HOLE TO HELL

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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
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Stinks????
Untouchable
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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

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Delhi Sewage System

• 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
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Manual Scavenging
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Objectives

• 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

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Methodology

• 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 Epi-Info 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.
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Demographic Characters

• Mean age 38.3 years.
• Minimum 23 years Maximum 59 years

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Demographic Characters

• 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

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Occupational Health (Acute Symptoms)
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Work Load
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Statistical Analysis-(Acute Symptom Vs Work Load)
The P-values less than or equal to 0.05 are
suggestive of significant correlation (with a
confidence level of 99.95)
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Occupational Health (Chronic Symptoms)
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Occupational Health (Chronic Symptoms)
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Work Load
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Statistical Analysis (Chronic Symptom Vs Work
Load)
The P-values 0.05 (with a confidence level of
99.95)
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Occupational SAFETY
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Skin- Protective Cloth!!
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Occupational SAFETY

• 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 Muster-roll workers

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Personal Habits

• 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
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Blood Profile

• 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 (gt6 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)
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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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Media Campaign
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Media Campaign
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Media Campaign
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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