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‘HOLE TO HELL’
A Report on
Health & Safety Status
of Sewage Workers
in Delhi
Pranjal Jyoti Goswami
CEC, New Delhi, India
Untouchable
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Stinks????
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Background
• Sewage work in India is a modern day
extension of ‘manual scavenging’ or
the age-old practice of ‘untouchables’
• More than 30 workers have died in
just two years in various incidents
• The pattern of tragedy in a majority of
the cases was strikingly similar
• No Policy/ Accident Investigation by
Delhi Jal Board (DJB)
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Delhi Sewage System
• Population 16 M & sewage
generated 2,871 mld
• A network of about 5,600 km of
internal, peripheral and trunk
sewers
• Approximately 5,500 Beldars
(40% Casual)
• No separation of domestic waste
and industrial effluents
Delhi Sewage System
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• Primitive working conditions
without any kind of protection or
supervision
• Manual operations with limited
tools
• No training nor job permit for
confined space entry
• Social Discrimination / no Social
Security / No Insurance
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Legacy of ‘DIRTY’ Work
‘Manual Scavenging’
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Objectives
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• Generating baseline
data on H & S
• Provide Advocacy tool
for workers Union
• Building self-sustainable
OSH mechanism for
Workers
• Creating awareness
among workers
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Investigation for
Probable Health Effects
• Skin Effects
• Eye Effects
• Upper
Respiratory Tract
Effects
• Gastro-intestinal
Effects
• CNS Effects
• Parasitic
Infections
• Hepatitis
• Asthma
• Liver Dysfunction
• Kidney Damage
• Haematological
Effects
Methodology
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• Randomly selected sample of
200 sewage workers
• Pre-tested semi-structured
questionnaire based interview.
• Routine tests such as
Hemogram, urine analysis.
• PFT and X-rays chest were
performed in selected subjects
by std procedures.
• Data was analyzed using EpiInfo computer software package
of the WHO.
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OBSERVATIONS
AND FINDINGS
OF THE STUDY
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Two workers died during
the course of the study due
to chronic illness.
(age 59 and 55)
One Died in an Accident
while cleaning underground
sewer line. Age 29.
Demographic Characters
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• Mean age 38.3 years.
Minimum: 23 years
Maximum: 59 years
Demographic Characters
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• 93.5% of the workers are
married with an average
of 3.37 children per family.
• Average Members per
Family is 5
• Single Income
• 34.5% of the workers
were illiterates
Occupational Health (Acute Symptoms)
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Symptom
Eye irritation
Positive
Response
159 (79.5%)
URT irritation
114 (57.0%)
Difficulty in
breathing
Skin rash
76 (38.0%)
Cut injury
183 (91.5%)
Headache
68 (34.0%)
121 (60.5%)
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Work Load
Employment
Permanent
Underground Entry
(Times per Month)
>10
3-10
0-2
59.3%
36.5% 4.2%
Muster roll
58.5%
31.7%
Average
59.0%
34.5% 6.5%
9.8%
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Statistical Analysis(Acute Symptom Vs Work Load)
Symptom (Acute)
Chi Sq
P value
Eye irritation
11.26
0.0035
URT irritation
12.82
0.0016
Light Headedness
7.29
0.026
Skin rash
8.73
0.012
Cut injury
25.35
0.00000313
The P-values less than or equal to 0.05
are suggestive of significant correlation
(with a confidence level of 99.95%)
Occupational Health (Chronic Symptoms)
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Symptom
Tiredness
Positive
Response
152 (76.0%)
Body ache
83 (41.5%)
Headache
97 (48.5%)
Watering of eyes
73 (36.5%)
Cough
145 (72.5%)
Breathlessness
31 (15.5%)
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Occupational Health
(Chronic Symptoms)
Symptom
Skin irritation
Positive
Response
83 (41.5%)
Skin roughness
72 (36.0%)
Skin rash
91 (45.5%)
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Work Load
Employment
Permanent
Underground Entry
(Times per Month)
>10
3-10
0-2
59.3%
36.5% 4.2%
Muster roll
58.5%
31.7%
Average
59.0%
34.5% 6.5%
9.8%
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Statistical Analysis
(Chronic Symptom Vs Work Load)
Symptom
Tiredness
Chi Sq
21.48
P value
0.000021
Watering of eyes 8.36
0.015
Burning of eyes
10.38
0.0055
Skin irritation
6.5
0.0370
Skin roughness
7.85
0.019
Skin rash
6.45
0.039
The P-values ≤ 0.05
(with a confidence level of 99.95%)
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Occupational SAFETY
Protective Gear
Users
Mask (Chin
Cartridge)
Safety Shoe
(gumboots)
Gloves
24 (12.0%)
Eye Protection
0 (0.0)
Safety Belt
185 (92.5%)
15 (7.5%)
15 (7.5%)
Skin- Protective Cloth!!
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Occupational SAFETY
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• None of the workers had been
given any formal hazards
communication.
• None had been trained to
provide first aid in case of any
mishap.
• Gloves and Gumboots do not
provide any protection against
injuries from sharp or broken
objects
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Respirators
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Respirator- Blunder
(This chin cartridge contains particulate filter for
removal of toxic particulate matter contaminants
including aerosols)
– Chin cartridge for protection against
organic vapour
– For use in atmosphere containing not more
than 5000 ppm by volume of contaminants
(that is, in combination of any or all these
pollutants)
– Must not be used in closed tank spaces, in
oxygen deficient atmosphere, that is, less
than 18 per cent oxygen
– When gas detected by odour, taste, eye
irritation, return to fresh air immediately
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Labour Rights
• 81.7% of Daily Wagers have been
working for more than six years &
14.6% for more than 10 years
without being regularized
• Half of them have to work more
than 8 hours a day
• Neither appointment letters nor
contracts
• Not entitled to any leave other than
1 day weekly off day
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Monthly Wage
• Permanent workers INR 3500-8000
(USD 80-200)
• Muster-roll INR 2950 ($67)
• The additional benefits of dirt
allowance, washing allowance,
GPF and insurance only to
permanent workers
• No annual increment for Musterroll workers
Personal Habits
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•
•
•
•
Current Smokers 68.5%
Current Alcohol consumer 65.5%
Smokeless Tobacco 22%
The principal reason of High level of
addiction is the filth and unpleasant
nature of work.
• Most of them started the consumption
of alcohol and smoking only after
joining sewer work
Body Mass Index (BMI)
50% of the respondents across all age
groups underweight
Blood Profile
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• 18.5% Anaemic
• 34.2% Low RBC count
• In spite of having normal leukocyte
counts (91 per cent), 67.3 per cent
had higher eosinophil counts (>6 per
cent)
• 11.7 per cent showed more ESR
than the normal range
• No abnormality in Kidney function
test
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Statistical Analysis(Correlation with Eosinophil)
Eosinophil
Normal
0-2
Work
3-10
Load
>10
> Normal
9
4
28
39
27
89
Chi Sq
pvalue
15.09
0.00052
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Damage to Respiratory
System
• Of 53 pulmonary function tests,
over half were abnormal
• Of 35 Chest X-rays, 23 were
normal.
• Six had the evidence of lung
tuberculosis
• hypertensive heart changes. Five
had evidence of infective lung
disease, and one showed the
presence of
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Outcome of the
Study
• Set Up a new Department on OSH
• Formulation of job entry procedure for
Manhole more than 6 feet depth
• Mandatory Supervision by Senior
Official while working in Confined
Space
• Increased in the Insurance Benefit for
workers
• Initiation of Safety Training???
• Policy to modify Respiratory Protection
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Thank You