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Prevalence and associated factors of occupational injuries among municipal solid waste collectors in four zones of Amhara region, Northwest Ethiopia

  • Debassu Eskezia1,
  • Zewdie Aderaw2,
  • Kedir Y. Ahmed2Email author and
  • Fentaw Tadese2
Contributed equally
BMC Public HealthBMC series – open, inclusive and trusted201616:862

https://doi.org/10.1186/s12889-016-3483-1

Received: 25 November 2015

Accepted: 11 August 2016

Published: 24 August 2016

Abstract

Background

Refuse collectors are at a high risk for fatal and non-fatal occupational accidents. This is more intensified in developing countries, like Ethiopia, due to physically demanding nature of the job. However, information on occupational injuries and related factors are almost non-existent in Ethiopia. Thus, the aim of this study was to assess the prevalence of occupational injuries and its associated factors.

Methods

A cross-sectional study was conducted among municipal solid waste collectors in four zones of Amhara region from February to May 2015. Computer generated simple random sampling technique was used to select the samples. Interviewer administrated questionnaires were used for the data collection process. Binary logistic regression was used to assess the association between outcome variables and explanatory variables.

Results

In this study, the annual prevalence of at least one occupational injury among solid waste workers was 34.3 % (95 % CI: 29.52, 39.10). Of these, 50.7 % of them were visited health facility to receive health care. The independent predictors of at least one occupational injury were shorter service years, low monthly salary, history of job related stress, and sleeping disturbance related to the job. Being illiterate, having lower monthly income, and those who reported sleeping disturbance were significantly and positively associated with severe occupational injuries of solid waste collectors.

Conclusion

The magnitude of occupational injuries among municipal solid waste collectors is lower than other similar studies conducted in Ethiopia. Based on the finding of this and other studies, job rotation among work components, improvement of employees’ income, job specific guideline regarding maximum production limits, and replacement of bags and bins with wheeled containers are an interventions expected to cope with the problem. There is also a need of specific periodic health surveillance (PHS) for refuse collectors to detect early signs of work related complaints and to monitor work ability.

Keywords

Occupational injuries Municipal solid waste workers

Background

Occupational injury is any physical injury conditions sustained on a worker in connection with the performance of his or her work [1]. It poses a major public health problem and are a source of substantial human and economic cost in both developed and developing countries [2, 3]. The International Labor Organization (ILO) estimates that 270 million occupational accidents and diseases occur each year, around 2.3 million workers die as a result of it [4]. Estimates from member States of the European Union indicated that the economic cost of all work-related ill health ranges from 2.6 to 3.8 % of the GDP [5, 6]. Sub-Saharan Africa countries appear to have the greatest rate of occupational injuries followed by Asia [3, 7].

Municipal solid wastes (MSW) consists of many different things including food and garden waste, paper and cardboard, glass, metals, plastics and textiles [4]. Despite waste collection has been contributing greatly to human health by reducing the risk of several infectious diseases, workers are at a high risk for fatal and non-fatal occupational accidents [8]. One systematic review showed that the occupational accident rate among Danish MSW workers was 5.6 times higher than that of total workforce [9, 10]. The standards and norms for handling municipal solid waste in developed countries have reduced its occupational health impacts substantially. However, in developing countries solid waste workers and waste pickers are at much higher risk of occupational injuries [1115]. In these countries, the collection system is labor-intensive, workers have less protection, most waste is not safely contained in readily lift able load sizes, recycling are conducted from mixed waste, many waste pickers are children or women of child-bearing age, disposal is by open dumping, disposal equipment operators are not in closed air conditioned cabs [12, 16, 17].

In Ethiopia, municipal solid waste workers organize door to door waste collection from households and commercial areas. More typically, the waste is placed on the ground directly, thus requiring being shoveled by hand; or it is left in plastic bag or basket to be picked up by hand. Then, sack or pushcart are used to transfer the wastes to collection sites and finally it is manually emptied to a refuse truck. Therefore, the above facts indicate that workers have direct contact with solid waste, and are also exposed to strenuous working conditions. However, in Ethiopia data on health and accident consequences are almost non-existent. Two studies conducted in Addis Ababa and Northwest Ethiopia showed that the prevalence of occupational injuries among solid waste workers were 43.7 and 63.9 % respectively [11, 18]. Moreover, this study was conducted in capital cities of four zones (an administrative unit next to district) which expected to increase the representativeness of the data. Thus, the aim of this study was to assess prevalence of occupational injuries and factors associated with it.

Methods

Study design

A cross-sectional study design was used to assess the prevalence of occupational injuries and its associated factors among municipal solid waste collectors in four zones of Amhara region, Northwest Ethiopia.

Study setting

The study was conducted in Debre Markos, Finote Selam, and Injibara towns and Bahir Dar city Administration from February to May 2015. Debre Markos town, Finote Selam town, Injibara town and Bahir Dar city administration are located 300, 387, 420 and 565 Km from the capital city of Ethiopia, Addis Ababa, respectively. In these towns, there are a total of 561 members of solid waste collection workers from 12 associations found in the four zone capital cities of Northwest Ethiopia.

Participants

The source population were municipal solid waste collectors, who were working in the capital cities of four zones of Amhara region. Of these, those who had at least one year work experience and who were selected by stratified simple random sampling technique were included. Workers who had seriously illness (unable to respond due to the illnesses other than occupational injury) during the data collection period were excluded from the study.

Sampling technique and procedure

Single population proportion formula was used to calculate the sample size of this study. By using prevalence study conducted in Northwest part of Ethiopia (P = 63.9 %) [11] and by assuming 95 % CI and 5 % margin of error and considering 10 % non-response rate, the final sample size was found to be 394. Stratified simple random sampling technique was used for this study. The samples selected by computer generated simple random sampling technique were distributed proportional to the number of workers in the towns.

Data collection and data quality control

Data were collected using semi-structured interviewer administered questionnaire. The questionnaire was prepared in English and translated to Amharic and then translated back to English to check consistencies. The main contents of the questionnaire were including; socio-demographic characteristics (age, sex, residence, marital status, religion, educational status, forms of employment), working environment (working hours, PPD utilization, work experience etc.), behavioral characteristics of MSWs (sleeping disturbance (yes/no), work related stress (yes/no), Job satisfaction (yes/no), Substance (Khat, Alcohol and Cigarettes) use) and work related injuries.

Twelve diploma nurses as data collectors and two BSc Environmental health professionals as supervisors employed for the data collection process. One day training was given to data collectors, and supervisors in accordance with training manual developed beforehand. The questionnaire was pretested on 5 % MSW workers that fulfill the inclusion criteria but resided outside the study area. Inputs from the pre-test were used to modify the questionnaire in more suitable manner so as to generate the desired data. The interview was conducted in private setting and the interviewers were supervised at each site, regular meetings were held between the data collectors, supervisors and the principal investigator. Moreover, consistency was checked before, during and after entering the data in to computer.

Operational definitions

Those who reported work related any physical damage to body tissues caused by accident or by exposure to environmental stressor in the last one year in working area were categorized as “presence of occupational injury”. Severe occupational injuries comprised of workers who reported at least one occupational injury and received health care at health facility level. Presence of job satisfaction (yes/no): It is a subjective response of study participants about their job whether it is pleasurable or not. Presence of job related stress (yes/no): subjective response of respondents whether they feel stress due to the job or not. Use of personal protective device (PPD): A municipal solid waste collector who are using all PPD (eye goggles, boots, gloves, face shield) required for solid waste collection during collection time. Current substance use: those who reported use of specified substance in the last one year.

Data processing and analysis

Coded data were organized and entered in to Epi Info version 3.5.1 computer software package and were exported to SPSS 20.0 version computer software package for further analysis. Five questionnaires found to be incomplete and excluded from the final analysis. Frequencies, percentages and means of variables were computed to describe the data. Binary logistic regression was used to assess the association between outcome variables and independent variables. To avoid unstable estimates in the subsequent model, variables that reached a p-value of less than 0.2 at the bivariable analysis level were kept in the final model. Finally, multivariable logistic regression model was fitted in order to identify factors associated with at least one occupational injury and severe occupational injuries of workers. P value of 0.05 was used to declare significant association.

Result

Socio-demographic characteristics

Three hundred seventy nine municipal solid waste collectors participated in the study yielding response rate of 96.2 %. The majority of them were females which account 285 (75.2 %) and the mean (±SD) age of respondents was 30.7 (±8.75) years. About 200 (52.8 %) of them were married in marital status and 159 (42 %) of them were unable to read and write in their educational status. Among respondents, 287 (75.7 %) of them reported work experience of more than 3 years (Table 1).
Table 1

socio-demographic characteristics of municipal solid waste collectors’ in four zones of Amhara region, Northwest Ethiopia, 2015 (n = 379)

Variables

Frequency

Percentage (%)

Sex

 Female

285

75.2

 Male

94

24.8

Age group

 < 30 years

244

64.4

 ≥ 30 years

135

35.6

Residence

 Urban

363

95.8

 Rural

16

4.2

Marital status

 Married

200

52.8

 Single

91

24.0

 Divorced

48

12.7

 Widowed

25

6.6

 Separated

15

4.0

Religion

 Orthodox

346

91.3

 Muslim

22

5.8

 Others

11

2.9

Ethnicity

 Amhara

358

94.5

 Others

21

5.5

Educational status

 Can’t read and write

159

42.0

 Can read and write

47

12.4

 Primary schools (1–8th)

84

22.2

 Secondary and above (9th +)

89

23.5

Employment pattern

 Permanent

289

76.3

 Temporary

90

23.7

Monthly salary

 ≥ 600 Eth. birr

307

81.0

 < 600 Eth. Birr

72

19.0

Work experience

 > 3 years

287

75.7

 ≤ 3 years

92

24.3

Work related and behavioral characteristics

One hundred (26.4 %) of study participants were working less than 5 days per a week. Among respondents, 332 (87.6 %) of them were used personal protective device (PPD). The reason for non-use includes; lack of PPD by 40 (85.1 %) and not comfortable with the device by 7 (14.9 %). About 261 (68.1 %) of them reported that no training was given during their employment time and 125 (33 %) and 155 (40.9) of them reported job related stress and history of sleeping disturbance in the last 1 year, respectively. Nearly one third (65.2 %), 22 (5.8 %) and 14 (3.7 %) of them had history of alcohol consumption, Khat chewing and cigarette smoking in the last 1 year respectively (Table 2).
Table 2

Work related and behavioral characteristics of municipal solid waste collection workers at four zones of Amhara Region, Northwest Ethiopia, 2015 (n = 379)

Variables

Frequency

Percentage (%)

Working hours per week

 < 5 days (39 h)

100

26.4

 ≥ 5 days (40 h)

279

73.6

Job related training

 Yes

118

31.1

 No

261

68.9

Alcohol use

 Yes

247

65.2

 No

132

34.8

Khat use

 Yes

22

5.8

 No

357

94.2

Cigarette use

 Yes

14

3.7

 No

365

96.3

Job satisfaction

 Yes

236

62.3

 No

143

37.7

PPD use

 Yes

332

87.6

 No

47

12.4

Reason for non-use

 Lack of PPD

40

85.1

 Not comfortable

7

14.9

Sleeping disturbance

 Yes

155

40.9

 No

224

59.1

Job related stress

 Yes

125

33.0

 No

254

67.0

PPD personal protective devise

Prevalence of occupational injuries

Out of 379 municipal solid waste collection workers, 130 (34.3 %) with 95 % CI (29.52, 39.10) were reported at least one injury in the last one year. Of these, 54 (41.5 %) workers were injured once and the rest 76 (58.5 %) of them injured two or more times. About 45 (34.6) of them reported injured body part of hand only. The most common type of injury was cut/punctures which was 68 (52.3 %) followed by abrasion 20 (15.40 %) and dislocation 12 (9.23 %). Regarding the source of injury, 47 (37.0 %) of them hit by falling objects and 29 (22.0 %) of them injured by hand tools. Ninety six (73.8 %) of them were lost more than ten working days due to an injury. Of those who reported occupational injury, 66 (50.7 %) treated at health facility level, of which 13 (10 %) of them admitted in Hospital (Table 3).
Table 3

Prevalence of occupational injuries among municipal solid waste collection workers at four zones of Amhara Region, Northwest Ethiopia, 2015

Variables

Frequency

Percentage (%)

Occupational injury

 Yes

130

34.3

 No

249

65.7

Frequency of occupational injury (n = 130)

 Once

54

41.5

 Two or more times

76

58.5

Types of injury

 Cut/Puncture

68

52.30

 Abrasion

20

15.40

 Dislocation

12

9.23

 Fracture

11

8.46

 Ear injury

10

7.69

 Eye injury

9

6.92

Parts of body injured

 Hand

45

34.6

 Leg

26

20.0

 above neck

21

16.2

 more than one body parts

38

29.2

Source of injury

 Hit by falling objects

47

37.0

 Hand tools

29

22.0

 Falls

24

18.0

 Lifting heavy objects

13

10.0

 Splintering objects

12

9.2

 Collision

5

3.8

Working days lost

 < 10 days

34

26.2

 ≥ 10 days

96

73.8

Treated at health facility

 Yes

66

50.7

 No

64

49.3

Admission due to an injury

 Yes

13

10

 No

117

90

Factors associated with occupational injuries

In multivariable analysis, work experience, monthly salary, sleeping disturbance, and job related stress were significantly associated with at least one occupational injury of municipal solid collection workers.

The likelihood of occupational injury was found to be significantly higher (AOR = 1.92 95 % CI: 1.11, 3.31) among respondents with three or less service years. Having monthly salary of less than 600 Eth. Birr (AOR = 3.0 95 % CI: 1.64, 5.48) was significantly and positively associated with occupational injury. The odds of occupational injury was 2.57 times (95 % CI: 1.48, 4.47) higher among those who reported sleeping disturbance as compared to their counterparts. Job related stress (AOR = 1.94 95 % CI: 1.11, 3.40) was also significantly and positively associated with occupational injury (Table 4).
Table 4

Factors associated with occupational injuries among municipal solid waste collection workers at four zones of Amhara Region, Northwest Ethiopia, 2015

Variables

Occupational injuries

Crude Odd Ratio with 95 % CI

Adjusted Odd Ratio with 95 % CI

Yes

No

Work experience

 ≤ 3 years

43

49

2.02 (1.25–3.26)

1.92 (1.11, 3.31)*

 > 3 years

87

200

1

1

Residence

 Urban

128

135

3.81 (0.85, 17.04)

4.43 (0.9, 21.83)

 Rural

2

14

1

1

Monthly salary

 < 600 Eth. Birr

46

26

4.70 (2.73, 8.08)

3.0 (1.64, 5.48)**

 ≥ 600 Eth. Birr

84

223

1

1

Sleeping disturbance

 Yes

85

70

4.83 (3.07, 7.61)

2.57 (1.48, 4.47)**

 No

45

179

1

1

Job related stress

 Yes

70

55

4.12 (2.61, 6.50)

1.94 (1.11, 3.40)*

 No

60

194

1

1

Note: 1 = Reference ** = p ≤ 0.001 * = p < 0.05

From all variables entered in the final multivariable model fitted for severe occupational injuries, sleeping disturbance related to the job, monthly salary, and literacy level were remained significant after adjusting for other independent factors. Monthly salary (AOR = 4.09 95 % CI: 2.15, 7.76) and literacy level (AOR = 2.22 95 % CI: 1.22, 4.04) were socio-demographic variables significantly associated with severe occupational injuries. Job related sleeping disturbance (AOR = 2.24 95 % CI: 1.22, 4.11) was also another variable that showed significant association with severe occupational injuries (Table 5).
Table 5

Factors associated with severe occupational injuries among municipal solid waste collection workers at four zones of Amhara Region, Northwest Ethiopia, 2015

Variables

Severe Occupational injuries

Crude Odds Ratio with 95 % CI

Adjusted Odds Ratio with 95 % CI

Yes

No

Sleeping disturbance

 Yes

42

113

3.10 (1.78, 5.38)

2.24 (1.22, 4.11)*

 No

200

24

1

1

Monthly salary

 < 600 Eth Birr

29

43

4.92 (2.75, 8.82)

4.09 (2.15, 7.76)**

 ≥ 600 Eth. Birr

37

270

1

1

Literacy level

 Illiterate

43

163

1.72 (0.99, 2.99)

2.22 (1.22, 4.04)*

 literate

23

150

1

1

Note: 1 = Reference ** = p ≤ 0.001 * = p < 0.05

Discussion

This study showed that the overall annual prevalence of occupational injury was found to be 34.3 %. The result of this study found to be lower than studies conducted in Addis Ababa (43.7 %) and Northwest Ethiopia (63.9 %) [11, 18]. As municipal Solid waste is produced as a result of economic productivity and consumption; the compositions of wastes collected from small towns expected to be less hazardous and more garbage in nature and smaller in size which could explain the above difference. More than half of respondents also reported occupational injury of more than once in the last one year. In this study, cut/puncture, abrasion and dislocation are the most common type of injuries reported. Similarly, different local and abroad studies reported that cut and/or puncture as the most common type of occupational injuries [4, 11, 16, 18, 19].

Regarding the body parts injured, hands are the most common body parts followed leg. The same finding was reported in Ethiopian studies conducted among solid waste collectors [11, 18]. The possible explanation for this may be due to the fact that waste collectors wipe waste and put it in to the cart and tracks using their hands which increase the probability of having injury [18]. In this study, hit by falling objects and hand tools are the most common patterns of injuries reported. Similarly, different literatures are showing the same regarding common agents of work related injuries [4, 12].

The occurrence of any type of (either non-severe or severe) occupational injuries are significantly associated with monthly salary of the workers. This is explained by the fact that better salaries mean better chances of treatment and better protection from work related accidents which helps them to be less exposure to waste dust and less contact with waste material [20]. Having work experience of three or less years was positively associated with at least one occupational injury. This is in line with already existing knowledge that more experienced waste collectors work safer [2124]. The possible explanation might be due to both life experience and years of experience on the job better predict job performance [12]. The higher level of job dissatisfaction and social stigma in new workers owing to the nature of job might also explain the finding. In contrary, other studies conducted globally showed that more experienced waste collectors are more vulnerable to occupational accidents [4, 11, 16, 19].

Having job related stress showed significant association with occupational injury of solid waste collectors. This finding is in line with other studies conducted among industrial workers [1, 25, 26]. The possible explanation for this finding could be workers who had stress might be preoccupied by extra thinking which emanated from physical symptoms (which includes headache and abdominal pain), and disturbance of psychological and family relationships related to stress. The result of the study has revealed that the occurrence of any type of occupational injuries are significantly related to sleeping disturbance. This finding is similar with other studies conducted in Ethiopia [11, 18]. A meta-analysis also suggested that workers with sleep problems had a 1.62 times higher risk of being injured at work compared to workers without sleep problems [27]. As more than three-fourth of study participants were women, the increased association might be due to factors such as marital status, number of children in the house and family responsibilities that affect the quality of life and sleeping pattern of women. Sleeping disturbance also affect the ability to maintain wakefulness, concentration, ability in assessing or watching the work environment and working conditions. Moreover, almost all refuse collection works are conducted at the morning time in Ethiopian setting which might also be the possible explanation.

The literacy level of workers was significantly associated with the occurrence of severe occupational injuries. This might be due to the fact that education is more likely to increase workers safety and health practice that can prevent them from occupational injuries [1].

The use of the capital cities of four zones which increase the representativeness of the information is the strength of the study. Unable to infer causal relationship owing to cross-sectional nature of the study and the presence of recall bias due to the long time pass are among the potential limitations.

Conclusion

This study demonstrated that the magnitude of occupational injuries among municipal solid waste collectors found to be lower compared to similar studies conducted in Ethiopia. Working for short service years, having lower monthly income, being stressed due to the job and experiencing sleep disturbance are significantly and positively associated with at least one occupational injury. Moreover, being illiterate, having lower monthly income and those who reported sleeping disturbance had significant association with severe occupational injuries of solid waste collectors Based on the finding of this and other studies, job rotation among work components, improvement of employees’ income, job specific guideline regarding maximum production limits, and replacement of bags and bins with wheeled containers are an interventions expected to cope with the problem. There is also a need of specific periodic health surveillance (PHS) for refuse collectors to detect early signs of work related complaints and to monitor work ability. In addition, the relationship between work experience and occupational injuries need further investigation.

Declarations

Acknowledgement

We would like to express our gratitude to data collectors and supervisors for their timely submission of completed questionnaires and to respondents for their willingness to participate in this study. We want also like to thank Debre Markos University for arranging internet and library services.

Funding

“Not applicable”.

Availability of data and materials

“The dataset will not be shared in order to protect the participants’ identities”.

Authors’ contributions

DE conceived and designed the study, performed analysis and interpretation of data. ZA and KY supervised the design conception, analysis, interpretation of data and made critical comments at each step of research. KY drafted the manuscript. All authors read and approved the final Manuscript.

Competing interests

The authors declared that they have no competing interests.

Consent for publication

“Not applicable”.

Ethics approval and consent to participate

The Study was reviewed and approved by the Ethical review committee of Debre Markos University, College of Medicine and Health Science. All participants were informed of the aim of the study and their full right to withdraw or refuse to participate before their verbal consent was obtained.

Confidentiality was maintained by omitting respondents’ name and personal identification.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Health Extension Program, Debre Markos Town Health Bureau
(2)
Department of Public Health, College of Medicine and Health Science, Debre Markos University

References

  1. Aderaw Z, Engdaw D, Tadesse T. Determinants of occupational injury: a case control study among textile factory workers in Amhara Regional State, Ethiopia. J Trop Med. 2011;2011:567275Google Scholar
  2. Yiha O, Kumie A. Assessment of occupational injuries in Tendaho Agricultural Development S.C, Afar Regional State. Ethiop J Health Dev. 2010;24(3):167–74.Google Scholar
  3. Olorunnishola OA, Taylor AK, Byrd L. Occupational injuries and illnesses in solid waste industry: a call for action. Journal of Morgan State University School of Community Health and Policy. 2010;20(2):211–23.Google Scholar
  4. Rushton L. Health hazards and waste management. Br Med Bull. 2003;68(1):183–97.View ArticlePubMedGoogle Scholar
  5. Piedrahita H. Costs of work related Musculoskeletal Disorders (MSDs) in developing countries. International Journal of Occupational Safety and Ergonomics (JOSE). 2006;12(4):379–86.View ArticleGoogle Scholar
  6. Blair S, Djupsjöbacka M, Johansson H, Ljubisavljevic M, Passatore M, Windhorst U, et al. Neuromuscular mechanisms behind chronic work-related myalgias: an overview. In: Johansson H, Windhorse U, Djupjöbacka M, Passatore M, editors. Chronic work-related myalgia. Neuromuscular mechanisms behind work-related chronic muscle syndromes. Gävle: Gävle University Press; 2003. p. 5–46.Google Scholar
  7. Mehrdad R, Majlessi-Nasr M, Aminian O, Sharifian SA, Malekahmadi F. Musculoskeletal disorders among municipal solid waste workers. Acra Med. 2008;46(3):233–8.Google Scholar
  8. Kuijer P, Frings-Dresen M. World at work: refuse collectors. Occup Environ Med. 2004;61:282–6.View ArticlePubMedPubMed CentralGoogle Scholar
  9. Kuijer P, Sluiter J, Frings-Dresen M. Health and safety in waste collection: towards evidence-based worker health surveillance. Am J Ind Med. 2010;53:1040–64.View ArticlePubMedGoogle Scholar
  10. Poulsen OM, Breum NO, Ebbehøj N, et al. Collection of domestic waste. Review of occupational health problems and their possible causes. Sci Total Environ. 1995;170:1–19.View ArticlePubMedGoogle Scholar
  11. Gizaw Z, Gebrehiwot M, Teka Z, Molla M. Assessment of occupational injury and associated factors among municipal solid waste management workers in Gondar town and Bahir Dar City, Northwest Ethiopia, 2012. J Med Med Sci. 2014;5(9):181–92.Google Scholar
  12. Frumkin H. Environmental health: from global to local. 2nd ed. USA: Jossey-Bass; 2010. p. 374–587.Google Scholar
  13. Frey M, Battaglia M, Passetti E: Investing in safety in the environmental hygiene sector. Franco Angeli 2014Google Scholar
  14. Athanasiou M, Makrynos G, Dounias G. Respiratory health of municipal solid waste workers. Occup Med. 2010;60:618–23.View ArticleGoogle Scholar
  15. Tooher R, Griffin T, Shute E, Maddern G. Vaccinations for waste-handling workers. A review of the literature. Waste Manag Res. 2005;23:79–86.View ArticlePubMedGoogle Scholar
  16. Thirarattanasunthon P, Siriwong W, Robson M, Borjan M. Health risk reduction behaviors model for scavengers exposed to solid waste in municipal dump sites in Nakhon Ratchasima Province, Thailand. Risk Manag Healthc Policy. 2012;5:97–104.View ArticlePubMedPubMed CentralGoogle Scholar
  17. London L, Tangwa G, Matchaba-Hove R, Mkhize N, Nwabueze R, Nyika A, et al. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context. BMC Med Ethics. 2014;15:48.Google Scholar
  18. Bogale D, Kumie A, Tefera W. Assessment of occupational injuries among Addis Ababa city municipal solid waste collectors: a cross-sectional study. BMC Public Health. 2014;14:169.View ArticlePubMedPubMed CentralGoogle Scholar
  19. European Agency for Safety and Health at Work. The occupational safety and health of cleaning workers. European risk observatory literature review. Luxembourg; 2009Google Scholar
  20. Ahmad Khalil MM. Investigation of occupational health and safety hazards among domestic waste collectors in Bethlehem and Hebron Districts. Master’s Thesis. Najah National University, Faculty of graduate studies; 2004Google Scholar
  21. Rachiotis G, Papagiannis D, Markas D. Hepatitis B virus infection and waste collection: prevalence, risk factors, and infection pathway. Am J Ind Med. 2012;55:650–5.View ArticlePubMedGoogle Scholar
  22. Authier M, Lortie M, Gagnon M. Manual handling techniques: comparing novices and experts. Int J Ind Ergon. 1996;17:419–29.View ArticleGoogle Scholar
  23. Ivens UI, Lassen JH, Kaltoft BS, et al. Injuries among domestic waste collectors. Am J Ind Med. 1998;33:182–9.View ArticlePubMedGoogle Scholar
  24. Terry LB, Slavova S, Tang M. Injuries among solid waste collectors in the private versus public sectors. Waste Manag Res. 2011;29(10):1043–52.View ArticleGoogle Scholar
  25. Ghosh AK, Bhattacherjee A, Chau N. Relationships of working conditions and individual characteristics to occupational injuries: a case–control study in coal miners. J Occup Health. 2004;46(6):470–8.View ArticlePubMedGoogle Scholar
  26. Soori H, Rahimi M, Mohseni H. Occupational stress and work-related unintentional injuries among Iranian car manufacturing workers. East Mediterr Health J. 2008;14(3):697–703.PubMedGoogle Scholar
  27. Uehli K, J. Mehta A, Miedinger D, et al. Sleep problems and work injuries: a systematic review and meta-analysis. Sleep Med Rev. 2014;18:61–73.View ArticlePubMedGoogle Scholar

Copyright

© The Author(s). 2016

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