OCCUPATIONAL AND OCCUPATIONAL AND ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH

ISSUES OF ISSUES OF SOLID WASTE MANAGEMENT SOLID WASTE MANAGEMENT IN DEVELOPING COUNTRIESIN DEVELOPING COUNTRIES

by Sandra Cointreau

HEALTH RISK FACTORS OF HEALTH RISK FACTORS OF SOLID WASTE:SOLID WASTE:

Feacal Matter, Blood, Body Fluids and Diseased Dead Animal Matter

Particulates, Bioaerosols Hazardous Chemicals, Heavy Metals Volatile Organics, Volatilized Heavy Metals Lifting Exertion, Vibration Slides, Accidents, Fires Noise

El Salvador, 1998

Bombay, India, 1995

Seoul, Korea, 1990

Izmir, Turkey, 1994

POORER COUNTRIES have POORER COUNTRIES have greater greater Occupational Health RisksOccupational Health Risks

for Solid Waste Workersfor Solid Waste Workers Collection is by labor-intensive

systems with no protection Recycling is on exposed piles of

mixed waste with no protection Most waste pickers are children

or women of child-bearing age Disposal is by open dumping,

usually with open burning Mauritius, 1998

POORER COUNTRIES have POORER COUNTRIES have greater greater Public Health RisksPublic Health Risks from from

Uncollected WasteUncollected Waste

Collection service levels are low in poorer countries: 30-60% in Low Income Countries 50-80% in Middle Income Countries 90-100% in High Income Countries

POORER COUNTRIES have POORER COUNTRIES have greater greater Public Health RisksPublic Health Risks from from

Unsafe DisposalUnsafe Disposal

Safe Disposal is not prevalent in poorer countries: 0-5% safe disposal in Low Income Countries 5-10% safe disposal in Middle Income Countries 90-100% safe disposal in High Income Countries

The Relative Risk Of Solid The Relative Risk Of Solid Waste Work Can Be Waste Work Can Be

SignificantSignificant Solid Waste Workers in Denmark are 1.5 times

more likely to have Occupational Disease and Injury than other workers (Denmark country-wide statistics, 1995)

Risks to Solid Waste Workers in low income countries are expected to be much higher because worker protection is not required

OCCUPATIONAL OCCUPATIONAL DISEASEDISEASE RISK (RR= Relative Risk):RISK (RR= Relative Risk):

6 RR of Infectious Disease (Denmark country data)

2.6 RR of Allergic Pulmonary Disease (Denmark country data)

2.5 times more risk of Chronic Bronchitis (Switzerland study)

1.2-1.4 times more risk of Hepatitis (Italy study)

3 times more risk of Parasites (India study)

2 times more risk of Coronary Disease Events (USA study)

RR means “relative risk” and refers to increased risk levels

based on statistically valid and controlled studies

Intestinal Parasite Infection Intestinal Parasite Infection Among Waste Pickers:Among Waste Pickers:

65% incidence in Bangkok, Thailand

98% incidence in Manila, Philippines (child waste pickers only)

97% incidence in Olinda, Brazil

92% incidence in Calcutta, India

Bombay, India, 1995

Bio-aerosol Levels:Bio-aerosol Levels: 10-1000 times Higher near the

truck loading hopper (Switzerland, Denmark local studies)

2-10 times Higher inside materials recovery plants (USA, Finland local studies)

2-4 times Higher at sanitary landfills (Italy local studies)

Izmir, Turkey, 1994

Particulate Levels:Particulate Levels:

2-25 times Higher at open dumps (Thailand, Philippines local studies)

4-10 times Higher at materials recovery sorting stations (Finland local study)

Dominican Republic, 1998

Pulmonary Function:Pulmonary Function:

23% Dumpsite Workers with Abnormal Pulmonary Function (India local study)

40% Dumpsite Waste Pickers with Abnormal Pulmonary Function (Thailand local study)

53% Dumpsite Child Waste Pickers with Abnormal Pulmonary Function (Philippines local study)

Blood Lead Levels:Blood Lead Levels: 70% Dumpsite Children

Pickers above WHO lead guideline --children pickers mean lead was 2.5 times higher than in control slum children (Philippines local study)

1.5-3 times Higher in MSW Incineration Workers than in Heating Plant Workers (USA local study) Quezon City, the Philippines,

1995

OCCUPATIONAL OCCUPATIONAL INJURYINJURY RELATIVE RISK (RR= Relative RELATIVE RISK (RR= Relative

Risk):Risk): 5.6 RR for Accidents

(Denmark country data)

10 risk for Accidents (USA, local study 20 years ago)

1.9 RR for Musculoskeletal Problems (Denmark country data)

4 risk for Musculoskeletal Restrictions from Arthritis (USA local study) Quito, Ecuador, 1994

Dumpsite Injuries:Dumpsite Injuries:

Calcutta, India quarterly injuries among waste pickers: 69% with cuts 33% with pin pricks 16% with eye injuries 49% with dog bites 16% with rat bites

Bangkok, Thailand sources of injuries: 88% from glass 73% from needles 30% from bamboo 25% from metal

Tema, Ghana, 1998

Slides at Open Dumps:Slides at Open Dumps: Istanbul, Turkey

39 killed, 1993 O Portino, Spain

1 killed, 250 evacuated, 1994

Calcutta, India 2 killed, 1992

Bogota, Colombia no deaths, 1997

Manila, the Philippines over 50 killed, 2000 Tashkent, Uzbekistan, 2001

Hazardous Gases at Solid Waste Hazardous Gases at Solid Waste Facilities:Facilities:

benzene, toluene, ethylbenzene, methylene chloride, dichloromethane, carbon tetrachloride in landfill gas

chlorinated and brominated dioxins and furans in incinerator stack gas

volatilized heavy metals at burning open dumps elevated levels of carbon monoxide at landfills

PUBLIC HEALTH RELATIVE PUBLIC HEALTH RELATIVE RISK (RR):RISK (RR):

1.3-1.8 risk of Cancer for residents with 4 km of 20 year old Landfill (Canada local study)

1.4 risk of Liver Cancer for residents within 2 km of Incinerators (Great Britain country study)

Diseases from Vectors in Contact Diseases from Vectors in Contact with Solid Waste:with Solid Waste:

Hanta Virus, Plague, and Leptospirosis increase with exposure to rat droppings and urine -- more solid waste means more rats

Dengue Fever increases where uncollected solid waste (i.e., tires, cans) holding water provides mosquito breeding sites

Bacterial Infections spread by houseflies which have come in contact with feacal material in solid waste

Diseases from Eating Undercooked Diseases from Eating Undercooked Meat from Animals Raised in Meat from Animals Raised in

Contact with Solid Waste:Contact with Solid Waste: Trichinosis increases where

pigs and bear feed on solid waste with uncooked meat containing whipworm

Taeniasis increases where pigs, beef and dogs feed on solid waste with human and animal feacal matter containing tapeworm Dominican Republic, 1998

New Initiatives Point the WayNew Initiatives Point the Way Private Subscription by hospitals with

licensed private operators to handle segregated biomedical wastes

Hyderabad, India, 2001

New Initiatives Point the WayNew Initiatives Point the Way

Manila, the Philippines, 1996

Private Subscription for biomedical wastes

New Initiatives Point the WayNew Initiatives Point the Way Protective Gear for workers

specified in service agreements

Khulna, Bangladesh (syringes), 2001 Tema, Ghana, 1998

New Initiatives Point the WayNew Initiatives Point the Way

Neighborhood composting systems lessen the need to transport waste to disposal.

Composting produces less greenhouse gas than landfill disposal, and also destroys disease micro-organisms.

Dakha, Bangladesh, 2001

New Initiatives Point the WayNew Initiatives Point the Way

Greater containment of waste from the source to the point of transport lessens worker contact with waste.

Containers sized for easier lifting lessen back injuries.

Ahmedebad, India, 2001

New Initiatives Point the WayNew Initiatives Point the Way

Yr. 2000 Indian Law mandates biodegradation of putrescible organics in waste Composting (aerobic

decomposition) Vermi-composting (worm

decomposition) Biomethanization (anaerobic

decomposition)Trivandum, India, 2001

New Initiatives Point the WayNew Initiatives Point the Way

Yr. 2000 India Law mandates upgrading of all open dumps to sanitary landfill standards Leachate control Landfill gas control Stable slopes Compaction and cover Recultivation

Ahmedabad, India, 2001