
related hazards. Just by separating inorganic waste and sharp objects from municipal waste, and
other hazardous waste management, and by mechanization of waste handling practice, health
problems of waste workers can be reduced in significant level. The major causes responsible for
diseases and accident reported by the participants of the survey were: violation of safety rules,
carrying heavy load, lack of awareness among workers, unavailability of the safety
equipments/tools as necessary. Likewise, lack of training, lack of inspection, supervision and
monitoring are also the important factors responsible for high incidence of disease and accident
in workplace. Thus, making waste workers aware of health impact and encourage them to use
protective measures properly, making trained waste workers to handle hazardous waste, regular
monitoring of waste workers’ health status and providing them necessary treatment could bring
remarkable change in waste workers’ health.

5.2 Recommendations for Workers

 In order to take care of their health and safety, the scavengers themselves need to
understand about the direct and indirect cost of diseases and accidents occurred due to
work.
 Need to take precaution knowing the preventive method well regarding their safety and
health.
 Seek awareness programs on the issue through respective management and government.
 Use the PPEs whatever provided by the management properly and demand collectively
such items as necessary.

Recommendation for KMC

 Make aware on OSH issues and educate on importance of using the PPEs to the entire
workers.
 Provide standard PPEs as the nature of the work and make it mandatory if the workers are
not using them voluntarily.
 Conduct OSH training programs regularly by coordinating with concerned
stakeholders/agencies to make sound work environment.

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