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

A comprehensive overview on solid waste leachate effects on terrestrial organisms

Leachate is a highly complex waste with high toxicological potential that poses a significant threat to the terrestrial environment. Determining leachate physicochemical parameters and identifying xenobiotics alone is, however, not enough to determine the real environmental impacts. In this context, the use of terrestrial model organisms has been highlighted as a tool in ecotoxicological leachate assessments and as a guiding principle in risk assessments. In this context, this review aimed to present the most current state of knowledge concerning leachate toxicity and the bioassays employed in this evaluation concerning terrestrial plants and animals. To this end, a literature search on leachate effects on terrestrial organisms was carried out using ten search terms, in 32 different combinations, at the Web of Science and Scopus databases. A total of 74 eligible articles were selected. The retrieved studies analyzed 42 different plant and animal species and employed nine endpoints, namely phytotoxicity, genotoxicity, bioaccumulation, antioxidant system, cytotoxicity, reproduction, physiological changes, behavior and lethality. A frequent association of toxic leachate effects with metals was observed, mainly Pb, Cd, Cr, Mg, Zn and Cr, which can cause antioxidant system alterations and cyto- and genotoxicity. These elements have also been associated to reproductive effects in earthworms and mice. Specifically concerning plants, most of the retrieved studies employed Allium cepa in toxicity assays, reporting phytotoxic effects frequently associated to metals and soil parameter changes. Animal studies, on the other hand, mostly employed mice and evaluated genotoxicity and antioxidant system effects. Even with the description of toxic leachate effects in both plants and animals, a lack of knowledge is still noted concerning reproductive, physiological, cytotoxic, and behavioral effects in terrestrial species. We, thus, suggest that further studies be carried out on other animals, advancing our understanding on potential environmental leachate effects, also allowing for human health risk assessments.

Prevalence of low back pain in India: A systematic review and meta-analysis

BACKGROUND: Although many studies have investigated the prevalence of low back pain (LBP) among Indian subjects, no meta-analysis has been conducted to determine the comprehensive epidemiological point, annual, lifetime prevalence of LBP among Indian subjects. OBJECTIVE: The purpose of this systematic review and meta-analysis was to investigate the point, annual, and lifetime prevalence of LBP in the Indian population. METHODS: We searched PubMed, Embase, Science Direct, and Cochrane Library databases for relevant studies that reported point, annual, or lifetime prevalence of LBP among Indian subjects,. Pooled point, annual and lifetime prevalence rates were calculated. Meta-analysis, subgroup analysis, sensitivity analysis and publication bias assessment were performed. RESULTS: Ninety-seven studies were included in this review. Fifty-four studies included in the review (55.5%) were found to be of higher methodological quality. The pooled point, annual, and lifetime prevalence of LBP in India was 48% (95% CI 40–56%); 51% (95% CI 45–58%), and 66% (95% CI 56–75%), respectively. The pooled prevalence rates were highest among females, the rural population, and among elementary workers. CONCLUSION: The point, annual, and lifetime prevalence rates of LBP in the Indian population is higher compared to global and other ethnic populations affecting a large proportion of the population, especially among women, rural population and in elementary workers. The findings of this study can be the basis for formulating policy regarding the prevention and treatment of LBP in a large part of the global population.

Intersecting Systems of Power Shaping Health and Wellbeing of Urban Waste Workers in the Context of COVID-19 in Vijayawada and Guntur, Andhra Pradesh, India

Background: Waste work in India is an undervalued role relegated to historically marginalised communities. The informal nature of their work coupled with lack of state regulation keeps waste workers trapped in poverty. This study aims to understand how intersecting systems and relations of power impact the agency of waste workers to shape their health and wellbeing. Methods: We used in-depth interviews, key informant interviews, and focus group discussions to collect primary data from waste worker communities in Vijayawada and Guntur in India. Thematic analysis was used to analyse data using conceptual frameworks relating to wellbeing and power. Results: Inter-generational poverty and lack of access to social determinants of health keeps waste workers trapped in a cycle of debt and poverty. They experience negative wellbeing owing to material and relational deprivations that are sustained by a nexus of power relations, explained using the themes of “power over”, “power to”, “power with”, and “power-within”. Conclusions: The ability of communities to exercise agency is constrained by the power exercised on their lives by the state and society. NGOs play a supportive role for the realisation of rights, but the ability of waste workers to organize and effect change is limited to coping strategies.

Health Help-Seeking Behavior: The Scavengers' Perspective

Scavengers are prone to various health problems, hence seeking healthcare is inevitable. Despite the importance of the help-seeking behavior of scavengers, it has not been addressed explicitly in the existing literature. Addressing this gap, this study intends to explore the help-seeking behavior of scavengers and to identify the factors that influence healthcare utilization among them. This qualitative study conducted thirty-one in-depth interviews through a semi-structured interview guide and analyzed them using thematic analysis. Andersen’s Behavioral Model of Health Service Use was employed to explore the findings. The findings showed that the scavengers utilized multiple healthcare options depending on the severity and reoccurrence of the illness. The process of help-seeking and health services utilization was largely influenced by the cost of the health service, long distance to the health facility, traveling cost and waiting time. The study highlights the need for scavengers’ enrolment in micro health insurance schemes. The initiative would facilitate scavengers’ access to medical care. Health awareness campaigns and the provision of free mobile medical services, especially at the landfill sites, would also improve curative treatment among scavengers.

Health concerns among waste collectors during pandemic crisis

The COVID-19 pandemic has negatively affected the economic, social, and psychological aspects globally. COVID-19 can possibly spread through municipal solid waste (MSW) if it is collected, bagged, transported, and disposed inappropriately. Such situation has posed significant challenges to MSW management (MSWM), which has led waste personnel under massive pressure. This study aims to examine the health-protective behavior of sanitation workers/MSW collectors (MSWCs) during the COVID-19 crisis. Quantitative data were collected by using a self-administered survey from 418 MSWCs working in Mainland China. The study extended the traditional health-belief model and proposed education and training as a facet of the behavioral model. Result showed that education and training were a significant predictor of health-protective behavior. Moreover, the moderating incremental influence of regulative assistance significantly affected the behavioral mapping of MSWCs. This study contributes to the literature by mapping the concerns, risks, and challenges experienced by MSWCs in times of a health crisis. Policymakers should specially consider the safety and hygiene concerns of frontline workforce in the whole chain of waste management (including the outsourced operations of MSWM). Lastly, the adoption of smart communication with the frontline workforce (i.e., MSWCs) is in dire need to maintain trust and avoid rumors and misconceptions during the time of a pandemic situation.

Prioritizing health, safety and environmental hazards by integrating risk assessment and analytic hierarchy process techniques in solid waste management facilities

The aim of this research was to assess and prioritize risk levels of health, safety, and environmental (HSE) hazards in solid waste management facilities of Tehran, Iran. The risk of HSE hazards was assessed using Fine-Kinney and environmental failure mode and effects analysis (EFMEA) methods and then the high-risk hazards were prioritized for implementing corrective actions by analytic hierarchy process (AHP) considering six criteria of (1) probability of occurrence, (2) severity of consequences, (3) simultaneous HSE effects, and (4-6) feasibility, effectiveness, and cost of corrective actions. A total number of 485 HSE hazards were identified, of which 78% were health and safety hazards and 22% were environmental hazards. The proportions of the transfer and transport, material recovery and composting facilities and landfill sites in the identified hazards were 21%, 38%, and 41%, respectively. Based on the AHP method, the leading hazards in the transfer and transport, material recovery and composting facilities, and landfill sites were exposure to bioaerosol in carwash facilities, exposure to bioaerosols and odor/volatile organic compounds (VOCs) in manual waste separation, and leachate spills in the former landfill site, respectively. This study showed that the hybrid method was an appropriate and reliable tool to prioritize HSE hazards.

Bioaerosols in the landfill environment: an overview of microbial diversity and potential health hazards

Landfilling is one of the indispensable parts of solid waste management in various countries. Solid waste disposed of in landfill sites provides nutrients for the proliferation of pathogenic microbes which are aerosolized into the atmosphere due to the local meteorology and various waste disposal activities. Bioaerosols released from landfill sites can create health issues for employees and adjoining public. The present study offers an overview of the microbial diversity reported in the air samples collected from various landfill sites worldwide. This paper also discusses other aspects, including effect of meteorological conditions on the bioaerosol concentrations, sampling techniques, bioaerosol exposure and potential health impacts. Analysis of literature concluded that landfill air is dominated by microbial dust or various pathogenic microbes like Enterobacteriaceae, Staphylococcus aureus, Clostridium perfringens, Acinetobacter calcoaceticus and Aspergillus fumigatus. The bioaerosols present in the landfill environment are of respirable sizes and can penetrate deep into lower respiratory systems and trigger respiratory symptoms and chronic pulmonary diseases. Most studies reported higher bioaerosol concentrations in spring and summer as higher temperature and relative humidity provide a favourable environment for survival and multiplication of microbes. Landfill workers involved in solid waste disposal activities are at the highest risk of exposure to these bioaerosols due to their proximity to solid waste and as they practise minimum personal safety and hygiene measures during working hours. Workers are recommended to use personal protective equipment and practise hygiene to reduce the impact of occupational exposure to bioaerosols.