Occupational Health and Safety Risk Assessment of Child Labour in Scavenging Sector in Lahore

Occupational Health and Safety Risk
Assessment of Child Labour in Scavenging

Sector in Lahore
Report of research study

by
Centre for the Improvement of Working Conditions & Environment

Labour & Human Resource Department Government of the Punjab
Lahore
Author:
Saeed Ahmed Awan,

MSc Occupational Health (UK) MSc. Chemistry
Tamgha-e-Imtiaz, Laureate of Tech Award of Innovation
Director Centre for the Improvement of Working
Conditions & Environment (CIWCE), Lahore Pakistan
Year of Publication: 2003
Saeed Ahmed Awan
Contents
Main Findings ------------------------------------------
01
Introduction -----------------------------------------------------------
04
1.1
Background Information -------------------------------------------------------------------------------
04
1.2
Objectives ------------------------------------------------------------------------------------------------
06
Study Design & Methodology -------------------------------------
08
2.1
Data compilation and analysis ------------------------------------------------------------------------
12
2.2
Sample Size of Significance ---------------------------------------------------------------------------
12
Chapter 1
Chapter 2
2.3
2.2.1
Sample Proportion Z-test ------------------------------------------------------
12
2.2.2
Sample Mean t-Test -------------------------------------------------------------
12
Assessment of Workplace Environment
13
Profile of Working Children, Adults and Control Group ---
14
3.1
Types of materials Collected --------------------------------------------------------------------------
15
3.2
Age and Gender Profile of the Respondents ---------------------------------------------------------
16
3.3
Immigration Status of the Respondents --------------------------------------------------------------
18
3.3
Family Profile of the Respondents --------------------------------------------------------------------
19
3.4
Work Experience ----------------------------------------------------------------------------------------
21
3.5
Loads ands modes of Transport -----------------------------------------------------------------------
21
3.6
Age of Starting work ------------------------------------------------------------------------------------
22
3.7
Working Hours Pattern --------------------------------------------------------------------------------
22
3.8
Living Arrangements -----------------------------------------------------------------------------------
23
3.9
Sports and recreation -----------------------------------------------------------------------------------
24
3.10
Psychological Problems and attitudes ----------------------------------------------------------------
24
3.11
Nutritional Status of Respondents ---------------------------------------------------------------------
25
3.12
Injuries at Work ------------------------------------------------------------------------------------------
26
3.13
Health Complaints of the Respondents ---------------------------------------------------------------
28
Health and Safety Indicators of the Working Children,

Control Group and the Adult Workers -------------------------
31
4.1
Weight and Height of Children ----------------------------------------------------------------------
31
4.2
Physical Appearance and Personal Hygiene ---------------------------------------------------------
33
4.3
General Health Examination ---------------------------------------------------------------------------
34
4.4
Respiratory health Indicators and diseases ----------------------------------------------------------
36
Chapter 3
Chapter 4
4.5
Skin Allergies and diseases ----------------------------------------------------------------------------
39
4.6
Musculo-skeletal Problems ----------------------------------------------------------------------------
40
4.7
ENT Examination --------------------------------------------------------------------------------------
41
4.8
Eye Problems --------------------------------------------------------------------------------------------
42
4.9
Blood Examination --------------------------------------------------------------------------------------
43
4.10
Urine Examination --------------------------------------------------------------------------------------
44
4.11
Screening for Hepatitis and HIV ----------------------------------------------------------------------
45
Assessment of Workplaces, Living Conditions and Task

Analysis ----------------------------------------------------------------
46
5.1
General Hygiene Thermal Comfort and other Facilities ------------------------------------------
47
5.2
Dust Exposure of the Workers -------------------------------------------------------------------------
48
5.3
Task Analysis --------------------------------------------------------------------------------------------
48
5.4
Living Conditions --------------------------------------------------------------------------------------
51
53
6.1
Combating Health & Safety Hazards to Child Workers in

Scavenging Sector Need for an Action Oriented Approach --------------------------------------------------------------
6.2
Reduction in Working Hours -------------------------------------------------------------------------
54
6.3
Banning of Hazardous Activities ----------------------------------------------------------------------
54
6.4
Awareness Programmes -------------------------------------------------------------------------------
55
6.5
Healthcare facilities -------------------------------------------------------------------------------------
55
6.6
Population Control --------------------------------------------------------------------------------------
56
6.7
Skill Training of the Adults ----------------------------------------------------------------------------
56
Chapter 5
Chapter 6
53
Improvement of living and working conditions -----------------------------------------------------
Appendix -A
Forms used for Data Collection -----------------------------------
57
-1-
Main Findings
A total of 102 scavenging children (93 boys and 9 girls) from Lahore
city alongwith, 25 adults, who had been working as scavengers since
childhood were examined for health and safety risks they face.
A control group of 52 school-going non-working children (all male)

from working class localities in Lahore were also examined. The data of
health and safety indicators of working children was compared with that
from control group.
The scavengers were involved in collecting and sorting of urban/commercial/industrial/hospital wastes and were interested mostly in
paper, plastic, glass, metal edibles and bones.
63% of the working children were immigrants of Afghan origin.

The average family size of working children was 8.9, while those of
control group was 6.5. The difference was found statistically significant.
The mean experience of working children was 4.6 years, while that of
adults it was 15.3 years
Majority of the children told that they had started working as scavengers
when they were in the age group of 10-14 years.
Most of the scavengers worked very early (around 4:00 a.m.) and late in
night, while rested or sorted the collected items in the noon. Mean
working hours for children were 11 hours.
Most of scavengers (60%) told that they live alongwith other adult and
child co-workers at the places provided by either the contractor or rented. In some cases, 8-10 workers (children and adults) slept on one charpoy or floor of a room.
Most of the child workers (95%) reported disturbed sleep, some reported physical punishment (19%), most (60%) disliked their work.
-2-
A sizeable proportion (21%) of the working children told that they ate
edibles from the scavenged items. Use of meat was much higher in the
working children than the control group, which was attributed to cultural differences.
62% of children and 84% of adults reported injuries during work, which
included cuts, falls, road accidents, dog bites and violence.
Body aches and pains (caused by malnutrition, excess loads, long and
odd working hours) were the most frequent health related complaints of
the working children. Ratio of these complaints was significantly higher
in the working children than the control group.
The basic health indicators (height, weight, pulmonary functions) when

compared across the same age groups, were much poor in the working
children than the control group children of same age groups.
Personal hygiene of the child scavengers was very poor compared with
adults or control group.
The ratios of anaemia, palpable lymph nodes, and worm infestation was
much higher in the working children than the control group and the differences were statistically significant.
The ratio of respiratory diseases and disorders (pain chest, cough,

chronic bronchitis, TB, dysponea) was much higher in the scavenging
children than the control group. In most cases the difference in proportions was statistically significant.
A higher proportion of scavenging children and adults suffered from

skin problems (cuts/bruises, scabies, dermatitis) than the control group
children.
Musculo-skeletal disorder like low back pain and pain neck and shoulder were very common in the working children and the ratios were statistically significant compared with those in the control group.
The ratios of ENT disorders (Rhinitis, tonsillitis and ear infections) were
2-8 times higher in the working children than the control group.
-3-
Eye problems were 2 times more common in the scavenging children

than the control group.
The blood examination revealed twice the rate of abnormalities in the

working children in esr and hb than in the control group, similar was the
case with urine examination, which indicated probability of urinary tract
infections in a large proportion of working children and adults.
-4-
Chapter-1
Introduction
1.1 Background Information
Child labour has become one of the most challenging issues of modern times.
The hazardous and exploitative forms of child labour are a matter of great concern, as they endanger the safety and health of child workers at a tender age.
The scars left by exposure to health and safety hazards at an early age leave a
permanent mark on the physical and psychological personality of a person.
During the recent years, the scavenging of garbage for useful items like glass,
plastic, wood, metals etc., has become a lucrative business. The arrival of refugees from Afghanistan has swelled the ranks of scavengers and this has become a well organized trade mainly in the big metropolitan cities of the country. Besides the adults, a number of child workers are seen prowling the garbage dumps, commercial and municipal waste sites and even hospital waste
sites.
The children and adults involved in this sector face severe risks to their health
and safety, which are compounded by long working hours, lack of access to
basic housing, sanitation and health facilities, and malnutrition.
The main health and safety hazards faced by child workers in this sector can be
classified into following categories:
-5-
Exposure to toxic and hazardous materials from searching

with bare hands into the potentially dangerous waste sites.
Injuries from bruises and cuts by sharp objects in the waste.
Ingestion of contaminated and putrefying foodstuffs leading
to illnesses.
Musculoskeletal problems due to lifting of heavy loads and
their manual transportation
Exposure to harmful biological agents including fatal and
communicable diseases from the hospital and municipal
waste sites.
Abuse in the form of violence and verbal and physical assault
Malnutrition and poor healthcare resulting in impeded physical development.
Poor housing and living conditions exposing the workers to a
number of health and other hazards.
The Government of Pakistan in the year 2001 ratified ILO Convention 182 on
Worst Forms of Child Labour. Under the auspices of ILO-IPEC and Ministry
of Labour, Government of Pakistan, a series of consultative tripartite and
stake-holders workshops were held during the year 2002 to identify the occupations and processed hazardous for the children. Considering the hazards involved in the scavenging, this sector was identified as one of the occupations
deemed to be hazardous for children below the age of 18 years and this process
was listed in the consensus list of 29 occupations & processes identified at national level after the consensus at provincial levels was achieved.
Furthermore a result of consultations among stakeholders, the scavenging\g
sector was identified as an area of priority action for direct and indirect interventions under the Time Bound Programme (TBP) to be launched soon by the
Government with the technical support of ILO-IPEC.
During 2003, the ILO Office in Islamabad requested the Labour and Human
Resource Department in the Government of the Punjab to provide expert ser-
-6-
vices of Centre for the Improvement of Working Conditions and Environment

Lahore to carry out a risk assessment of occupational health and safety hazards
faced by the child workers in the ragpicking/scavenging sector. A small study
was planned and carried out during June 2003 to assess the OSH problems of
such workers.
1.2 Objectives
The main objective of the study was to provide preliminary data on the health,
safety and working conditions of the children involved in the scavenging. The
data of study is intended to be used for:
1. Identification and quantification of the health and safety risks posed by

scavenging.
2. Formulation of methodologies and plan of action for proper interventions in
this sector.
3. To use the findings as training and awareness tool for the parents, community, traders, and other concerned stake-holders in this and other sectors of
economy where child labour is found.
4. Identification and provision of guidelines for eventual reduction and/or removal of hazardous conditions in Scavenging to ensure the safety and
health of child and adults workers.
5. Assessment of the workplaces and the tasks in such a way that:
a. A list of various tasks involved in this occupations was to be developed.

b. Characterization of each task on being light, regular, hazardous
for three age categories 5-10 years, 11-14 years, 15-18 years
-7-
c. Scientific/medial evaluation of each task to determine requisite

minimum age of person to perform each particular task; which
may be referred as cut-off age
d. Task determination included:
- nature of the task, variety of tasks during the workday
- duration of the task, time of day the task occurs
e. It was ensured that enough number of children are interviewed
who are or may be performing those tasks
6. Formulation of methodologies and plan of action for proper interventions in
this sector.
-8-
Chapter 2
Study Design & Methodology

The universe for the study were all the children between the age of 5 to 18
years involved in scavenging in Lahore city and its surrounding areas. For the
purpose of study following samples of different categories were selected:
102 working children reflecting the age and gender variations in the
universe as well as the various categories of wastes involved.
52 control group children of similar age/gender groups as the working
children, except that these were regular school going children belonging
to the same localities and socio-economic strata as the working children
25 adult workers (over 18 years), who have been working as scavengers
since childhood. The data from this group is expected to shed light on
the cumulative and long term impact of work in this sector.
10 waste sites (including dumping, collection and re-purchase sites) reflecting various steps involved in the sector, for the purpose of risk assessment of the working environment and identification of potential
hazards.
10 living places of those children were also visited who exhibited health
impairment for the household observations and parent interviews regarding health/hygiene issues.
A preliminary survey was carried out in and around Lahore city to observe the
processes and discussions were held with key informants including child scavengers, adult workers, contractors, to assess the pattern of work and the processes involved. This information proved vital in sample selection, which was
done in such a way that the scavengers involved in collection, sorting or selling
of different categories of wastes were selected as respondents. Furthermore the
-9-
study was spread to different localities of Lahore city, where sizeable number
of scavengers were found. Effort was made to reflect the different ethnic
groups involved with the work. Following table provides the sampling plan for
selection of respondent working children for the study
Sampling Plan for selection of child workers for the study

Main Areas with
Scavenging Concentration
Green Town/
Kotlakhpat
Fruit Mkt K.
Lakhpat
T. Niaz Baig
Gulberg III
Baghbanpura
Badami Bagh Fruit

Mkt
B. Bagh Industries
Area
Shahdara
Bund Road
Baidian Road
Baker mandi
Sagian Bridge
Kahna Chingi Amer
Sidhu
Inner city areas
Model Town
Township
G.T. Road/Batapur
Iqbal Town
TOTAL
Type of Material
Approx No.
of Collection/Sorting
Sites
No. of
sites selected for
Study
No. of
child
workers
at the
selected
sites
40
No. of
child
workers
included
in the
study
6
Urban waste Hospital

waste Industrial Waste
Fruit & Vegetable
10
5
50
Bone. Urban Waste

Urban H.C. waste industrial
Urban municipal/industrial waste +
hospital
Fruit & Vegetable
03
05
01
01
200
100
07
5
20
02
175
18
03
160
Industrial Auto parts Etc.
15
02
175
Industrial Waste Municipal waste

Industrial waste
Industrial waste municipal waste
Bone Urban waste
01
70
25
07
02
02
250
80
5
4
07
10
7
02
01
01
50
25
15
05
03
03
02
30
10
10
03
45
03
05
01
02
50
60
8
7
04
168
02
34
30
1605
5
102
Health care waste Industrial waste urban waste

Urban waste H. care
waste
Urban waste municipal
waste
Municipal urban waste
Auto part Industrial
waste
Municipal urban waste
- 10 -
To record the data, questionnaires and forms were developed. Four kinds of
forms were be used for recording of data:
Form I was intended to collect background information about the child.
Besides recording data like age, gender and address etc., the investigators will inquire from the child about the size of his family, migration
status, his waking and sleeping pattern, schooling and literacy, working
pattern, rest breaks, recreation, game participation, physical punishment,
availability of foods and health complaints. Questions will also be asked
to assess the psychological stresses on the children. This questionnaire
will be administered by trained interviewers from CIWCE. All the questions were posed in Punjabi/Pushto (as was required depending on the
mother tongue of respondent) and the responses were recorded in English.
Form II was used by the occupational physician to record his observations based on the medical checkup and tests performed on each
child/adult. Data about weight, height, eyesight, was recorded. In order
to assess the impact of work on the lungs of children all the study population were given Pulmonary Function Test. The physician also carried
out examination of the limbs, respiratory system, evidence of injuries,
systemic exam, gastro-intestinal system, cardio-vascular system and
musculo-skeletal system. Blood and urine samples of the respondents
who consented to the tests were obtained and got analysed from the laboratory. The blood was analysed for hemoglobin level (to assess nutritional status) and ESR (erythrocyte sedimentation rate) in order to assess the infections among the respondents. The blood of both the working children and adults and the control group children was also screened
for Hepatitis B, C and HIV. The urine sample was analyzed for all the
standard urine parameters, which are discussed in relevant section in
this report.
For measurement of the pulmonary (lung) function of the respondents,
Vitalograph Spirometer was used. Spirometer is used to measure how
much air the lungs can hold and how well the respiratory system is able
to move air into and out of the lungs. All the respondent children and
adults were instructed on the technique for blowing air into the mouth
piece of the equipment. The children were asked to inhale deeply, close
the mouth tightly around the tube of spirometer and then exhale through
the tubing while measurements are taken by the instrument. Some of the
- 11 -
test measurements are obtained by normal breathing, and other tests require rapid and forceful inhalation and/or exhalation. The volume of air
inhaled or exhaled, and the length of time each breath takes are recorded
and analyzed. This test is used to determine the cause of shortness of
breath, to rule out any kind of obstructive disease that blocked breathing, or restrictive disease that limits the expansion and capacity of the
lungs. Spirometry is most often used to diagnose and monitor lung problems, such as chronic bronchitis, emphysema, pulmonary fibrosis,
chronic obstructive pulmonary disease (COPD), or asthma.
Form III was used to assess the conditions of working environment at
the workplaces. Data about the biological, physical and chemical exposures was collected by a trained industrial hygienist Dust monitoring
equipment was used to assess dust exposure during sorting at 3
worksites.
The study was carried out under the supervision of Mr. Saeed Awan, Director
CIWCE, who has around 15 years of experience in the field of occupational
health and safety in Pakistan and has also done a number of studies for occupational health and safety risk assessment of child workers in different sectors of
economy, both in Pakistan and abroad.
2.1 Data Compilation and analysis

The forms were designed with the consultation of experts in occupational
health, pediatrics, child psychology, industrial hygiene, data analysis etc. The
collected data was entered into database programme. All the forms were also
manually checked to remove any anomalies. All the questions in the data forms
collected from the field were coded and entered into a database designed for
this purpose. This database was later analysed by using SPSS and Excel software in order to calculate statistics of the study, to compare the results of controls versus working children and to establish correlations between work and
different occupational health and safety indicators if they existed. All the forms
were manually rechecked and edited for accuracy of the data and completeness
of information.
- 12 -
2.2 Sample Size of Significance

While comparing vital data between working and control group children, tests
of significance i.e. Z-test or t-Test1 (as appropriate) were applied for evaluating
the significance of difference in proportions and means of these groups in relation to health and safety indicators. The following two statistical formulae were
used to assess the significance of difference between two proportions and two
means. (M. Sher 1968). If the Z value was 1.96 or more than the difference
in proportions or means was considered as significant.
2.2.1 Sample Proportion Z-test
Z
P1 P2
p q ( 1 + 1 )
n1 n2
Where
P
=
n
=
Proportion
Sample Size
n1P1 + n2P2
n1 + n 2
1 - p
2.2.2 Sample Mean t-Test

t
=
s
(X1 X2 ) (1 - 2)
(
1 + 1)
n1
n2
An Introduction to Statistical Analysis for Economists, by J. J. Thomas
- 13 -
where
s2
= (n1 - 1 ) s21 + (n2 - 1) s22

n1 + n 2 - 2
where
= Mean of sample
2.3 Assessment of Workplace Environment

In order o assess the workplace hazards, 10 sites representing various stages
and processes of the scavenging business were visited in order to assess the
specific hazards posed by the workplaces. Form III (given in Appendix-A) was
used to record observations and measurements carried out in this part of assessment. These measurements were carried out by trained hygienist from the
CIWCE. For estimation of dust exposure of workers Method 0500 of US national Institute for Occupational Safety and Health (NIOSH) was used. The detailed method is attached as Appendix-B. Similarly for measurement of illumination levels in the workplaces a calibrated LUX meter was used.
The results of measurements were then compared with internationally recommended exposure limits.
In most cases the workplaces were also used as living quarters. A separate
Form-IV was used to assess the living conditions of 10 children showing signs
of sickness.
- 14 -
Chapter-3
Profile of Working Children, Adults

and Control Group
As described earlier the working children (below 18 years of age) and adults
(over 18 years of age) involved in various stages and processes concerned with
scavenging were selected for the study. Non-working and school going children belonging to class 9 and 10 studying in Government Boys High School
Township Lahore were selected as Control Group. These children were selected due to the fact that they belonged to a working class locality and their ages
were similar to those of the working children. All these children were interviewed by using a questionnaire which contained questions about the background, family profile, working pattern, nutritional status, recreational facilities, psychological problems and health and safety complaints. Only the working children and adults were asked questions about the nature of their work,
their working hours, health and safety related complaints, and their attitudes
towards work and other workers and supervisor. All the respondents (working
children, control group children and adult workers) were subsequently examined by a physician, who noted the complete health and safety profile of these
children. The results of working children were compared with those of the control group to identify the relationship if any, between work and occupational
diseases and accidents.
In this section, the results of the first part of the questionnaire based on the interviews of the children are presented.
- 15 -
3.1 Types of materials Collected

All the working children and adults were asked about the materials they collected during. A large variety of materials were mentioned by the respondents,
in which they were interested. Only a few of them were interested in single
item, most of them collected whatever they knew had a value. The example of
specialized scavengers included those working around the abattoirs and butcher shops to collect bones and those working around the fruit and vegetable
markets to collect edibles for re-selling and eating. One clan of local gypsies
was only interested in melon seeds, which were collected from the fruit market.
They later on washed, dried and sold these seeds in a local market, where these
are a sold as valuable item. Similarly some of the local and Afghans were interested in only the metals which they extracted form the industrial waste by
Fig 3.1 Items collected by the child and adult workers
20
Fruit
10
Eatables
24
Rags
28
Leather
34
Metals
52
Bones
69
Glass
76
Plastic
78
Paper
43
Hospital W aste
Others
20
40
60
80
100
No. of respondents
burning the cables and metallised materials found on the dumps near the industrial areas. None of the scavengers was specially focused on hospital waste, but
many of them regularly collected plastic, glass, edibles, syringes and other
items from the garbage thrown by local clinics and small hospitals. Large hospitals did not allow the entry of scavengers, but some of the items from such
- 16 -
hospitals were thrown on the waste skips outside the hospitals and were available for scavenging. The overall pattern of materials collected by these scavengers is given in Fig-1. Majority of the respondents (80%) worked as collectors,
while 20% (mostly female workers) worked as sorters. But the collectors also
helped with sorting. Sorting needed more skill than collection.
3.2 Age and Gender Profile of the Respondents

The data about age and gender pattern of the respondents is given in Table3.13.3. As can be seen, 102 working children, 50 controls and 25 adults were included in the study. The age of working children ranged between 7 18 years
while that of control group was 11 to 17 years. The adults were between the
age of 19 to 50. The gender distribution of the working children and adults
(91% working children and 76% adults were male) reflects approximately the
gender pattern of the scavengers as was found in the preliminary observations.
Table 3.1 Gender Profile of the Respondents

Gender
Working Children
Control
Adults
Males
93
91.2%
9
8.8%
102
52
100.0%
-
19
76.0%
6
24.0%
25
Females
Overall
52
- 17 -
Table 3.2: Age Distribution of the Working Children and Controls

Age
Upto 7 Years
8
9
10
11
12
13
14
15
16
17
18
Overall
Group
Working
3
2.9%
2
2.0%
3
2.9%
8
7.8%
2
2.0%
7
6.9%
6
5.9%
8
7.8%
13
12.7%
14
13.7%
13
12.7%
23
22.5%
102
100.0%
Note: Figure in parenthesis indicate percentages
Control
1
1.9%
5
9.6%
29
55.8%
11
21.2%
5
9.6%
1
1.9%
52
100.0%
- 18 -
Table 3.3 Age Distribution of the Adult Workers

Age
19
20
24
25
26
28
29
30
35
40
45
46
50
Overall
Frequency
(percentage)
1
4.0%
3
12.0%
1
4.0%
4
16.0%
1
4.0%
1
4.0%
1
4.0%
2
8.0%
3
12.0%
2
8.0%
3
12.0%
2
8.0%
1
4.0%
25
100.0%
3.3 Immigration Status of the Respondents

Majority of the scavengers were found to be immigrants of Afghan origin.
Even within these Afghani immigrants, there were variations, most were Pushto speaking Afghans, while a some were Persian and Turkish speaking Af-
- 19 -
ghans. They worked within their own clans. Locals were also found engaged in
scavenging. Most of the local scavengers were gypsy families living in shanties. They worked as garbage collectors from homes and then brought the garbage on donkey carts to their homes for sorting by the family members. The
data about immigration status of the respondents is given in Table 3.4 & 3.5.
Table 3.4 Immigration Status of respondent working children
Status
Local
Immigrant (afghan)
WORKING
37.3%
62.7%
Mean age
13.24
15.44
Table 3.5 Immigration Status of respondent working adults

Status
Local
Immigrant (afghan)
ADULTS
44.0%
56.0%
Mean age
37.55
28.21
3.3 Family Profile of the Respondents

All the respondents were asked questions about the number of their siblings
and the status of their parents, whether alive, or if there was one parent due to
death or divorce of one of the parents. These questions were asked to affirm
the common assumption that working children tend to belong to large families
and children with one parent alive are more likely to work than those with both
parents alive. Furthermore due to lack of any social safety net, children with
single parents are more likely to suffer from nutritional deficiencies due to
poverty in the family. The results of analysis are presented in Tables 3.6 and
3.7.
- 20 -
Table 3.6: Family Size Differences of the Respondents
Category
Working Children
Control Group
Adults workers
Entire Population
Mean Family
Size
Std.
Dev.
Z-value
8.90
2.89
102
6.48
1.57
52
7.20
3.65
25
7.96
2.91
179
5.63**
** Indicates significant difference at 95 % confidence interval
Table 3.7: Information about parents of respondent children
Status of parents
Both alive
One alive
Divorced
Working Children (%)
Control group (%)
74.5
84.6
23.5
2.0
15.4
-
As can be seen (Table 6) the average family size of the working children was
8.9 while that of the control group was 6.48. The difference in the family sizes
between the working children and control group was found to be significant
statistically, which confirms the assumption that families with large number of
children are more likely to put their children to work even in such hazardous
jobs as scavenging than those with smaller family sizes. This data can be interpreted both ways i.e., the scavenging families are less likely to use the population control measures than the general population in the same area or families
with larger size are more likely to engage in scavenging as a means of earning
livelihood.
Similarly as shown in Table 7, a sizeable proportion of working children (23%)
had only one parent alive, while 15% of the control group children had a dead
parent. None of the working children had ever attended school, on the other
hand some adult workers particularly those from Afghanistan had attended
school but had dropped out in elementary classes.
- 21 -
3.4 Work Experience
The mean experience of working children was found to be 4.6 years, while that
of adults, it was 15.3 years. The experience profile of the child and adult workers is presented in Fig 3.2
(%)
Fig3.2 Experience Pattern of Child and Adult Workers
90
80
70
60
50
40
30
20
10
0
Child workers
Adult workers
<1
1-2
2.01-3
4-5
6-7
8-9
>10
Experience in Years
3.5 Loads ands modes of Transport
Most of the children and adults worked on foot. They carried a large woven
plastic sheet formed into a back-pack, in which they collected their items. The
average weights brought in one trip was 20-40 kilograms. Those a little better
off had their own bicycles. Such workers were mostly self employed, they collected and sorted the materials themselves and later sold them at the sale
points. The workers on foot worked mostly for the contractors, who provided
shelter, some food and a some money. The pattern of wages and earnings was
- 22 -
not explored during this study, as the focus was on health and safety issues.
Sixty persons of the respondents worked for a contractor, while the remaining
40% were self employed.
Table 3.8 Mode of Transportation of Working Children
Mode
Foot
Bicycle
Donkey cart
Children
Adults
55.9%
60.0%
30.4%
28.0%
13.7%
12.0%
3.6 Age of starting work
All the working children and adults were asked about the age at which they had
started work. Majority of the children responded that they had started working
as scavengers when they were in the age group of 10-14 years.
3.7 Working Hours Pattern
The respondents were asked about their waking, sleeping, rest and holiday patterns. They told that the best time for picking was either early morning or late
in the night. Most of them rose very early in the morning (around 4:00 a.m.)
and went to the garbage collection places within their reach. They had a long
break during noon and again started working in the afternoon and continued till
late in the night (around 10:00 p.m. in most cases). The working hours pattern
of the respondents is given in Table 3.9.
- 23 -
Table 3.9
Working Hours Pattern of Respondents
Working Hours
Children (%)
Adults (%)
Upto 4
4-6
20
16
6.01-8
19
24
Over 8
58
56
11 hrs
10 hrs.
Mean working hours
Most of the respondent children (80%) and adult workers (76%) observed one
weekly holiday, while a significant number (20% children and 24% adults) had
no weekly holiday.
3.8 Living Arrangements
The working children and adults were asked, where they lived. Most of them
(60%) told that they live alongwith other adult and child co-workers at the
places provided by either the contractor. In some cases, 8-10 workers (children
and adults) slept on one charpoy, if it was available, otherwise all of them slept
on plastic or cloth sheets spread on the floor of rooms. Such living arrangements may expose children to abuse by co-workers.
- 24 -
Table 3.10 Living arrangements of the child workers

Living with
(%)
Mean age
(Years)
Parents
27.5%
12.18
Relatives
12.7%
14.85
Other workers
59.8%
15.69
3.9 Sports and recreation

Both the working children control group children were asked questions about
the facilities and opportunities for participation in games and their recreational
activities. The game participation rate was much lower in the working children
(56%) compared with that in the control group (88%).
3.10 Psychological Problems and attitudes

The children were asked a number of questions, which might shed some light
on the psychological stresses they face as well as the attitudes of their coworkers, contractors, parents and others. The responses to such questions are
summarized in Table 3.11.
Table 3.11 Stresses and Attitudes
Type of Stress Indicator
Disturbed Sleep
Physical punishment
Dislike the work they do
Bedwetting
% of Respondents
95
19
60
6
- 25 -
3.11 Nutritional Status of Respondents
Some of the children (21%) and adults (16%) reported that they eat the edible
items from the garbage they find. The urban waste contains lot of edible items,
but many of them are putrefying, any person eating such items is likely to suffer form infections and illnesses.
Availability or meat the diet was considered as indicator of nutritional status of
the children. As meat is relatively expensive and it can be presumed that children who have very little or no access to meat in their diet are likely to suffer
from malnutrition, as most likely they will not have access to proper and balanced diet. However the response to this question as presented in Table 3.12
indicates that the working children ate more meat than the control group children. While 12 % working children & adults reported no meat in the diet, 35%
of the control group children had no meat. On the other hand over 48% of their
working children/adults reported availability of meat more than twice per
week, while only 2% control group children reported that they had access to
meat more than two times per week. The reason for this apparent anomaly in
the nutritional status can be sought in the ethnic composition of the two groups.
While the working children and adults were predominantly of Afghan origin,
they seldom eat a meal without meat. On the other hand the local population
uses vegetables, pulses and dairy products more often than the meat. Despite
eating meat, the nutritional status of the working children was poor as they did
not have a balanced diet. The health indicators presented in the next chapter
indicate that the impairment of physical development was much more pronounced in the working children than the control group.
- 26 -
Table 3.12 Availability of Meat in the diet of respondent children
No. of times meat is eaten

in a weak
Working children +
adults (%)
Control group (%)
None
11.8
34.6
Once
26.0
42.3
Twice
12.6
21.2
More
48.7
1.9
3.12 Injuries at Work
A large proportion of working children and adults reported (Table 3.13) that
they suffered from frequent injuries during their work.
Table 3.13 Do you suffer from injuries during work?
Working Children
Adults
Yes
62.7%
84.0%
No
37.3%
16.0%
Various types of injuries were reported by the respondents, the data is presented in Table 3.14
- 27 -
Table 3.14 Types of Injuries faced by the working children

Nature of injury
(%) of working children
Cut
95.3
Fall
70.3
Road accident
25.0
Dog bites
18.8
Violence
9.4
Others
7.8
As may be seen cuts, falls and road accidents are most common causes of injuries in the working children. Furthermore dog bites and violence was common
in the respondents. Several of the working children and adults showed deep
gashes due to dog bites or violence. Some child workers had burn wounds
(probably afflicted by cigarette butts). The children told that they commonly
had fist fights with each other and with children from other clans. Sometimes
the fights are over the right to pick materials from certain areas. In the fruit and
vegetable market, two clans had reached a truce in such a way that each clan
had the right to collect melon seeds on alternate days. On those days the fruit
market was off limits for the other clan.
- 28 -
3.13 Health Complaints of the Respondents
All the respondents were asked about the common illnesses and health related
complaints they had. The complaints of working children and adults were then
compared with those of control group children, which are presented in Table
3.15 and Fig 3.3
Fig 3.3 Comparison of Health Related Complaints of Working
Children, Adults and Control Group Children
90
80
70
60
Working Children
50
Adult Workers
40
Control Group
30
20
10
0
Skin problems
Cuts & Bruises
Less Hunger
Excess Hunger
Fatigue
Stomachache
Diarrhea
Joints Pain
Backache
Cough
Cold
Fever
Headache
- 29 -
Complaint
Table 15 Health Complaints of the Respondents

Ratio
in Ratio
in Ratio in con- Z-value (for difference of proportions
working chil- adults
trol group
between working and
dren
control group children
Headache
69.6%
56.0%
44.2%
2.198
Fever
33.3%
16.0%
21.2%
0.759
Cold
37.3%
12.0%
42.3%
-0.382
Cough
44.1%
40.0%
19.2%
1.456
Backache
81.4%
84.0%
34.6%
4.057
Joints pain
69.6%
80.0%
40.4%
2.434
Diarrhea
13.7%
8.0%
11.5%
0.134
Stomachache
57.8%
56.0%
26.9%
2.080
Fatigue
67.6%
80.0%
59.6%
0.776
Excess hunger
38.2%
24.0%
19.2%
1.121
Less hunger
26.5%
12.0%
13.5%
0.719
Cuts/bruises
72.5%
52.0%
36.5%
2.938
Skin problems
20.6%
16.0%
40.4%
-1.394
47.7%
Others
Significantly different proportions at 95% confidence interval have been highlighted
- 30 -
As can be seen from this data, working children in general had more healthrelated complaints than either the adults or the control group children. Pains in
head, joints and back were the most common complaints by all the respondents. It might be caused by the stress of work or school and malnutrition.
Cough, cuts and bruises, stomachache, and fatigue were the other most important health related complaints of respondents.
This data was further analysed to calculate the statistical significance of difference in proportions of working children versus the control group. The results
of analysis as shown in Table 14. As may be seen, the ratios of working children complaining of different health related problems was higher than that for
the control group. The differences in ratios for headache, backache, joints pain,
stomachache and cuts/bruises were found to be statistically significant, indicating that these complaints are caused by work as scavengers.
- 31 -
Chapter 4
Health and Safety Indicators of the Working
Children, Control Group and the Adult Workers
An analysis of health and safety indicators measured as a result of clinical observations as well as the tests administered to the working children, control
group and adult workers is given in this section. The adult workers (who had
started as child workers) as mentioned earlier were included in the study and
were physically examined to assess the cumulative effect of work on their
health. A total of 25 adults including 19 men and 6 women aged 19 to 50 were
examined. All the respondents were examined by a physician, who also asked
questions about the history of illnesses and some aspects of psychological
stresses. The physician used a standard questionnaire (Form II-Appendix-A
given at the end of this report) to record his observations. The data of these
findings is summarized below. It is arranged according to the body and organ
systems examined. The data of working children was compared with that from
control group, while that for the adult workers is also presented. The differences in proportions between working and control group children were
checked through statistical formulae to test the significance of these differences. The results of this part of examination are summarised below:
4.1
Weight and Height of Children
A comparison of mean heights and weights of the male working children is

presented in Fig 4.1 and 4.2. Although there are no control group cases for
lower age groups, but wherever matching age groups were available, the data
shows the tendency of the working children to be of lower weight and lesser
height.
- 32 -
Fig 4.1 Comparison of mean weight by age between

working and control group children
70
Weight (Kg)
60
50
40
30
20
Working Children
10
Control group
18
17
16
15
14
13
12
11
10
Upto 7
Age (years)
Fig 4.2 Comparison of mean height by age between

200
180
Height (cm)
160
140
120
100
80
Working Children
60
Control group
40
20
0
18
17
16
15
14
13
12
11
10
Upto 7
Age (years)
- 33 -
The difference in heights was statistically significant for the boys of age groups
of 16 (t-value = -2.349). However the differences in weights were not found to
be statistically significant.
This data indicates that there is increased likelihood of working children to be
of shorter heights. The reason may be either the social and economic status of
the families. As described earlier the many of the scavenging children are immigrants or gypsies, most of them belong to large-sized families, who are impoverished, some having only one parent to tend for them, thus it is more likely
that they are suffering from nutritional deficiencies, affecting their growth.
Their nutrition is further worsened by the nature of work they do, and unbalanced diet they use. As described earlier most of the scavenging children reported access to meat in diet. But still their growth seems to be hampered compared with the regular school going children of similar age groups.
4.2
Physical Appearance and Personal Hygiene
Fig 4.3 Comparison of general appearance and personal hygiene

of respondents
Unkempt hair
Unclipped nails
Dental carries
Unclean teeth
Dirty look
0
Working Children
20
Adults
40
%
60
Control Group
80
- 34 -
The physical appearance of the working as well as control group children was
noted by the physician. The indicators used for this purpose included general
look of cleanliness or dirtiness, clipping of nails, look of hair, appearance of
clothes, cleanliness of teeth, carries of teeth. The comparison of physical appearance is given in Fig 4.3.
4.3
General Health Examination
All the children were physically examined by the occupational physician. The
physician recorded his opinion on vital health indicators and diseases suffered
by these children. The results of this part of examination are presented in Table
4.1.
As can be seen, there is a consistent pattern of differences between the working
children/adults and the control group children. Most of the Every fourth working girl was found to be anaemic. Symptoms of anaemia and vertigo were also
very high among the adult workers. The control group children had a higher
ratio of palpable lymph nodes, which might be due to some seasonal infections.
Statistically significant differences were found in the incidence of palpable
lymph nodes, headache/vertigo and worm infestation between the working and
control group children.
Table 4.1
Comparison of Vital Health Indicators
Disease/Health
Indicator
Incidence
in Working
Children
(%)
Incidence in
Adults (%)
Incidence in
Control
Group (%)
Z-value (for
difference of proportions between
Anaemia
Palpable Lymph
Nodes
Headache/vertigo
Worm Infestation
78.4
82.4
84.0
52.0
65.4
38.5
1.457
4.020
73.5
68.6
80.0
64.0
26.9
23.1
3.383
2.999
- 35 -
Anaemia, what it is- its causes and prevention

Anaemia is a deficiency of red blood cells, which can lead to a lack of oxygen-carrying
ability, causing unusual tiredness and other symptoms. The deficiency occurs either
through the reduced production or an increased loss of red blood cells. These cells are
manufactured in the bone marrow and have a life expectancy of approximately four
months. To produce red blood cells, the body needs (among other things) iron, vitamin
B12 and folic acid. If there is a lack of one or more of these ingredients anaemia will
develop. Most common cause of iron deficiency in children is the poor diet containing
little iron. Children also need high amount of iron during growing period. Among the
first symptoms of anaemia are shortness of breath and dizziness, tiredness and palpitations (awareness of the heartbeat). In case of long-term cases of iron deficiency,
there may be a burning sensation in the tongue, dryness in the mouth and throat,
sores at the corners of the mouth or a smooth tongue and difficulty in swallowing.
Anaemia can be prevented and cured by eating a balanced diet rich in iron, Good
sources of iron include liver, beef, spinach, cereals, eggs and dried fruit. In severe and
long-term cases, doctor should be consulted.
Swelling of Lymph NodesA cause to worry?

The Lymph vessels are distributed throughout our body in the same areas the blood
vessels are. The job of Lymph vessels is to pick up fluid and waste from between the
cells. Along the Lymph vessels are lymph nodes, these are collecting areas for lymph
and waste materials that have been collected. The Lymph Nodes are through out the
entire body. These are the normally soft, barely palpable fleshy masses felt in the
neck, behind the ears, in the armpits, and in the groin area of normal healthy persons.
They are part of the filter system in the body that traps germs and allows infection
fighting white blood cells to congregate and destroy invading germs. After exposure to
an infection, or especially after a bout of illness, these lymph nodes become swollen,
which should not be cause of worry. They just indicate that bodys defenses against
diseases are working. They become normal after sometime. An infection of the lymph
nodes needs to be taken seriously and treatment has to be taken
It is evident that there is a remarkable tendency for the working children to be

dirtier than their non-working school going counterparts. The nature of work
for the working children and adults is such that they always are working with
dirty things and materials. Furthermore they seldom had access to basic sanitary facilities.
- 36 -
4.4
Respiratory health Indicators and diseases
As mentioned earlier, pulmonary function tests were performed on all the respondents, the results of these tests indicate the health of lungs and breathing
system of the person. Additionally through clinical examination, the physician
diagnosed the respondents for respiratory illnesses. In this section the comparative data for the incidence of respiratory diseases among the respondents is
presented. Here it would be pertinent to explain a few terms repeatedly used in
this section.
The most important parameters that are measured by through pulomonary
function test are:
Forced Vital Capacity (FVC) - The maximum volume of air, measured

in liters that can be forcibly and rapidly exhaled.
Forced Expiratory Volume (FEV1) - The volume of air expelled in the

first second of a forced expiration.
Vital capacity (VC) The total volume of air exhaled after filling the
lungs to their maximum capacity.
Age in Years
18
17
16
15
14
13
12
11
10
Working Children
Controls
&
le
ss
100
90
80
70
60
50
40
30
20
10
0
Vital Capacity (%)
Fig 4.4 Comparison of Mean Vital Capacity (%) data by age
- 37 -
120
100
80
60
40
Working Children
Controls
20
18
17
16
15
14
13
12
11
10
&
le
ss
Forced Vital Capacity (%)
Fig 4.5 Comparison of Mean Forced Vital Capacity (%) data

by age
Age in Years
Age in Years
18
17
16
15
14
13
12
11
10
Working Children
Controls
&
le
ss
80
70
60
50
40
30
20
10
0
FEV 1 (%)
Fig 4.6 Comparison of Mean FEV1 (%) data

by age
- 38 -
The instrument measures these values and compares them with the predicted
values for normal persons of same age, gender and height. The results are then
printed in the form of percentages. In the present case the instrument compared
the measured values against normal predicted values for the Caucasian race,
therefore the data may not be highly accurate in individual cases, but since the
same test was performed on all the respondents (working and controls) the
comparisons of the data will be valid to estimate the differences and trends for
impairments. There are a number of systems which physicians use to determine
the severity of disease. Here is just one way that is very commonly used :
Normal PFT Outcomes - > 85 % of predicted values
Mild Disease - > 65 % but < 85 % of predicted values
Moderate Disease - > 50 % but < 65 % of predicted values
Severe Disease - < 50 % of predicted values
The pulmonary function data for the respondents is given in Figures 4.4-4.6.
The data in these three figures provides vital clues on the respiratory health of
the respondents. First of all it indicates that almost all of the working children
had some form of respiratory aliment. Furthermore the working children of the
same age group had much lower lung function than the control group children.
This data was further confirmed by the clinical examination of the respondents
for the evidence of respiratory diseases. The data about respiratory diseases is
presented in Table 4.2
- 39 -
Table 4.2
Comparison of respiratory illnesses in the respondents
Disease/Health In- Incidence Incidence in Incidence in Z-value (for
dicator
in Working Children (%)
Adults (%)
Control
Group (%)

Pain chest
55.3
64.7
23.1
3.812
Cough
60.5
64.7
21.2
2.346
Pulmonary Tuberculosis*
15.8
29.4
Dysponea
60.8
64.0
1.9
1.941
Chronic bronchitis
30.3
41.2
5.8
0.894
* Suspected cases on the basis of clinical exam
As can be seen from the comparative data is given in Table 17, the incidence of
pain chest, cough, dysponea, TB and other respiratory diseases was higher in
the working children as well as the adults in comparison with the control
group. This indicates the susceptibility of these workers to respiratory illnesses
due to exposure to dust, harmful biological materials from the work, combined
with very unhealthy living conditions and general lack of healthcare and personal hygiene/sanitation.
4.5
Skin Allergies and diseases
Severe cases of skin allergies, infections, cuts/bruises and scabies were found
in the working children and adult. The ratios in the control group were much
lower. This again indicates the likelihood of skin problems in the working
group due to dirty and hazardous materials they handle, coupled with unhygienic and cramped conditions in their living places. The data for skin infections is presented in Table 4.3
- 40 -
Table 4.3
Comparison of skin problems in the respondents
Disease/Health In- Incidence Incidence in Incidence in Z-value (for
dicator
Adults (%)
Control
Group (%)

Allergic dermatitis
28.9
23.5
7.7
0.893
Cuts/bruises/burns
51.3
35.3
3.8
1.311
Boils
3.9
5.9
Scabies
19.7
5.9
3.8
0.391
14
17
0.294
Other skin problems
4.6
Musculo-skeletal Problems
The work on the scavenging sector involves manual lifting and carrying of
heavy loads and use of hands, shoulders, back muscles and joints. In order to
assess the impact of work on the musculo-skeletal system of the children, they
were thoroughly examined. The results of this part of examination are given in
Table 4.4
The comparative results of this section reveal that the scavenging children are
highly likely to suffer from musculo-skeletal disorders than the non-working
school going children.
All the respondent children were asked questions about the symptoms of various musculo-skeletal problems This data is indicative of the high incidence of
musculo-skeletal disorders among the scavengers, which are caused by awk-
- 41 -
ward working posture, heavy loads, traumas and stresses on the muscles, long
working hours and poor nutritional status of the workers.
Table 4.4
Comparison of musculo-skeletal disorders
Disease/Health Indicator
Incidence
Incidence in
Adults (%)
Incidence in
Control
Group (%)
Z-value (for
Low back pain
76.3
88.2
44.3
2.729
Pain neck &

shoulders
77.6
94.1
34.8
3.411
As can be seen the working children and adults are twice more likely to suffer
from musculo-skeletal problems than the non-working control group children.
These differences in proportions were found to be statistically significant.
4.7
ENT Examination
The clinical examination of ear, nose and throat of all the respondents was carried out. The results are presented in Table 4.5. The incidence of ENT problems particularly rhinitis and tonsillitis was much higher in the working children than the control group. This is most probably due to the allergic responses
to the materials the working children are exposed to. Additionally the eating
habits and poor sanitation may compound such problems.
- 42 -
Table 4.5
Comparison of ENT disorders
Incidence
Incidence in
Adults (%)
Incidence in
Control
Group (%)
Z-value (for
Rhinitis
31.6
11.8
13.5
1.539
Tonsillitis
27.6
17.6
3.8
0.738
Ear discharge
7.9
DNS
7.9
5.9
1.9
0.217
Ear diseases was high among the male working children than the control
group. Similarly many of the adults were also found to be suffering from ENT
maladies.
4.8
Eye Problems
The ratio of working children having eye problems was higher than the control
group. The main problem was the conjunctivitis (redness and watering) caused
by allergic response to dirty materials and hands. This is again an indication of
the impact of handling dirty materials and lack of personal hygiene in the
working children and adults. Around 30% of the adults were found suffering
from trachoma, a painful condition of the eye, caused in this case by exposure
to dust and dirty hands. The data for eye problems is given in Table 4.6
- 43 -
Table 4.6
Comparison of eye problems
Incidence
Incidence in
Adults (%)
Incidence in
Control
Group (%)
Z-value (for
Conjunctivitis
30.3
35.3
13.5
0.883
Trachoma
3.9
29.4
1.9
0.096
Other eye problems
3.9
5.9
4.9
Blood examination
The respondents of the study were requested to provide blood samples. To

draw the blood and to examine the samples, services of local laboratories were
acquired. Trained technicians collected the blood samples, in most cases the
respondents were transported to the lab in order to collect the sample. The
blood maws examined for hemoglobin level (HB) and erythrocyte sedimentation rate (ESR). The HB and ESR levels were compared with the normal range
for the gender groups of the respondents. The lower HB levels are indicators of
malnourishment. High ESR level indicates disease or infection. Usually both
these tests are interpreted in conjunction. The data for the abnormalities found
in these tests as presented in Table 4.7 indicates that the working children and
adults are highly likely to suffer from infections than the control group children. This data is confirmed by the clinical findings described in earlier sections.
- 44 -
Table 4.7
Comparison of HB and ESR abnormalities in the blood test of respondents
Parameter
Incidence of
Incidence of
Incidence of
abnormalities abnormalities abnormalities
in Working in Adults (%)
in Control
Children (%)
Group (%)
Z-value (for
HB
62.7
1.9
1.24
ESR
74.5
34.6
3.23
As seen above the difference in the proportion of working children showing

abnormalities in ESR was statistically significant compared with that of the
working children indicating that work in scavenging sector is closely linked to
infections.
4.10 Urine Examination
The respondents of the study were also requested to provide urine samples. In
most cases the respondents were transported to the lab in order to collect the
sample. The urine was physically, chemically and microscopically examined
for routine parameters. The main purpose for urine examination was to assess
the probability urinary tract infections, which may serve as an indicator of the
likelihood of sexual abuse in the studies population. But abnormalities in urine
test may not be directly linked with sexual abuse, as a number of other factors
including nutrition, working environment, heart stress and lack of proper hygiene may lead to abnormal results. The urine was analysed for the relevant
parameters. The results for abnormalities detected are presented in Table 4.8.
- 45 -
Table 4.8
Comparison of abnormalities in the urine test of respondents
Parameter
Incidence of
abnormalities
in Working
Children (%)
Incidence of
abnormalities
in Adults (%)
Incidence of
abnormalities
in Control
Group (%)
Low pH (acidity)
38.2
36.0
1.9
Protein
13.7
12
Blood
2.9
8.0
WBC
53.9
52.0
Pus cells
19.6
16.0
5.4
Epithelial cells
57.8
60.0
Crystals
6.9
The above data (specially the protein, white blood cells, epithelial cells ) in the
urine samples indicates that there is a remarkable likelihood of urinary tract
infections in the working children. The reasons may be low intake of fluids unsanitary conditions, dirty water and utensils. One possibility for such infections
may be the sexual abuse resulting in genital infections, but UTI in itself may
not be enough to prove the existence of sexual abuse.
4.11 Screening for Hepatitis and HIV

The respondents blood was also screened for Hepatitis B, C and HIV. The results of this part of examination are yet to be received.
- 46 -
Chapter 5
Assessment of Workplaces, Living Conditions
and Task Analysis
A total of 10 workplaces were visited for assessment of the hazards posed by
the working environment. As the work of scavenging is mobile in nature, they
spend their time visiting the sites where useful garbage is found and most of
them bring it back to a collection site, where the materials are sorted and separated. Later on the sorted materials are sold mostly at a larger collection site
(kabaria) where a large weighing scale is installed to weigh the items, for
which payment is made according to the value of the items. Some materials are
also sold directly to the industries and businesses who have use for such materials. A number of industries and businesses rely on the work of scavengers,
these include:
Plastic goods industry
Paper & board industry.
Packaging material industry
Glass industry
Metal furnaces
Bottle washing and refilling plants.
In order to record observations about the sites where working children worked,
a Form-III (given in Appendix-A) was used. Airborne dust exposure was also
monitored at 3 sorting sites. For estimation of dust exposure of workers Method 0500 of US National Institute for Occupational Safety and Health (NIOSH)
was used. The description of sites selected for this part of study is given in Table 5.1
- 47 -
Table 5.1 Nature of workplaces selected for working conditions and environment assessment
Nature of workplace
Sorting/collection sites
Shanty neighbourhoods
Fruit/vegetable market
Urban waste dumps
Industrial waste dump
Local market with miscellaneous
shops)
Number
4
2
1
1
1
1
The transient worksites like markets and dumps were visited for task analysis
only, besides noting the working environment hazards. All the collection sites
and shanties served as living quarters as well. The analysis of living conditions
is presented separately in this Chapter
5.1 General Hygiene Thermal Comfort and other Facilities

All the worksites were assessed for the adequacy of thermal comfort, ventilation, availability of toilet, cleanliness and availability of the first-aid in case of
accidents and injuries. None of the workplaces had adequate thermal comfort.
Most of the work in this sector whether collection, sorting, packing or sale is
carried out in the open air. Al the workplaces were open sheds. None had a
proper drinking water facility. There usually was a dirty small toilet, where a
water tap was available. The same tap was used to fill in the drinking water
containers. In the shanties even this tap facility was not available. Similarly
electricity was available in the form of electric bulbs and fans in the collection/sale sites. The shanties did not have even electricity. All the sites were
- 48 -
poorly organized with materials scattered all around posing tripping and fall
hazards. No first aid facility was available on the worksites.
5.2 Dust Exposure of the Workers

The dust emanating during the collection, sorting and packing process constrains a number of harmful materials including putrefying matter, toxic metals, chemicals, even pathogens in the hospital wastes. This dust can cause a
number of respiratory, ENT, and allergic disorders. Some of the dusts may
have long term toxic effects on the body. At the three cites dust was monitored
during sorting operation, which is the dustiest job. Six samples were collected.
The levels measured ranged from 5 to 13 mg/m3, which is way above the exposure limits in most countries for hazardous dusts (1 mg/m3) If these standards
are considered as yardstick, then most of the workplaces had excessive dust
exposure, which is further compounded by the fact that such standards are
meant for healthy adults and not children and are applicable for 8-hour work
day, not excessively long working hours as are observed in the scavenging sector.
5.3 Task Analysis

An important aspect of the present study was to observe the tasks involved in
all the scavenging related operations, to know about the gender and age pattern
of persons performing those tasks, time of day when these tasks are performed,
assessing the particular hazards faced by the workers in each task and to recommend safest minimum age for the specific tasks. The task analysis was done
at each of the worksites, where the working environment and conditions were
assessed. The tasks in scavenging sector are not very well defined, and all the
workers usually perform all kinds of tasks. However the women are rarely involved with transportation. Similarly some families and clans are focused on a
few items like bones or metals. . The data for the task analysis is summarized
in Table 5.2.
- 49 -
Table 5.2 Analysis of Tasks involved in Scavenging
2.
Manual
transport
of
collected materials
8-25
Males
(some
males)
fe
3.
Transport
of
collected materials on bicycle
15-35
Males
(mostly
immigrants)
4.
Transport
of
collected materials on donkey
cart
15-50
Males
(sometimes
helped by
females),
mostly
local families
Heat
stress
Risk
of
injuries
Dog bites
Violence
Hazardous
materials
Long
working
hours
Eating of
items
from garbage
Heat
stress
Heavy
loads
Dog bites
Violence
Hazardous
materials
Long
working
hours
Heat
stress
Heavy
loads
Dog bites
Violence
Hazardous
materials
Long
working
hours
Heat
stress
Hazardous
materials
Over 18
Suitability for the task of

the age groups
15-18
Mostly
males,
some
females specially
on
dump sites
Hazard category
11-14
Main hazards
involved
5-10
Collection of
garbage from
dumps, households and bazaars
Genders
involved
High
1.
Age
group
of persons
involved
in the
task
8-25
Medium
Description of
all the tasks
carried out at
the worksite
Low
S.
No
- 50 -
6.
7.
8.
Weighing
of
sorted items
Sale of sorted
items
Collection of
vegetables/fruits/melo
n seeds from
market
17-50
17-50
5-25
Males
Males
Males
(some
males)
fe
9.
10.
11.
Washing/drying/sale
of melon seeds
15-35
Bone collection/transport
8-35
Sale of bones
Males/fema
les
18-45
Males
Males
Heat
stress
Chemical/dust
exposure
Uncomfortable
posture
Long/odd
working
hrs.
Cuts/injuri
es
Heavy
loads
Heavy
loads
Biological
hazards
Eating of
puterifying materials
Heat
stress
Heavy
loads
Abuse/vio
lence
Heat
stress
Long
hours
Biological
hazards
Long hrs.
Heat
stress
Biological
hazards
Heavy
loads
Heat
stress
Over 18

the age groups
15-18
Males
(some females
in
local gypsies)
Hazard category
11-14
Main hazards
involved
5-10
Sorting
Genders
involved
High
5.
Age
group
of persons
involved
in the
task
8-25
Medium
Description of
all the tasks
carried out at
the worksite
Low
S.
No
- 51 -
8-45
Males
Toxic
smoke inhalation
Heat
stress
Burns
Biological
hazards
Cuts
Risk
of
highly infections
Over 18

the age groups
15-18
Collection,
transportation,
sorting, packing of waste
items
from
clinics, hospital
and bio-labs
Males
Hazard category
11-14
13.
Main hazards
involved
5-10
Burning
of
cables,
tyres
and other scrap
to extract useful metals
Genders
involved
High
12.
Age
group
of persons
involved
in the
task
15-45
Medium
Description of
all the tasks
carried out at
the worksite
Low
S.
No
5. 4 Living Conditions
The living conditions of 10 workers, who were showing signs of illness and
health impairment were also observed. The workplaces for most of the workers
also served as sleeping places, therefore the distinction between the two is
blurred in case of the scavengers. The children in case of shanties lived alongside their parents, some of the immigrant children (around 30%) lived with
their parents, while the remaining immigrant children lived alongside other coworkers either at the same place where they brought in their load or lived in
rented houses, which were basically collection of one-room houses sharing a
common toilet, bath room and water supply. Each room was shared by 10-15
persons, who slept either on the floor or a large-sized charpoy. The shanties
had no electricity, while the other places had electricity for lighting and fans.
Cleanliness in all places was very bad, one toilet was shared by 60-70 persons.
In most cases only one water tap was available, which was used for drinking
water as well toilet. There was no arrangement anywhere for either flush in the
toilet or to wash hands with soap. It is suspected, that many of the diseases in
the scavengers are spread by their living conditions and style. Wood was used
- 52 -
in all places as fuel for cooking, gas was not available. In some cases, used oil
collected from auto workshops was used alongwith wood, cardboard pieces
and paper to cook food. This generated lot of thick smoke. The thermal conditions in most places were uncomfortable, which probably lead to dehydration
and many of the urinary tract infections indicated in previous chapter.
- 53 -
Chapter 6
Combating Health & Safety Hazards to Child Workers in Scavenging Sector- Need for an Action Oriented
Approach
The scavenging has become an important economic sector in most metropolitan cities. A number of industries and businesses rely on the work of scavengers to fulfill needs for raw materials and related items. A large number of
workers most of them immigrants are subsisting on this business. A large proportion of these workers are children below the age of 18. This sector despite
being and important economic activity has remained largely invisible for the
government agencies, NGOs, social protection institutions, education and
health service providers. A large number of contractors and businessmen are
thriving on the work of scavengers, who have largely remained deprived of the
economic benefits of the business. While it provides a means of earning livelihood for vulnerable and poor segments of society, its impact on the health,
safety, education and well being of child workers is a cause of great concern.
There is an urgent need to take action to save the children from harmful impact
of scavenging. Outline of an action-oriented approach is given in the following
paragraphs.
6.1
Reduction in Working Hours
Most of the scavenging is carried out at odd hours. Either very early in the
morning or late in the night. These hours exacerbate the vulnerability of the
children to abuse, violence, dog bites, accidents and injuries. Scavenging is a
dirty, tedious and time-consuming task, requiring immense concentration,
which causes musculo-skeletal disorders in the children as shown in the present study. By reduction in working hours of the children major improvements
can be made in their health and safety profile. Working hours for children in all
- 54 -
sector should be regulated. Children should not be allowed to work on such occupations from 8:00 p.m. to 8:00 a.m. These children should be given opportunities for participation in positive recreational activities, games, and provided
education whether formal or non formal. This will result in reduction of their
working hours.
6.2 Banning of Hazardous Activities

Certain activities pertaining to scavenging expose the workers to extreme hazards. Scavenging of hospital waste exposes the workers to infectious and fatal
diseases. Although major hospitals have somewhat regulated their waste collection and disposal, still a large number of clinics, small hospitals and medical
labs throw their waste in the municipal waste. The hospital waste items particularly syringes, infusion bags, medicine bottles are valuable items for scavengers. Therefore they like to collect these items, thus exposing themselves
and the general public through them to grave health risks. There is need to
adopt a strict hospital and healthcare waste management law, requiring the
generators to be responsible for their waste. Infrastructure for such waste management should be provided within the municipal waste management system.
The owners and medical staff of the healthcare facilities should also be trained
on hazardous aspects of waste and waste management.
Some activities of scavengers like burning of metal and cable scrap including
tyres generate toxic particulates, which are inhaled by the scavengers as well as
by the general public, creating grave public health problems. Such waste burning should be completely banned.
6.3 Awareness Programmes

It is important that the results of OSH studies be discussed with parents, contractors, government officials and other stakeholders and their opinion and cooperation be sought to combat hazardous impacts of scavenging on the children. Any strategy in this area should only be evolved with their consultation
- 55 -
and participation. The representatives of local bodies should be taken on-board

in any effort to combat child labour in their areas
6.4 Healthcare facilities

The present study indicates that the scavengers have no access to even the minimum healthcare facilities. Any effort at combating child labour in this sector
should have a health component, whereby the workers should be provided
basic health facilities and taught the importance of basic personal hygiene and
health care. They also need to be educated ton the harmful impact of certain
kinds of wastes and dangerous practices of collection/sorting. The messages
also need to be conveyed to the parents of the child scavengers, who in many
cases do not know the dangers their offspring are exposed to.
6.5 Population Control

It was noted during the survey, that the scavenging children belonged to relatively larger families than the control group children who also belonged to poor
socio-economic strata. This observation confirms the assumption that largesized families are more likely to engage their children for work. It is evident
that such huge families cannot be supported by the work of one or two adult
members of the family. Children have to join hands with adults to feed and
sustain the family. Thus these families as well as the others in the areas where
such families belong have to be made aware of and encouraged to use population control measures. For this an interface of the NGOs can be established
with the existing government institutions providing health care and population
control measures.
- 56 -
6.6 Skill Training of the Adults

If the income of the family is improved, then perhaps they will not put their
children to hazardous types of work like scavenging. Ways and means should
be searched to enhance the income of the families. The families involved with
scavenging are mostly immigrants and local gypsies. There should be special
income generation programmes tailored to the needs of such families.
6.7 Improvement of living and working conditions

The living and working conditions of the studies population were sub-human.
The sleeping arrangement of child workers specially where they had to sleep
with other coworkers in large numbers meant exposing them to grave risks at
tender ages. Some minimum steps need to be taken and the employers/contractors should be reached out to provide decent accommodation as well
as reasonable toilet, washing facilities.
- 57 -
Appendix-A
Forms used for Data Collection
FORM-I
Questionnaire for the Children in Rag picking & Scavenging Sector
(to be conducted by an interviewer)
Note: The grey-shaded questions are not to be asked from control group children
Investigator's Name:
____________________________
Date of Completion:
____________________________
Signatures:
____________________________
I.
General Background of the Child
Name:
____________________________
Sex:
Age:
____________________________ yrs
Address
____________________________
Number of siblings
________________
Are the parents:
both alive
only one alive
divorced
Are you
III Education/Work
local Immigrant Origin________________
Do you attend school ?
Yes
If yes then :
Full time
No
Part time
- 58 -
IV. Employment & Working Conditions

At what age did you start work: ______________
Type of materials you collect fruit & vegetables
plastic
hospital waste paper & board
glass bones metals leather rags eatables any other (specify

______________)
Are you collector sorter
What is the load you normally bring ________________ kg
Do you work on foot bicycle donkey cart
Are you self-employed work for contractor
Do you live with
parents relatives other workers
When do you get up:

When do you start work
When do you finish work
When do you go to bed
___________________ a.m.
___________________ a.m.
___________________ p.m.
___________________ p.m.
Do you have sound sleep
Yes
No
Do you have a rest break
Yes
No
If yes, how long
___________________ minutes
How may rest days you have per week None One Two
Yes
Are you punished at work

If yes by whom
parent
No
family member supervisor employer
other (pl. describe _____)

Do you like your work
Yes
Do you eat from the collected items

Have you suffer from any injuries during work, Yes
No
Yes
No
No
If yes specify their nature cut fall road accident dog bites violence tools
other specify_______________
How long ago did you suffer an injury: _______________ months
- 59 -
VI. Recreation/Health complaints

How many times in a week do you eat meat
Do you play with the friends
If yes, which games
If yes, how long
none once Twice More
Yes
No
___________________
___________________ minutes
What other recreational facilities do

___________________
you have (e.g., radio, tape recorder/TV etc)
Do you smoke
Yes
No
Do you suffer frequently from any complaints like:
headache
fever cold cough backache joints pain diarrhea stomachache
fatigue excess hunger less hunger cuts/bruises skin problems, any other
_____
- 60 -
FORM-II
Medical & Physical Examination of Working Children in Rag picking & Scavenging Sector
(to be conducted by a physician)
Name: ____________________
I.
Place: ___________
Date: ______________
General Physical Examination
Pulse
per minute
Temperature
Normal/Abnormal
Anaemia
+ve
- ve
Weight
Kg
Jaundice
+ve
- ve
Height
cm
Oedema
+ve
- ve
Clubbing
+ve
- ve
Dyspnoea
+ve
- ve
Palpable lymph nodes
+ve
- ve
Nocturnal enuresis
(bedwetting)
+ve
- ve
Vertigo/headache
+ve
- ve
Worm infestation
+ve
- ve
Any deformity
+ve
- ve
Hernia
+ve
- ve
II.
Personal Hygiene/Habits (Tick the relevant box)

Clean
Dirty
Healthy
Unclean
Carries
3. Nails
Clipped
Unclipped
4. Hair
Combed
Unkempt
1. General appearance
2. Teeth
_______
5. Skin Clean
Dirty
Any other problem
- 61 -
III.
Musculo-skeletal Problems
Abnormalities detected
+ ve
-ve
Remarks
Ganglionic cyst
Low Back Pain
Pain neck & shoulders
Calliosities
Knock-knee
Bow legs
Any other problems
IV.
Respiratory Examination
Yes
No
Remarks
Yes
No
Remarks
Pain chest
Cough
Chronic bronchitis
Asthma
Pulmonary Tuberculosis (suspect)
Any other (describe)
V.
Allergic Disorders
Allergic dermatitis
Conjunctivitis
Rhinitis
Tonsillitis
Any other
- 62 -
VI.
Skin
Any deformities observed

Yes
No
Remarks
Cuts/Bruises
Burns
Boils
Scabies
Dermatitis
Any other
VII.
Eyes
Trachoma
Injuries
Redness
Watering
Any other
VIII. EARS
Deafness
Discharge
Any other
IX. Nose
DNS
Nosebleed
Any other
Was a sample taken for
blood
Were abnormalities detected in blood
urine
urine (describe nature ______________)
Other Observations/Remarks by Physician ________________________________
- 63 -
FORM-III
Working Conditions and Environment Questionnaire for use at the worksites
Address of the workplace:
_____________________________
____________________________
Date of Completion::
____________________________
Signatures:
____________________________
I.
General Background
Name of owner
Describe the type of work as
____________________________
Garbage dump
Waste sale site Market
Hospital waste site Other (Pl. describe
_______________)
No. of child workers (including helpers) ______________ No. of adult workers __________
Is the work site also used as living quarters Yes No
II.
Main Physical hazards
Adequate Inadequate
Remarks
Electric Fans
Natural ventilation
Natural lighting
Artificial lighting
Thermal conditions
(ambient)
Thermal conditions
(workplace)
Cleanliness
Toilet facility
Drinking water facility
First-aid Facility
Exposure of workers to airborne dust __________ mg/m3 (use separate form for recording
the dust levels)
Noise level (dBA) (if measured ______________
- 64 -
III.
S.
No.
Over 18
15-18
Suitability for the task

of the age groups
11-14
Hazard category
5-10
Main
hazards
involved
High
Age group
of persons
involved in
the task
Medium
Description
of all the
tasks carried
out at the
worksite
Low
Task Analysis
- 65 -
FORM-IV
Living Conditions Questionnaire
(for use with children with serious health problems)
Name of child
_____________________________
Address of the living place:
_____________________________
____________________________
Date of Completion:
____________________________
Signatures:
____________________________
I.
General Background
Does the child live with parents
relatives
others
describe __________
Describe the type of home as katcha packa shanty Owned by the family
rented provided by employer Other arrangement (please describe) _______________
Is electricity available
Yes
No
Sources of energy do you use for cooking/lighting
natural gas Kerosene
Dung Other (specify________)
Number of persons living at the home/room_______________
Total number of rooms _______________
II. Main health and hygiene characteristics
Adequate
Electric Fans
Natural ventilation
Natural lighting
Artificial lighting
Thermal conditions (ambient)
Cleanliness
Toilet facility
Drinking water facility
Inadequate
Remarks
LPG

Occupational Health and Safety Risk Assessment of Child Labour in Scavenging Sector in Lahore

Загружено:

Сведения о документе

Исходное описание:

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Occupational Health and Safety Risk Assessment of Child Labour in Scavenging Sector in Lahore

Загружено:

Авторское право:

Доступные форматы

Occupational Health and Safety Risk

Assessment of Child Labour in Scavenging

Report of research study

Centre for the Improvement of Working Conditions & Environment

Saeed Ahmed Awan,

Year of Publication: 2003

Saeed Ahmed Awan

Background Information -------------------------------------------------------------------------------

Study Design & Methodology -------------------------------------

Data compilation and analysis ------------------------------------------------------------------------

Sample Size of Significance ---------------------------------------------------------------------------

Sample Proportion Z-test ------------------------------------------------------

Sample Mean t-Test -------------------------------------------------------------

Assessment of Workplace Environment

Profile of Working Children, Adults and Control Group ---

Types of materials Collected --------------------------------------------------------------------------

Age and Gender Profile of the Respondents ---------------------------------------------------------

Immigration Status of the Respondents --------------------------------------------------------------

Family Profile of the Respondents --------------------------------------------------------------------

Work Experience ----------------------------------------------------------------------------------------

Loads ands modes of Transport -----------------------------------------------------------------------

Age of Starting work ------------------------------------------------------------------------------------

Working Hours Pattern --------------------------------------------------------------------------------

Living Arrangements -----------------------------------------------------------------------------------

Sports and recreation -----------------------------------------------------------------------------------

Psychological Problems and attitudes ----------------------------------------------------------------

Nutritional Status of Respondents ---------------------------------------------------------------------

Injuries at Work ------------------------------------------------------------------------------------------

Health Complaints of the Respondents ---------------------------------------------------------------

Health and Safety Indicators of the Working Children,

Weight and Height of Children ----------------------------------------------------------------------

Physical Appearance and Personal Hygiene ---------------------------------------------------------

General Health Examination ---------------------------------------------------------------------------

Respiratory health Indicators and diseases ----------------------------------------------------------

Skin Allergies and diseases ----------------------------------------------------------------------------

Musculo-skeletal Problems ----------------------------------------------------------------------------

ENT Examination --------------------------------------------------------------------------------------

Eye Problems --------------------------------------------------------------------------------------------

Blood Examination --------------------------------------------------------------------------------------

Urine Examination --------------------------------------------------------------------------------------

Screening for Hepatitis and HIV ----------------------------------------------------------------------

Assessment of Workplaces, Living Conditions and Task

General Hygiene Thermal Comfort and other Facilities ------------------------------------------

Dust Exposure of the Workers -------------------------------------------------------------------------

Task Analysis --------------------------------------------------------------------------------------------

Living Conditions --------------------------------------------------------------------------------------

Combating Health & Safety Hazards to Child Workers in

Reduction in Working Hours -------------------------------------------------------------------------

Banning of Hazardous Activities ----------------------------------------------------------------------

Awareness Programmes -------------------------------------------------------------------------------

Healthcare facilities -------------------------------------------------------------------------------------

Population Control --------------------------------------------------------------------------------------

Skill Training of the Adults ----------------------------------------------------------------------------

Improvement of living and working conditions -----------------------------------------------------

Forms used for Data Collection -----------------------------------

A control group of 52 school-going non-working children (all male)

63% of the working children were immigrants of Afghan origin.

The basic health indicators (height, weight, pulmonary functions) when

The ratio of respiratory diseases and disorders (pain chest, cough,

A higher proportion of scavenging children and adults suffered from

Eye problems were 2 times more common in the scavenging children

The blood examination revealed twice the rate of abnormalities in the

Exposure to toxic and hazardous materials from searching