Multiple morbidities and health conditions of waste-loaders in Mumbai: A study of the burden of disease and health expenditure

Abstract

Study assesses the effects of solid-waste loading on workers, the resultant development of occupational morbidities, and economic burden of these morbidities. A cross-sectional survey was conducted with 360 municipal workers from six of 24 municipal wards in Mumbai. The nearest neighborhood method of Propensity Score Matching (PSM) examined the impact of waste-loading on the development of morbidities and to identify the risk factors – multiple logistic regression analysis was performed. The prevalence of musculoskeletal disorders (MSDs), injury, eye and skin infections found significantly higher for waste-loaders compared to comparison group. The PSM method revealed that the occupation of waste-loading significantly raised the risk of injury (34%), MSDs (23%), eye (19%), skin infection (15%) and disability (15%), compared to comparison group. Significantly higher health expenditure is observed among waste-loaders who have sought treatment in private health facility than public. The study recommends to offer assistance the medical insurance for reducing the financial burden on waste-loaders.

Keywords:

• Disability
• injury/accident
• musculoskeletal disorder
• respiratory infection and treatment seeking
• skin infection
• waste loader

Disclosure statement

The authors declare that they have no competing interests.

Ethical approval and consent to participate

Informed consent of the participants was obtained in the local language. Ethical clearance prior to data collection was obtained from the Student Research Ethics Committee (SREC12/3144) of the International Institute for Population Sciences, Mumbai.

Notes

1 The condition of informal conservancy workers in a developing country is even worse. They include those who work as conservancy staff in municipal corporations throughout India, but without entitlement to any welfare schemes as formal employees are. They are treated as voluntary workers and work without protective measures, on minimum wages of ₹200–250 per day.