Solid waste management in informal urban neighbourhoods. Occupational safety and health practices among tricycle operators in Kumasi,Ghana

ABSTRACT

The study examines the nature of activities and assess knowledge on occupational safety and health (OS&H) risks and practices among solid waste collectors in two low-income informal neighbourhoods in Kumasi (Aboabo and Asawase). Using observations and semi-structured interviews with 83 participants and relevant institutions, the findings indicate that informal tricycle waste collectors provided spot-to-spot waste collection using improvised sirens to signal their arrival. Workers generally had low knowledge, expressed less about occupational health risks, and thus adopted less safe work practices. The study however showed significant differences between knowledge of health risks (p < 0.000, R = 0.83) and years of working experience (p < 0.01, R = 0.74) and adoption of safe practices. Workers who had knowledge the associated health risks of the activity and also have been in the activity for more than 2 years were more likely to use at least one PPE/PPC. The study recommends that targeted interventions to mitigate risks and improve the health and safety of workers require effective risk communication. The study concludes that insight into OS&H is important to offer opportunities for better waste management strategies in the informal urban areas.     

永定县农村饮用水与环境卫生现状

目的掌握永定县农村饮用水、改厕和粪便处理现状，了解农村垃圾污水治理情况。方法填写统一的农村饮用水调查表和环境卫生调查表，水质检验方法按GB5750-1985进行，结果按《农村实施“生活饮用水卫生标准”准则》评价。结果饮用地面水的占32．5％、地下水的占67．5％，集中式供水的占62．8％，分散式供水的占37．2％，细菌学指标合格率较低；有卫生厕所的占45．4％，生活垃圾随意堆放的占70．0％，生产性垃圾收集堆放的占90．4％，生活污水随意排放的占12．9％，明沟排放的占82．4％，排放河流的占97．4％；生产性污水明沟排放的占96．1％，排放河流的占86．9％；农户喝开水习惯的占91％。家庭垃圾、污水来源为生活垃圾、生活污水。结论农村饮水水源以地下水为主，取水方式以集中式供水为主；改厕进度慢，垃圾污水缺乏治理。为此，要加快农村改水、改厕进度，治理垃圾污水。为制定该县农村饮用水安全发展规划，提出农村改厕与粪便无害化处理，垃圾污水治理策略及社会主义新农村建设提供科学依据。     

对武汉市医疗垃圾处理的调查分析

为了解武汉市医疗垃圾处理现状，为制定相应的对策和应急预案提供依据，对武汉市不同规模、不同性质的30所医院进行了医疗垃圾处理相关情况的调查。发现：（1）各医院对医疗垃圾处理的重视程度普通有所提高，但不同性质、规模的医院之间存在差异；（2）大型综合性医院、中型综合性医院、小型综合性医院、企业职工医院、专科医院平均每床日产生医疗垃圾量分别为0．49kg、0．53kg、0．55kg、0．46kg、0．83kg；不同性质、规模的医院平均每日产生的医疗垃圾量有显著性差异，但每日每床产生的医疗垃圾量没有显著差异；（3）医院每日产生的医疗垃圾量与医院病床数、病床使用率有密切相关关系，与年出院人次有密切相关关系；（4）不同性质、规模的医院对医疗垃圾的收集、储存和处理方式有显著差异。针对调查中发现的在医用垃圾管理、收集、储存、运输、处理方面存在的问题提了建议。     

Risk perception and occupational accidents: a study of gas station workers in southern Brazil

The present study aimed to identify the perceptions of gas station workers about physical, chemical, biological and physiological risk factors to which they are exposed in their work environment; identify types of occupational accidents involving gas station workers and; report the development of a socioenvironmental intervention as a tool for risk communication to gas station workers. A quantitative study was performed with 221 gas station workers in southern Brazil between October and December 2010. Data collection was performed between October to December 2010 via structured interviews. The data were analyzed using SPSS 19.0. The participants identified the following risk types: chemical (93.7%), physical (88.2%), physiological (64.3%) and biological (62.4%). In this sample, 94.1% of gas station workers reported occupational accidents, and 74.2% reported fuel contact with the eyes (p < 0.05). It is concluded that workers perceive risks, and that they tend to relate risks with the occurrence of occupational accidents as an indicator of the dangerous nature of their work environment.     

Two year follow-up of a garbage collector with allergic bronchopulmonary aspergillosis (ABPA)

BACKGROUND: Separate collection of biodegradable garbage and recyclable waste is expected to become mandatory in some western countries. A growing number of persons engaged in garbage collection and separation might become endangered by high loads of bacteria and fungi. Case history and examination A 29 year old garbage collector involved in emptying so-called biological garbage complained of dyspnea, fever, and flu-like symptoms during work beginning in the summer of 1992. Chest x-ray showed streaky shadows near both hili reaching into the upper regions. IgE- and IgG-antibodies (CAP, Pharmacia, Sweden) were strongly positive for Aspergillus fumigatus with 90.5 kU/L and 186%, respectively. Total-IgE was also strongly elevated with 5430 kU/L. Bronchial challenge testing with commercially available Aspergillus fumigatus extract resulted in an immediate-type asthmatic reaction. Two years later he was still symptomatic and antibodies persisted at lower levels. CONCLUSIONS: Our diagnosis was allergic bronchopulmonary aspergillosis (ABPA) including asthmatic responses as well as hypersensitivity pneumonitis (extrinsic allergic alveolitis) due to exposure to moldy household waste. A growing number of persons engaged in garbage collection and handling are exposed and at risk to develop sensitization to fungi due to exposure to dust of biodegradable waste. Further studies are necessary to show if separate collection of biodegradable waste increases the health risks due to exposure to bacteria and fungi in comparison to waste collection without separation.     

The evaluation of the physiological workload in the Brazilian legislation should be revised! The case of garbage collectors in Rio de Janeiro

The physiological workload (PW) involved in garbage collection was assessed in a probabilistic sample of 70 Rio de Janeiro city garbage collectors to determine the adequacy of Brazilian labor legislation regarding classification of work. PW was measured as energy expenditure (EE) and heart rate (HR) during total work time (TT) and actual time (AT) in garbage collection on 4 consecutive days. Median EE values were 288.4 and 319.1 kcal.h-1 during TT and AT, respectively, indicating moderately intense work according to Brazilian legislation. However, PW was considered heavy when work classifications based on individual response to work were used: 1) ratio of EE and resting metabolic rate was above 5.0, indicating heavy workload according to the WHO; 2) mean percentage of maximal EE was higher (36.2 and 41.1% for TT and AT, respectively) than the limit for garbage collection (30%) suggested as maximal for Dutch workers; and 3) percentage of maximal HR reserve was also higher than 30% (32.2 and 37.5% for TT and AT, respectively). These results indicate the need for a revision of the workload classification in the Brazilian legislation to take individual workers' characteristics into account.     

Hospital waste management status in university hospitals of the Fars province, Iran

Hospital waste contains large quantities of hazardous materials. In Iran, as in many developing countries, not much attention has been paid to this matter. Little information is available regarding the generation and disposal of medical waste in Iran, and this fact hinders planning for a better management of the aforementioned waste. This paper describes a survey performed on the collection and disposal of waste in the university hospitals of the Fars province, which are the medical referral centres in the southern half of the country, and the results obtained are fully discussed. The lack of separation between hazardous and non- hazardous waste, an absence of necessary rules and regulations applying to the collection of waste from the hospital wards and the on-site transport to a temporary storage location, a lack of proper waste treatment, disposal of hospital waste along with municipal garbage, insufficient training of personnel, insufficient personal protective equipment and lack of knowledge regarding the proper use of such equipment, were the main findings. For a rapid improvement of existing conditions, performing extensive research for the assessment of present situation in the hospitals of this country, compilation of rules and establishment of standards along with effective training for the personnel is recommended.     

Informal recycling and occupational health in Santo André, Brazil

The collection of recyclables is a widespread activity among urban poor, particularly in countries with large socio-economic disparities. The health of recyclers is at risk because of unsafe working conditions, socio-economic exclusion, and stigmatization. Our study focuses on health problems and occupational risks of informal recyclers (in Brazil known as catadores). In 2005 we conducted an in-depth socio-economic survey of 48 informal waste collectors in Santo André, Brazil. Almost all workers reported body pain or soreness in the back, legs, shoulders, and arms. Injuries, particularly involving the hands, are frequent. Flu and bronchitis are common, and one recycler had contracted Hepatitis-B. Policy makers at all government levels need to address the pressing health issues affecting large numbers of informal recyclers in Brazil and abroad. Recyclers need to be involved in the design of waste management policies, and the public must be educated about the important environmental service these people provide.     

A comparative study on the medical waste disposal in some hospitals in Alexandria

Though healthcare services aim to reduce the health problems and prevent the potential risks to the health of the community. These services create wastes which are considered as hazardous materials due to the higher potential of infection and injury possessed by these wastes than any other type of waste. Healthcare waste management is an integral part of healthcare services, and can create harm through inadequate waste management; thus reducing the overall benefits provided by healthcare centers. In the current study, a survey for medical waste disposal was performed in order to examine the current status of medical waste disposal in some hospitals in Alexandria and to properly assess management of this type of hazardous waste. A questionnaire was designed for hospitals to assess the quantity of medical waste, collection, sorting, storage, transportation and way of final disposal. From the total waste generated by healthcare activities, almost 80% are waste similar to domestic waste. The remaining approximate of 20% is considered as hazardous waste. As Alexandria has about 3911 healthcare facilities providing medical services for people, a huge amount of medical waste are generated daily with about 208 tons generated per month. The results revealed that the most common problems associated with healthcare wastes are the absence of waste management, lack of awareness about their health hazards, insufficient financial and human resources for proper management, and poor control of waste disposal. The current situation of medical waste disposal in Alexandria is depending on incinerators. Some of these incinerators are not working anymore. Incinerations as a system is not accepted at the time being in most developed countries due to the risks associated with it and suitable substitution management system for medical waste disposal is now taking its place.     

2016—2018年陕西省农村垃圾和污水处理现状分析

目的了解陕西省农村垃圾污水的处理现状及动态变化,为有关部门制订政策和措施提供依据。方法2016—2018年每年在全省各设区市分层随机选取30个涉农区县中的600个行政村作为监测点,3000户作为监测户,通过査阅资料、访谈、现场观察等方法获得监测数据。结果3年垃圾处理厂农村人口覆盖率分别为28.31%、36.10%、39.36%,污水处理厂覆盖率分别为12.27%、20.39%、15.02%,年度差异均有统计学意义(χ2=23.24、22.42,P=0.00);3年统一收集生活垃圾监测点占比分别为30.50%、43.67%、51.00%,焚烧垃圾监测点占比分别为16.67%、15.00%、8.33%,年度差异均有统计学意义(χ2=53.25、20.19,P=0.00);生活污水通过管道排放监测点占比分别为12.67%、11.17%、31.17%,排入处理厂监测点占比分别为4.33%、6.00%、15.17%,年度差异均有统计学意义(χ2=99.45、52.50,P=0.00)。结论近年陕西省农村垃圾污水处理情况有所改善,但还有很大的提升空间,建议加大环保宣传和政府投资力度,加强日常监督,建管并重,控制垃圾污水的随意堆放、排放,提高垃圾污水处理率。     

Household solid waste bagging and collection and their health implications for children living in outlying urban settlements in Salvador, Bahia State, Brazil

This paper presents a study on the bagging and collection of household solid waste and the health implications for children. The research was conducted in nine human settlements on the outskirts of Salvador, Bahia State, Brazil. Intestinal nematode infection, predominantly involving Ascaris lumbricoides, Trichuris trichiura, and hookworms, was used as an epidemiological indicator in 1,893 children from 5 to 14 years of age. The study also included diarrhea incidence and nutritional status as shown by anthropometric indicators in 1,204 children less than 5 years of age. There was a higher prevalence of the three nematodes in children living in households without proper bagging/isolation and collection of household solid waste as compared to those in areas with regular garbage collection and adequate isolation of solid waste. The differences were statistically significant when other socioeconomic, cultural, demographic, and environmental risks factors were considered in the analysis. Similar results were also observed for epidemiological indicators, diarrhea incidence, and nutritional status.     

Environment, wealth, inequality and the burden of disease in the Accra metropolitan area, Ghana

The study examines environmental problems and adverse impacts on the health of urban households in the Accra metropolitan area, Ghana. Accra is faced with severe inadequacy of urban infrastructure in the face of rapid population growth in the metropolis. More than half of the city's population do not have access to solid waste collection services. Only 39.8% of households have indoor pipe and over 35.0% of households depend on unsanitary public latrines whilst 2.5% do not have access to toilet facilities. Human excrement, garbage and wastewater are usually deposited in surface drains, open spaces and streams in poor neighbourhoods. The resultant poor sanitation has serious health impacts as more than half of reported diseases are related to poor environmental sanitation. The majority of households depend on solid fuels for cooking and this leads to indoor air pollution and high incidence of respiratory infections. Poor households bear a disproportionately large share of the burden of environmental health hazards than their wealthy counterparts, due to their particular vulnerability resulting from inadequate access to environmental health facilities and services.     

Household medical waste disposal policy in Israel

Background

Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies.

Methods

In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal.

Results

In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the “polluter pays” principle.

Conclusions

Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the “polluter pays” principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.

     

A spatial analysis of the physical and social environmental correlates of discarded needles

The role that the urban environment plays in influencing drug users' injection and needle disposal decisions is poorly understood. We identified potential attractors and deterrents of needle discarding, and then used a geographic information system (GIS) to quantify these factors for a neighborhood in Montréal, Canada. In multivariate logistic regression, discarded needles were found to have more associations with physical factors than with social factors. Visual exposure and proximity to a single-room occupancy hotel, a pay phone, an adult service or a pawnshop were important physical environmental predictors. These findings are discussed in relation to developing public health and urban design-based harm reduction approaches to needle discarding in public space.     

Geographical variations of motor-vehicle injuries in Quebec, 1983-1988

Data furnished by the Régie de l'Assurance Automobile du Québec (RAAQ) were used to describe the geography of motor vehicle accidents in the province of Quebec for the period 1983-1988. These were also used to evaluate the risk factors associated with zones of high risk with regards to accidents for the 97 Municipalités Régionales de Comté (MRC). The results demonstrate that non-severe accidents are more frequent in the urban context. On the other hand, severe accidents are more frequent in the rural context. The Standard Morbidity Ratio (SMR) highlights those MRC's with the risk of severe or non-severe accidents, where risks are twice that of Quebec as a whole. The demographic characteristics (age, sex) of the driver and passengers and the place of the accident (region, density) were used in the model LOGIT to evaluate risk factors associated with high risk zones. Results of the model for those severely injured are different from those for non-severely injured people. This holds true for the location of accidents as well as for demographic characteristics. In both models, women and people over 65 years of age are low-risk groups for accidents. The authors indicate certain action to be undertaken in Quebec by the Government to improve this situation.     

Environmental and health impacts of household solid waste handling and disposal practices in third world cities: the case of the Accra Metropolitan Area, Ghana

Inadequate provision of solid waste management facilities in Third World cities results in indiscriminate disposal and unsanitary environments, which threatens the health of urban residents. The study reported here examined household-level waste management and disposal practices in the Accra Metropolitan Area, Ghana. The residents of Accra currently generate large amounts of solid waste, beyond the management capabilities of the existing waste management system. Because the solid waste infrastructure is inadequate, over 80 percent of the population do not have home collection services. Only 13.5 percent of respondents are served with door-to-door collection of solid waste, while the rest dispose of their waste at communal collection points, in open spaces, and in waterways. The majority of households store their waste in open containers and plastic bags in the home. Waste storage in the home is associated with the presence of houseflies in the kitchen (r = .17, p < .0001). The presence of houseflies in the kitchen during cooking is correlated with the incidence of childhood diarrhea (r = .36, p < .0001). Inadequate solid waste facilities result in indiscriminate burning and burying of solid waste. There is an association between waste burning and the incidence of respiratory health symptoms among adults (r = .25, p < .0001) and children (r = .22, p < .05). Poor handling and disposal of waste are major causes of environmental pollution, which creates breeding grounds for pathogenic organisms, and the spread of infectious diseases. Improving access to solid waste collection facilities and services will help achieve sound environmental health in Accra.     

苏州市吴中区农村饮用水与环境卫生现状调查

目的掌握苏州市吴中区农村饮用水、改厕和粪便处理现状,了解农村垃圾污水治理情况,为制定我市农村饮用水安全及社会主义新农村建设规划提供科学依据。方法按吴中区人口比例分层随机抽取10个行政村,每个村随机选取10户入户调查。结果集中式供水人口占农村总人口的90.9%,分散式供水人口占9.1%;采集水样11份,合格率为63.6%,4份不合格项目主要以大肠菌群为主。卫生厕所使用户数占90.5%;生活性垃圾和污水主要为随意排放;生产性垃圾主要为收集堆放,生产性污水主要为管道排放。结论吴中区农村饮用水和环境卫生现状还有待于进一步改善。     

Improper office disposal of needles and other sharps: an occupational hazard outside of health care institutions

An employee of a private disposal company suffered a finger needlestick injury while collecting waste at curbside from a building containing medical offices. Subsequent inspection of the contents of the garbage bags revealed the presence of used syringes and unsheathed needles. The Ministry of the Environment has developed a regulation and guidelines for the handling and disposal of biomedical waste including needles and other sharps. These specify that approved carriers and receivers are required for disposal; properly decontaminated waste is considered non-hazardous solid waste and can go to landfills. However, responsibility for curbside pickup of waste lies with municipalities; some municipalities have enacted by-laws which prohibit collection of this waste at the curbside. This incident illustrates that improper disposal of biomedical waste (including that from private practitioners' offices) may occur despite efforts to control its handling, and that needlestick injuries can occur outside of health care facilities among personnel who are not health care workers. Efforts are needed to increase the level of awareness among health professionals regarding their responsibility to ensure proper biomedical waste disposal from private offices. In addition, efforts should be made to bridge the gap between all levels of government regarding the disposal of biomedical waste.