School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
PHASE Nepal, Dadhikot-9, Bhaktapur, Nepal.
Public Health. 2019 Jan;166:10-18. doi: 10.1016/j.puhe.2018.09.026. Epub 2018 Nov 9.
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 < 0.001), Indian origin (OR 1.35; P = 0.018), older age (OR 2.97 for more than the age of 55 years; P = 0.007) and low perception of occupational risks (OR 2.41; P < 0.001). Low perception of occupational risk was associated with older age (55 + years) and the lack of receipt of information on the risks.
IWWs are at increased risk of injury in their work, yet are poorly protected in relation to vaccine-preventable infections and workwear. The results suggest that information is important in relation to perception of occupational risk, which in turn is associated with the use of PPE. There is a need for policymakers and public health practitioners to have a robust understanding of the needs and vulnerabilities of this group, as well as identify effective interventions that can be taken to safeguard the health and welfare of IWWs.
描述加德满都谷地非正式废物工人（IWWs）的健康和职业风险，并探讨与不使用个人防护设备（PPE）相关的因素。
这是一项对加德满都谷地和尼泊尔相邻努瓦科特区从事废物场工作的成年 IWWs 的健康和职业风险的横断面调查。2017 年 11 月，通过便利抽样收集了有关 IWWs 的社会人口统计学数据、一般和职业健康指标、医疗保健获取和使用数据、身体风险、职业风险感知和个人防护设备使用的数据。使用多元逻辑回归分析检查了 PPE 使用与性别、年龄、教育、原籍国、伤害和职业风险感知之间的关联。
在接受调查的 1278 名 IWWs 中，普遍存在的身体风险包括伤害（过去 12 个月中 66.2%），过去 3 个月中主要报告的症状是呼吸道（69.9%）。最常见的伤害是玻璃割伤（44.4%）和金属割伤（43.9%）。只有不到一半的 IWWs（46.8%）接种了破伤风疫苗，7.5%接种了乙肝疫苗。72.5%的 IWWs 认为这项工作有“风险”，但只有 67.6%的人没有使用个人防护设备。不使用个人防护设备与男性（比值比[OR]2.19；P<0.001）、印度裔（OR 1.35；P=0.018）、年龄较大（年龄超过 55 岁的 OR 2.97；P=0.007）和职业风险感知较低（OR 2.41；P<0.001）独立相关。职业风险感知较低与年龄较大（55 岁及以上）和缺乏有关风险信息有关。
IWWs 在工作中受伤的风险增加，但在预防疫苗可预防感染和工作服方面保护不足。结果表明，信息在职业风险感知方面很重要，而职业风险感知又与个人防护设备的使用有关。政策制定者和公共卫生从业人员需要充分了解这一群体的需求和脆弱性，并确定可以采取哪些有效干预措施来保护 IWWs 的健康和福利。
