ObjectiveTo assess the prevalence of musculoskeletal disorders (MSDs) as well as the impact of the occupation of waste picking on complaints of MSDs among waste pickers. The study attempts to understand the risk factors for MSDs in various areas of the body.DesignA cross-sectional household survey was conducted using a case-control design. The survey instrument for measuring musculoskeletal symptoms was adopted from a standardised Nordic questionnaire. The impact of the occupation of waste picking on MSDs was analysed using the propensity score matching (PSM) method.ParticipantsThe study population consisted of waste pickers (n=200) who had been working for at least a year and a control group (n=213) selected from among or living close to the same communities.ResultsThe 12-month prevalence of MSDs was higher among waste pickers (79%) compared to controls (55%) particularly in the lower back (54–36%), knee (48–35%), upper back (40–21%) and shoulder (32–12%). Similar patterns were observed in the 12-month prevalence of MSDs which prevented normal activity inside and outside the home, particularly for the lower back (36–21%), shoulder (21–7%) and upper back (25–12%) for waste pickers and controls. Analysis of the impact of waste picking on complaints of MSDs suggests that the occupation of waste picking raises the risk of MSDs particularly in the shoulder, lower and upper back. Older age and longer duration of work are significant risk factors for MSDs.ConclusionsThe findings suggest a relatively higher prevalence of MSDs among waste pickers, particularly in the lower and upper back and shoulder, compared to controls. Preventive measures and treatment to minimise the burden of MSDs among waste pickers are strongly recommended.

BackgroundThe occupation of waste-picking characterised as 3Ds – dangerous, drudgery and demanding. In this context, the study aimed to assess occupational morbidities among the waste-pickers and attempts to identify potential individual level risk factors enhancing health risks. Additionally, economic burden of morbidities has been assessed.MethodsThe burden of the morbidities was assessed and compared with a comparison group through a cross-sectional survey. Waste-pickers (n = 200) and a comparison group (n = 103) working for at least a year were randomly selected from the communities living on the edge of the Deonar dumping site. The difference in the prevalence of morbidities was tested using the chi-square test. The effect of waste picking resulting the development of morbidities was assessed using the propensity score matching (PSM) method. A multivariate logistic regression model was employed to identify the individual risk factors. T-test has been employed in order to analyse the difference in health care expenditure between waste pickers and non-waste pickers.ResultsThe prevalence of morbidities was significantly higher among the waste-pickers, particularly for injuries (75%), respiratory illness (28%), eye infection (29%), and stomach problems (32%), compared to the comparison group (17%, 15%, 18%, and 19% respectively). The results of the PSM method highlighted that waste-picking raised the risk of morbidity for injuries (62%) and respiratory illness (13%). Results of logistic regression suggest that low level of hygiene practices [household cleanliness (OR = 3.23, p < 0.00), non-use of soap before meals (OR = 2.65, p < 0.05)] and use of recyclable items as a cooking fuel (OR = 2.12, p < 0.03) enhanced health risks among the waste pickers when adjusted for the age, duration of work, duration of stay in community and substance use. Additionally, the high prevalence of morbidities among waste pickers resulted into higher healthcare expenditure. Findings of the study suggest that not only healthcare expenditure but persistence of illness and work days lost due to injury/illness is significantly higher among waste pickers compared to non-waste pickers.ConclusionsThe study concluded that waste-picking raised the risk of morbidities as also expenditure on healthcare. Results from the study recommend several measures to lessen the morbidities and thereby incurred healthcare expenditure.

ObjectiveThis study aims to assess the exposure of those involved in street sweeping to the development of musculoskeletal disorders (MSDs) and related disabilities and tries to identify the individual risk factors thereof.DesignA cross-sectional survey was conducted among street sweepers together with a comparison group. A modified Standardized Nordic Questionnaire was adopted to measure the prevalence of MSDs and related disabilities. The impact of the occupation of sweeping on the development of MSDs and related disabilities was assessed using the propensity score matching (PSM) method. A multivariate logistic regression model was employed to identify the individual risk factors.ParticipantsStreet sweepers (n=180) and a comparison group (n=180), working for at least a year as formal employees of the Municipal Corporation of Greater Mumbai (MCGM), were randomly selected from 6 municipal wards.ResultsThe prevalence of the MSDs was significantly higher among the sweepers for shoulders (32%), wrists/hands (29%), elbows (27%) and neck (17%) compared with the comparison group, in which the prevalence was 11%, 19%, 9% and 11%, respectively. The disabilities too were significantly higher among the street sweepers for the lower back (27%), upper back (27%), wrists/hands (26%), shoulders (24%) and elbows (23%) compared with the comparison group, for which the figures were 18%, 19%, 13%, 9% and 6% respectively. The PSM method highlighted that the occupation of sweeping raised the risk of developing MSDs and disabilities particularly for the shoulders (17–16%), wrists/hands (14% each), elbows (13% each) and the upper back (12–13%). After adjusting the age, body mass index and the caste of the street sweepers, the number of years of engagement in street sweeping and the location of work emerged as potential risk factors in the development of MSDs and, thereby, related disabilities.ConclusionsThe study concluded that the occupation of street sweeping raises the risk of MSDs and related disabilities. This study recommends preventive and curative measures to deal with MSDs among street sweepers.

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While existing indices of gender equality measure the role of women’s status and position, they inadequately contextualize the broader construct of patriarchy, a social system that underlies many gender inequitable practices. An index capturing patriarchy may afford increased understanding of this social system, and may serve to complement other gender equality indices. This paper involves the development and testing of a novel composite measure, the India Patriarchy Index, to quantify the social and ideological construct of patriarchy using empirical data on family structure and gender roles. Using data from India’s National Family Health Survey, we develop an India Patriarchy Index to measure gendered social positioning in families based on sex by age, patrilocality, sex ratio imbalance among offspring, and gendered economic roles. Psychometric testing demonstrates good internal reliability and construct validity of this index, with validity indicated by its association with three gender equality indices used in India. Spatial and temporal analyses further indicate much state-level variation in India Patriarchy Index scores as well as slow change on this indicator over time, based on time trend analyses from 1992–93 to 2015–16. Results demonstrate the utility of the India Patriarchy Index to measure and track gender equality progress in India.