Health impact of occupational risks in the informal sector in Zimbabwe

Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India?

A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.

Informal-sector occupational hazards: an observational workplace assessment of the traditional medicine trade in South Africa

Informal traditional medicine markets are trading and processing hubs for a range of plant, animal and mineral materials; however, little is known regarding the occupational risks associated with the processing and handling of these products. The aim of this study was to identify the workplace hazards of the traditional medicine trade. A walk-through observation of the workplace was conducted by two independent observers with formal training in workplace risk evaluation. Ergonomic, physical, chemical, biological and environmental hazards were identified from the handling of plant, animal and/or mineral products. The study gives an insight into a unique and diverse sector.

Assessment of Occupational Injury among Industrial Workers in the Bahir Dar City of Northwest Ethiopia: Institution-Based Cross-Sectional Study

Background

Ethiopia is one of the economically fastest growing countries in the world. Industries in Ethiopia are booming, and Bahir Dar is one of the industrial zones in the country. The city administration is planning to recruit the majority of the workforce in these industries. However, injuries related to occupations in the industries are not that much studied yet. Therefore, this study aimed to assess the prevalence of occupational injury and its associated factors among industrial workers in the Bahir Dar city of Northwest Ethiopia.

Methods and Materials

Institution-based cross-sectional study design was used. Multistage stratified random sampling technique was employed to select 846 study participants from each stratum (small-, medium-, and large-scale industries). Data were analyzed using Statistical Package for Social Sciences (SPSS), version 21. Binary logistic regression was employed to determine the existence of an association between dependent and independent variables.

Result

A total of 803 participants were included in the study with a response rate of 95%. The mean age of respondents was 28.9 years (SD ± 8 years). Five hundred nine (63.4%) were occupationally injured in the last 12 months. Sex (AOR = 3.66, 95% CI = (2.53-5.29)), employment status (AOR = 7.33, 95% CI = (3.31-16.22)), regular health and safety supervision (AOR = 2.66, 95% CI= (1.79-3.96)), training prior to entry to actual work (AOR = 3.18, 95% CI= (2.14-4.74)), and use of personal protective equipment (PPE) (AOR = 2.48, 95% CI= (1.74-3.56)) were significantly associated with occupational injury.

Conclusion

The prevalence of occupational injury in this research is found to be very high. It is advisable to provide sustainable training and regular occupational health and safety supervision for industrial workers in the city. Moreover, research has to be conducted to know the reasons for the difference in the prevalence of occupational injury between large-, medium-, and small-scale industries.

Occupational Injury and Its Correlated Factors among Small-Scale Industry Workers in Towns of Bale Zone, Southeast Ethiopia

Introduction

In developing countries, the laborer forces have managed many of the industrial works. As a result, the process of the work has put the health and lives of workers at risk. Thus, this study was designed to assess occupational injury and its correlated factors among small-scale industry workers in the towns of Bale Zone, Southeast Ethiopia.

Methods

An institution-based cross-sectional study design was employed among five hundred ninety small-scale industries in towns of Bale zone, Southeast Ethiopia, in March to April 2016. Multistage sampling was applied to recruit the study subjects. Data were collected through interviewer-administered questionnaires. A structured questionnaire addressing the objectives of the study was used. EpiData was used for data entry, and the data were exported to SPSS windows version 20 for analysis. Descriptive statistics like frequency and percentage were used for the prevalence, whereas binary and multiple logistic regressions were employed to identify the predictors of the outcome variable.

Results

A total of 574 workers from different small-scale industries, including woodwork, metalwork, and concrete block construction, participated in the study with a response rate of 97.3%. In this study, among the total participants of the study, 43.2% (248), 30% (172), and 21.6% (124) of them had encountered lifetime, last one year, and six months occupational injury, respectively. Taking health and safety training, presence of any things on the floor that can cause accidents and occupational risk perception were independent predictors of occupational injury. The presence of any things on the floor that can cause accidents and having a low-risk perception increases occupational injury by 12.69 [AOR: 12.69, (1.67–96.13)] and 2.84 [AOR: 2.84, (1.80–4.49)], respectively.

Conclusion

About one in three occupational injuries occurred among small-scale industry workers. Health and safety training should be provided for every worker in small-scale industries. Supportive supervision focusing awareness creation, economic stability, and health care from health office, social and labor affair office, and other concerned body is highly recommended. District or town health office should address the identified factors to promote the health of the workers.

Association Between Informal Employment and Health Status and the Role of the Working Conditions in Spain

Informal employment is an employment condition in which workers are not protected by labor regulations. It has been associated with poor health status in middle- and low-income countries, but it is still a neglected issue in high-income countries. Our aim was to estimate the association between health status and employment profiles in Spain, attending to the role of workplace risk factors. We conducted a cross-sectional study of 8,060 workers from the Seventh Spanish Working Conditions Survey (2011). We defined 4 employment profiles and estimated the associations between them and poor self-perceived health using Poisson regression models. All analyses were stratified by sex. The prevalence of the informal profile was 4% for women and 1.5% for men. Differences in self-perceived health status among employment profiles were negligible. Only women engaged in informal employment had poorer self-perceived health than those in the reference profile. This difference disappeared after adjusting models for psychosocial risk factors. In conclusion, we did not find differences in self-perceived health status between employment profiles, except for women in informal employment. Efforts should be made to improve the psychosocial risk factors in women in informal employment.

Prevalence of Respiratory Health Symptoms among Landfill Waste Recyclers in the City of Johannesburg, South Africa

In developing countries, waste sorting and recycling have become a source of income for poorer communities. However, it can potentially pose significant health risks. This study aimed to determine the prevalence of acute respiratory symptoms and associated risk factors for respiratory health outcomes among waste recyclers. A cross-sectional study was conducted among 361 waste recyclers at two randomly selected landfill sites in Johannesburg. Convenience sampling was used to sample the waste recyclers. The prevalence of respiratory symptoms in the population was 58.5%. A persistent cough was the most common symptom reported (46.8%), followed by breathlessness (19.6%) and rapid breathing (15.8%). Approximately 66.4% of waste recyclers reported exposure to chemicals and 96.6% reported exposure to airborne dust. A multivariable logistic regression analysis showed that exposure to waste containing chemical residues (OR 1.80, 95% CI 1.01–3.22 p = 0.044) increased the odds of respiratory symptoms. There was a significant difference in respiratory symptoms in landfill sites 1 and 2 (OR 2.77, 95% CI 1.03–7.42 p = 0.042). Occupational health and safety awareness is important to minimize hazards faced by informal workers. In addition, providing waste recyclers with the correct protective clothing, such as respiratory masks, and training on basic hygiene practices, could reduce the risks associated with waste sorting.

Occupational health risk of working in garages: comparative study on blood pressure and hematological parameters between garage workers and Haramaya University community, Harar, eastern Ethiopia

Background

Occupational exposure to chemicals in garages causes a wide range of biological effects, depending upon the level and duration of exposure. In Ethiopia, there have been few studies conducted to assess the exposure of garage workers to chemicals. Preceding studies have not explored the effect of working in garage on blood pressure and hematological parameters. Therefore, this study aimed to assess differences in blood pressure and hematological parameters among garage workers compared to the Haramaya University community, Harar, eastern Ethiopia.

Materials and methods

A comparative cross-sectional study was conducted in Harar town, eastern Ethiopia. Thirty garage workers were selected and compared with 30 age- and sex-matched controls comprising of teachers and students. Demographic and occupational data were collected by using a structured questionnaire by a trained data collector. Blood pressure was measured using sphygmomanometry. Hematological parameters were measured with an automated hematology analyzer. Data were analyzed using Stata version 13.

Results

The majority of the garage workers did not implement effective preventive or control measures for workplace chemical exposure. Statistically significant increases were found in systolic (128.67±18.14 vs 106.33 ±9.27 mmHg, P<0.0001), diastolic blood pressure (90.33±11.29 vs 75.67 ±5.68 mmHg, P<0.0001), total white blood cells (7.9±1.51 vs 6.72±2.04×10⁹ cells/L, P=0.0138), and platelets (323.20±48.82 vs 244.1±47.3×10⁹ cells/L, P<0.0001) in garage workers compared to the control group. On the other hand, statistically significant decreases were found in red blood cells (5.13±0.38 vs 5.46±0.36×10¹² cells/L, P=0.0006), hemoglobin (14.89±0.71 vs 15.45±0.87 g/dL, P=0.0062), hematocrit (43.98%±1.99% vs 46.4%3±2.32%, P<0.0001), and mean corpuscular volume (83.19±2.93 vs 85.11±3.87 fL, P=0.0353) among garage workers compared to the control group.

Conclusion

There were significant differences in blood pressure and hematological parameters between garage workers and the control group. Therefore, appropriate and effective safety measures need to be taken by the workers to prevent possible chemical exposure during routine tasks.

Effects of occupational illness on labor productivity: A socioeconomic aspect of informal sector workers in urban Bangladesh

Objectives:

The informal sector is the dominant area of employment and the economy for any developing country including Bangladesh. The cost of productivity loss due to absence from work or presenteeism with illness has rarely been examined in the Bangladesh context. This current study, therefore, attempted to examine the impact of ill health of informal sector workers on labor productivity, future earning, and healthcare-related expenditure.

Methodology:

A cross-sectional survey was conducted among three occupational groups of informal workers (rickshaw pullers, shopkeepers and restaurant workers) that were generally found in all urban areas in Bangladesh. A total of 557 informal workers were surveyed for this study.

Results:

Most of the respondents (57%) reported that they had been affected by some type of illness for the last six months. The overall average healthcare expenditure of informal workers was US$48.34, while restaurant workers expended more (US$53.61). Self reported sickness absenteeism was highest (50.37days) in the case of shop keepers, followed by rickshaw pullers (49.31 days), in the last six months. Considering the income loss due to illness in the past six months, the rickshaw pullers were exposed to the highest income loss (US$197.15), followed by the shop keepers (US$151.39).

Conclusions:

Although the informal sector contributes the most to the economy of Bangladesh, the workers in this sector have hardly any financial protection. This study provides critical clues to providing financial and social protection to informal sector workers in Bangladesh.

Factors associated with severe occupational injuries at mining company in Zimbabwe, 2010: a cross-sectional study

Introduction

Injury rate among mining workers in Zimbabwe was 789/1000 workers in 2008. The proportion of severe occupational injuries increased from 18% in 2008 to 37% in 2009. We investigated factors associated with severe injuries at the mine.

Methods

An unmatched 1:1 case-control study was carried out at the mine, a case was any worker who suffered severe occupational injury at the mine and was treated at the mine or district hospital from January 2008 to April 2010, a control was any worker who did not suffer occupational injury during same period. We randomly selected 156 cases and 156 controls and used interviewer administered questionnaires to collect data from participants.

Results

Majority of cases, 155(99.4%) and of controls 142(91%) were male, 127(81.4%) of cases and 48(30.8%) of controls worked underground. Majority (73.1%) of severe occupational injuries occurred during night shift. Underground temperatures reached 500C. Factors independently associated with getting severe occupational injuries included working underground (AOR = 10.55; CI 5.97-18.65), having targets per shift (AOR = 12.60; CI 3.46-45.84), inadequate PPE (AOR= 3.65 CI 1.34-9.89) and working more than 8 hours per shift (AOR = 8.65 CI 2.99-25.02).

Conclusion

Having targets exerts pressure to perform on workers. Prolonged working periods decrease workers’ attention and concentration resulting in increased risk to severe injuries as workers become exhausted, lose focus and alertness. Underground work environment had environmental hazards so managers to install adequate ventilation and provide adequate PPE. Management agreed to standardize shifts to eight hours and workers in some departments have been supplied with adequate PPE.

Gender and ergonomics: a case study on the 'non-formal' work of women nurses

Women's work activities are often characterised by 'non-formal actions' (such as giving support). Gender differences in ergonomics may be due to this peculiarity. We applied the method of organisational congruencies (MOC) to ascertain the 'non-formal' work portion of nurses employed in three hospital units (haematology, emergency room and general medicine) during the three work shifts in a major University Hospital in Rome, Italy. We recorded a total of 802 technical actions performed by nine nurses in 72 h of work. Twenty-six percent of the actions in direct patient's care were communicative actions (mainly giving psychological support) while providing physical care. These 'double actions' are often not considered to be a formal part of the job by hospital management. In our case study, the 'non-formal' work of nurses (psychological support) is mainly represented by double actions while taking physical care of the patients. The dual task paradigm in gender oriented research is discussed in terms of its implications in prevention in occupational health.

PRACTITIONER SUMMARY

The main purpose of the study was to assess all the formal and non-formal activities of women in the nursing work setting. Offering psychological support to patients is often not considered to be a formal part of the job. Our case study found that nurses receive no explicit guidelines on this activity and no time is assigned to perform it. In measuring the burden of providing psychological support to patients, we found that this is often done while nurses are performing tasks of physical care for the patients (double actions). The article discusses the significance of non-formal psychological work load of women nurses through double actions from the ergonomic point view.

Work or Place? Assessing the Concurrent Effects of Workplace Exploitation and Area-of-Residence Economic Inequality on Individual Health

Building on previous multilevel studies in social epidemiology, this cross-sectional study examines, simultaneously, the contextual effects of workplace exploitation and area-of-residence economic inequality on social inequalities in health among low-income nursing assistants. A total of 868 nursing assistants recruited from 55 nursing homes in Kentucky, Ohio, and West Virginia were surveyed between 1999 and 2001. Using a cross-classified multilevel design, the authors tested the effects of area-of-residence (income inequality and racial segregation), workplace (type of nursing home ownership and managerial pressure), and individual-level (age, gender, race/ethnicity, health insurance, length of employment, social support, type of nursing unit, preexisting psychopathology, physical health, education, and income) variables on health (self-reported health and activity limitations) and behavioral outcomes (alcohol use and caffeine consumption). Findings reveal that overall health was associated with both workplace exploitation and area-of-residence income inequality; area of residence was associated with activity limitations and binge drinking; and workplace exploitation was associated with caffeine consumption. This study explicitly accounts for the multiple contextual structure and effects of economic inequality on health. More work is necessary to replicate the current findings and establish robust conclusions on workplace and area of residence that might help inform interventions.

Six Employment Conditions and Health Inequalities: A Descriptive Overview

Standard full-time permanent employment—providing a minimal degree of stability, income sustainability, workers' empowerment, and social protection—has declined in the high-income countries, while it was never the norm in the rest of the world. Consequently, work is increasingly affecting population health and health inequalities, not only as a consequence of harmful working conditions, but also because of employment conditions. Nevertheless, the health consequences of employment conditions are largely neglected in research. The authors describe five types of employment conditions that deviate from standard full-time permanent employment—precarious employment, unemployment, informal employment, forced employment or slavery, and child labor—and their health consequences, from a worldwide perspective. Despite obvious problems of measurement and international comparability, the findings show that, certainly in the low-income countries, these conditions are largely situated in informality, denying any possible standard of safety, protection, sustainability, and workers' rights. Considerable numbers of the world's working people are affected in geographically and socioeconomically unequal ways. This clearly relates nonstandard employment conditions to health equity consequences. In the future, governments and health agencies should establish more adequate surveillance systems, research programs, and policy awareness regarding the health effects of these nonstandard employment conditions.

Impact of injuries on work performance among the surgical blacksmiths of West Bengal

The manufacture of surgical instruments is one of the leading small-scale industrial sectors in West Bengal, India. The present study was undertaken to assess the rate, type and cause of injury incidents among surgical blacksmiths and whether these incidents affected the work performance of the blacksmiths. A cluster of 216 skilled and 225 unskilled blacksmiths (male), engaged in the manufacture of surgical instruments, was selected from Baruipur subdivision as study subjects. The study included: 1) completion of a questionnaire; 2) measurement of physical parameters; 3) incident records; 4) statistical analysis of the data. The present study revealed that the blacksmiths suffered very frequently from work-related injuries. The number of injuries that occurred during 2004 - 2005 for skilled and unskilled blacksmiths was 1413 and 1610 respectively. Unskilled blacksmiths were disproportionately affected. These injuries resulted in a high rate of lost workdays, i.e. 517 and 742 workdays for skilled and unskilled workers respectively. The study thus indicated that surgical blacksmiths are highly prone to injuries in their occupation, mostly affecting the fingers (23% and 23%) and back region (21.7% and 22%) in both groups, which consequently affected their health, productivity and work performance.

The global burden due to occupational injury

BACKGROUND

Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. We estimate the global burden of fatal and non-fatal unintentional occupational injuries for the year 2000.

METHODS

The economically active population (EAP) of about 2.9 billion workers was used as a surrogate of the population at risk for occupational injuries. Occupational unintentional injury fatality rates for insured workers, by country, were used to estimate WHO regional rates. These were applied to regional EAP to estimate the number of deaths. In addition to mortality, the disability-adjusted life years (DALYs) lost, which measure both morbidity and mortality, were calculated for 14 WHO regions.

RESULTS

Worldwide, hazardous conditions in the workplace were responsible for a minimum of 312,000 fatal unintentional occupational injuries. Together, fatal and non-fatal occupational injuries resulted in about 10.5 million DALYs; that is, about 3.5 years of healthy life are lost per 1,000 workers every year globally. Occupational risk factors are responsible for 8.8% of the global burden of mortality due to unintentional injuries and 8.1% of DALYs due to this outcome.

CONCLUSIONS

Occupational injuries constitute a substantial global burden. However, our findings greatly underestimate the impact of occupational risk factors leading to injuries in the overall burden of disease. Our estimates could not include intentional injuries at work, or commuting injuries, due to lack of global data. Additional factors contributing to grave underestimation of occupational injuries include limited insurance coverage of workers and substantial under-reporting of fatal injuries in record-keeping systems globally. About 113,000 deaths were probably missed in our analyses due to under-reporting alone. It is clear that known prevention strategies need to be implemented widely to diminish the avoidable burden of injuries in the workplace.

Occupational health research in developing countries: a partner for social justice

Occupational health remains neglected in developing countries because of competing social, economic, and political challenges. Occupational health research in developing countries should recognize the social and political context of work relations, especially the fact that the majority of developing countries lack the political mechanisms to translate scientific findings into effective policies. Researchers in the developing world can achieve tangible progress in promoting occupational health only if they end their professional isolation and examine occupational health in the broader context of social justice and national development in alliance with researchers from other disciplines. An occupational health research paradigm in developing countries should focus less on the workplace and more on the worker in his or her social context.

[Non-fatal occupational injuries: gender and job contract differences]

In Brazil, workers without a formal job contract comprise more than half of the labor force, a contingent formed mainly by women. This study presents estimates of the annual incidence of non-fatal work-related injuries and their distribution by gender and type of job contract in an urban area of Brazil. This was a community-based study with a random cluster area sample of the inhabitants from the city of Salvador, capital of the State of Bahia. The study population included all individuals from 18 to 65 years of age who reported having a paid job (n = 2,947). Data were obtained through individual household interviews. The overall estimated annual incidence rate was 5.80%, with a non-statistically significant difference between men (6.05%) and women (5.53%) or workers with (5.67%) and without (5.92%) a formal job contract. These similarities between work-related accidents across gender and type of job contract highlighted the need for greater attention to this problem among women and informal workers, who are largely ignored in official statistics.

The global expansion of precarious employment, work disorganization, and consequences for occupational health: placing the debate in a comparative historical context

Mounting research evidence suggests that the shift to contingent work arrangements in industrialized countries is having serious adverse effects on the health of workers, both directly and indirectly (by undermining regulatory and other protections). The authors place this research, and the issues surrounding it, in a comparative historical context. Extensive use of precarious employment is not essentially new. It was a characteristic feature of most if not all industrialized societies in the 19th and early 20th centuries. Though the two phases are not identical, historical comparisons are instructive for understanding recent experiences and ways of addressing them. The authors also make comparisons with the developing world, where the informal sector typically accounts for over half the workforce. Such comparisons are instructive in indicating the consequences of a shift to more precarious patterns of employment and disorganized work settings. There is also good evidence that precarious employment is expanding in the developing world. The growing precarious employment in both industrialized and developing countries is interconnected, and the authors identify a number of the mechanisms affecting workers' health.

International agency efforts to protect workers and the environment

Every year 335,000 workers die in occupational accidents and altogether 1.1 million fatalities are caused by work-related factors. Some 250 million nonfatal accidents causing absence from work are aggravated by permanent disabilities, reduced capacity of life and work, and economic losses amounting to 4% of gross national product. The role of the International Labour Office (ILO) in promoting social justice is based on ethical principles and demonstrated by the ILO's standard-setting work, information exchange, and proposed Global Program on Occupational Safety, Health and the Environment, Ethical and policy dimensions of the ILO's practices are targeted to a participatory process aimed at better legislation and enforcement, as well as trained and well-informed specialists to modify work environments and cultures to eliminate or reduce the problems and suffering. The ILO's key present and new activities and outputs, such as the new 4th edition of the Encyclopedia on Occupational Health and Safety, are described. A better system of collaboration and networking in occupational safety and health is still needed.