COLLEGE OF MEDICINE AND HEALTH SCINCE

DEPARTMENT OF ENVIRONMENTAL HEALTH

ASSESSMENT OF THE TYPES OF OCCUPATIONAL HAZARDS AMONG

STREET SWEEPERS IN DESSIE TOWN, SOUTH WOLLO ZONE, ETHIOPIA

BY: EYOB HUNEGNAW

ESHETE TESFAYE

ADVISOR: ADINEW GIZEYATU (BSc., MSc.)

RESEARCH PAPER SUBMITTED TO WOLLO UNIVERSITY, COLLEGE

OF MEDICINE AND HEALTH SCIENCES DEPARTMENT OF
ENVIRONMENTAL HEALTH, FOR PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR BACHELOR OF SCIENCE DEGREE IN
ENVIRONMENTAL HEALTH

JUNE, 2017
DESSIE, ETHIOPIA
 ABSTRACT
Introduction: street sweeping is an important job in maintaining the health of the people and
sanitation of the cities. But this job exposes street sweepers to different occupational health
hazards such as to physical, chemical, biological, psychosocial and ergonomic health hazards
because the conditions they work in, in terms of occupational safety and health are far less from
adequate.

Objective: the aim of this research was to assess the type of occupational health hazards among
street sweepers which are working under the municipality of Dessie town, South Wollo, Ethiopia

Method: A cross-sectional study design was carried out from January to June, 2017 G.C.

Result: the result of the study revealed that out of 94 street sweepers, who were interviewed
about the availability of PPEs, 39(42%) were responded that gloves, boots/safety shoes and
gowns were available for them and only 15 (35%) of them were utilize gloves, 11 (28%) utilize
safety boots and 13 (33%) of them were utilize gowns. None of them responded the availability
and utilization of respirators, nose and mouth mask, face shields, ear muffs, hats and helmets.
Regarding their personal hygiene, 64(68%) of street sweepers wash their hands only and
30(32%) sweepers take shower after finishing their daily job and none of them were having
training about proper waste collection and handling. Concerning the health problems they faced
during their working years, this study revealed that, most of the street sweeper’s responded
problem of respiratory systems like cough (76%) and asthma (67%), musculoskeletal disorders
(78%) and eye infection (66%).

Conclusion and recommendation: based on the overall result of the study, most of street
sweepers did not use personal protective devices during their working times and they are
exposed to dust, sharp materials and dead bodies of animals and, faeces. Most of the sweepers
did not also keep their personal hygiene after finishing their daily work, this things might
exposed them to different health hazards like asthma, cough, musculoskeletal disorders and eye
infection. To alleviate these problems, the municipality should fulfill PPEs to them and should
create awareness regarding the necessary precautions they should perform during and after
sweeping. They should also provide water supply for the sweepers.

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 ACKNOWLEDGMENT
First of all we would like to thanks to God. Next, we would like to forward great thank to our
advisor Mr. Adinew Gizeyatu for his support to complete this research paper. We would also like
to appreciate Wollo university in general and college of medicine and health science especially
department of environmental health for giving the chance to do this type of study. Finally we
would like to thank our teachers and classmates for their constructive comments and suggestions.

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Table of contents Pages
Abstract …………………………………………..……………………………………ii
Acknowledgment…………………………………….……………...…………………iii
Table of content………………..……………………………………………………….iv
List of tables add
figures…………………………………………………………………………….…….vi
Acronyms and Abbreviations………………..
…………………………………………………………vii
Chapter One: Introduction……………………………..……………………………….1
1.1 Back ground…………………………………….…………………………….…1
1.2 Statement of the
problem………………………………………………………………………..…3
1.3 Significance of the study…………………………………………………………………….
…….…5
Chapter Two: Literature Review ………………………………..…………....……….6
Chapter Three: Objectives………………………….…………………………….…….10
3.1 general objective…………………………………………………………….…10
3.2 specific objectives…………………………………………….…………….….10
Chapter Four: Methods and Materials ……………………………….…….…….…….11
4.1 study area…………………….…………….…………………………….…….11
4.2 study design and period……………………………………….………….….…11
4.3 Source population…………………………………………….………….….….11
4.4 study population………………………………………………………………..11
4.5 study unit …………………………………………………………………....... 11
4.6 Sample size and sampling technique…………………………………………...12
4.7 study variables………………………………………………………………….12
4.7.1 Dependent variables………………………………………….…………….12
4.7.2 Independent variables………………………………………..…………….12
4.8 Operational definition………………………………………………….………12
4.9 Data collection method………………………………………………………….12

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 4.10 Data quality control ………………………………………………..…………..12
4.11 Method of data analyzing and processing…………………………………….….13
4.12 Ethical consideration……………………………………………..………………13
4.13 Information dissemination …………………………..………………..………….13
Chapter Five: Results……………………………..…………………..…………………….14
Chapter Six: Discussion ……………………....………………………………………….....24
Chapter Seven: Conclusion and Recommendation ………………………………………...26
7.1. Conclusion …………………………………………….………………………………26
7.2. Recommendation …………………………………………………………………..….27
Annex I: References…………….…………………….…………………………………….28
Annex II: Questioners ………………………………………………………………............30

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 List of tables
Table 1: Socio-demographic characteristics of street sweepers in dessie town municipality, may,
2017

Table 2: Work environment of street sweepers working in the municipality of dessie town, May
2017.

Table 3: Response of street sweepers on the community and their own attitude towards the job in
dessie town municipality, may 2017

Table 4: Response of street sweepers about types of wastes they were exposed during sweeping
in dessie town municipality, may 2017.

Table 5: Knowledge of street sweepers about safety devices used during sweeping, method of
usage of PPEs, health impacts associated with street sweeping and purpose of using PPEs, in
dessie town municipality, may 2017.

Table 6: Response of street sweepers on availability of PPEs in dessie town municipality, may
2017.

Table 7: Response of street sweepers on health problems they faced during their working years in
dessie town municipality, which is identified by physicians, may 2017.

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 List of figures
Fig 1: Religion of street sweepers in dessie town municipality, may, 2017

Fig 2: Availability of PPEs for street sweepers in dessie town municipality, may 2017

Fig 3: utilization of PPEs by street sweepers in dessie town municipality, may 2017

Acronyms and Abbreviation

ILO International Labor Organization
NIOSH National Institute for Occupational Safety and Health
PPEs Personnel Protective Equipment’s
UK United Kingdom
URTI Upper Respiratory Tract Infection

CHAPTER ONE: INTRODUCTION

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1.1. Background

One of the most important jobs through history has been street sweeping. Early on city official
figured out that without street sweepers, health hazards would become rampant. Urban
thoroughfares in undated with litters, trash and animal wastes were perfect breeding ground for
diseases and vermin, to say nothing the sightless they generated (1).

Street refuse contain mixture of the refuses from many sources, because streets are used as a
dumping ground by all generators of wastes; streets also often used for extensive dumping of
construction and demolition debris and affecting further dumping of solid waste (2).

Street sweepers play significant role in maintaining the health of the people and sanitation of the
cities. Most of the time, people involved in this occupation are people with low economic
status,without much education and live in poor housing condition (3).

Street sweeping is to sweep waste materials thrown at public streets and it is considered as a
risky job due to the close contact to agents present in the urban waste that exposes sweepers to
different types of health problems(4).often, the conditions they work in, in terms of occupational
safety and health are far from adequate. For instance, they manage wastes without acceptable
protective equipment (5). Hence, it is presumed that this job exposes them to variety of risk
factors such as soil and dust. In addition to these, street sweepers can be exposed to chemical
hazards such as carbon dioxide, carbon monoxide and sulfur dioxide from vehicular emission
and bio-aerosols like pollens, endotoxin, fungal secretions and microorganisms present in
aerosols created during sweeping process(6).

At present the standards and norms for the management of municipal solid wastes in
industrialized countries are substantially reduced occupational health impacts. However, in
developing countries solid waste management including waste collection, street sweeping,
recycling and composition is a serious problem due to lack of resources, technologies ,low
standard of living, low level of education and poor planning(7).

8
The data available and research clearly suggested that the prevalence of health problems of street
sweeping work force is high. However the number of occupational diseases reported each year is
much slower (8).

1.2. Statement of the Problem

Street sweepers play an important role in maintaining the health and hygiene in the city.
According to ILO, 2000, working conditions tend to be unsafe for those who are directly
handling the waste, the street sweepers besides the dangers of cuts and infections from the waste
itself, they are exposed to dust and fume, speeding traffic and violence.

Street sweeping exposed road street sweepers to such as organic and inorganic dust, bio aerosols,
volatile organic matter, fumes which make them to be susceptible to various occupational
diseases; they are at risk of asthma, chronic bronchitis, and other respiratory symptoms (9).
Beyond the respiratory symptoms, morbidity conditions that are observed in these workers are
disease of the eye, accidents, injuries, cuts and wounds (10).

ILO, March, 2007, street sweepers’ illnesses they have experienced included occasional flu and
cough, and eye irritation, rush or skin irritation and other reported illnesses among street
sweepers included chronic coughing and eye disease.

According to Zock, occupational health hazards street sweepers can be exposed are physical
health hazards, chemical health hazard, biological health hazard, psychosocial health hazard and
ergonomic (11). Physical health hazard, physical signs and symptom include rash, sun burn, heat
stress, headache, breathlessness, skin cancer and temporary loss of hearing or permanent hearing
loss from exposure to noise. Chemical health hazards, risk of health include headaches,
dizziness, fatigue and respiratory problem of vehicles on the road such as carbon monoxide,
carbon dioxide, sulfur dioxide and particulate matter may serve as a vector for health effect air
pollutants.

Biological health hazard, street sweepers may be also exposed of biological include bacterial
endotoxins, fungal secretions and micro- organisms present in aerosols created during the
sweeping and cleaning process. psychosocial health hazard, involved factors are varied such as
requirements to work 8-hour of labor force, individual responsible area and they are monitored

9
daily work by supervisor which lead to adverse effects for street sweepers, such as social
isolation, higher risk being victim of violence, working at unsociable hours and exposure to
dangerous substances. Ergonomic risk factors involved tasks such as equipment or tool, work
station, practice, policy of organization and personal behavior (12).

NIOSH, 2008, estimated that deaths from work related respiratory disease and cancer account for
about 70 % of all occupational diseases death worldwide 5-15 % of new cases of asthma in
working adults are caused by occupational exposure (13). In India, 2008 study on street sweepers
and important morbidities were detected and prevalence of respiratory morbidity was 5.9 %
while prevalence of chronic respiratory morbidity was 8.1 % .The prevalence of respiratory
symptoms among street sweepers in Nigeria were reported to be cough 25.5 %, chest pain 13 %
and sneezing 6 % (14).

Street sweepers who rarely used personal protective equipment’s are exposed to high level of
dust which contributes to increase prevalence of respiratory health symptoms (15). A recent
study in Ethiopia, Addis Ababa estimated the occupational hazards among street sweepers
during the past year to be 43.7 % , with those who were not using protective devices having 2.6
times more likely to get injured.(16).

In our study area, Dessie town even if there are conditions that are exposed street sweepers to
greater occupational hazards , the study conducted to assess the type of health hazards to them
were limited .Thus this study tried to assess the type of occupational health hazards that street
sweepers are facing.

1.3. Significance of the Study

Assessments of the type of occupational hazards to which street sweepers exposed have not been
studied sufficiently in dessie town. Furthermore, there was no study that have been examined
their use of PPES during working places. So, the findings of this study can provide relevant
information so as to take possible measures that can improve the health status of the street
sweepers and the use of PPEs during sweeping. Moreover, the overall result could be useful in
that, it can serve as background for further study.

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 CHAPTER TWO: LETRATURE RIVIEW

Work occupies a central place in most people’s lives, but overall Context of Work is often
ignored or poorly understood. The effective understanding of work place injury and diseases
requires a full comprehension of the natures of work and the social, political and economic
context of the work place (17).

Socio- economic status is a determinant of health and is well known to play an important role in
the development of several diseases among them (18). Education is a key determinant of life
system and status an individual enjoy in a society and provide people with the skill and
knowledge that can lead to a better quality of life (19). Also level of education influences the
types of occupation and income which can determine the home living condition (18).

It has strong effect in attitude and awareness related to family health and hygiene. The low
awareness of health and safety would make more vulnerable to illnesses (20). Hand washing
practice is the single most important means of preventing spread of infection (Abash s, Ohimain
E, 2011). A study done on assessment of knowledge, attitude and practice among 400 street
sweepers on prevention of occupational health hazards, in Addis Ababa, 350(88%) wash their
hand with soap after work and 50 (12%) did not wash. And 150(38%) take shower daily after
work and the rest 250(62%) did not (21).

A study done in dhaka city, Bangladesh, in depth interview on 15 street sweepers, almost all the
participants reported routine exposure to dust particles at their work. 40 % of participants
reported that they were exposed to sharp objects (22) A study done in Egypt on 138 street
sweepers showed that about 13.8 % of them complained of skin irritation (23). Occupational
exposure to dust particles is a significance cause of work disability, morbidity, mortality in
working populations in worldwide (24).

A study by O. OKU (2005) indicated that there is a higher prevalence of respiratory symptoms
among the street sweepers, the major symptoms were cough, catarrh as well as sneezing. it is
likely that paved road dust which is a complex mixture of soil dust, deposited motor vehicle
exhaust particles, tire dust, plant fragments and other biological material is allergic and may
therefore irritate the respiratory track leading to cough and other respiratory symptoms ( 25).

11
A study by Gupta SC in 1962 on the street sweepers and their families in locknuts revealed
the most significantly detected morbidities were skin diseases (2.6%), URTI(0.8%) , bronchitis
(0.5%) and conjunctivitis(0.3%). The effect of occupational exposure range from lung diseases
,cancer, hear loss, and dermatitis to more subtle psychological effects, many of which are only
now being recognized .Work place exposures include those to air born contaminants, ionizing
radiation, and ultraviolet and visible light, electric and magnetic fields, infrared radiation,
microwave heat, cold, noise, extremes of barometric pressure and stress and a work place can
also be the source of a wide range of infectious diseases (26).

Lung diseases among worker who breathe the high concentrations of contaminated air have been
recognized for century and one group of occupational lung diseases, pneumoconiosis, and result
when workers breathe dust that penetrates to the lungs, accumulates and causes pathological
reactions (27).

According to the review carried out by Bello et.al for their own study (Bello, A, Quinn.
m.m.et.al.2009), the incidence of the asthma and asthma like symptoms has increased
among street sweepers in the last decade, and the hypothesis that the development or the
aggravation of respiratory disorders, including asthma seem to be confirmed by
epidemiological studies.

Skin disorders are common work place related health complexions contact dermatitis accounts to
90 % of work related skin disorders. Workers are exposed to chemicals, which gain access to the
body by inhalation, ingestion, dermal absorption, or rarely by injection which may leads to
extreme health defects (28). Nature of the work itself predisposes workers to various types of
harmful agents or substances. Cleaners are exposed to respiratory diseases, dermatological
disorders, allergic conditions that are associated with cleaning agents, wet work, and rubber latex
(29).

Questionnaire –based study of 5000 cleaners in the UK also showed that, the prevalence
of health problems such as musculoskeletal complaints ,skin problems and psychosomatic
disorders among street sweepers was higher than in other profesion.23% of the
respondents had been absent from working in the last 12 months as a result of ache and
pains caused by work.

12
The potential for infection was associated with contaminated needles ,broken glasses, waste
material, and other trash through which workers can be exposed to biological agents, muscular
skeletal disorders where associated with awkward posture and other organic hazards (30). Mental
disorders are mostly associated with psychological stresses and social stigma of the job (31).

In 2000,the German DAK and BGW carried out survey on work related psychosocial
aspects in 23 types of occupation. The survey included a total of 8,015 workers of which
238 were street sweepers in the sector(occupational group member 933 in the German
classification of occupation),94.5%were female cleaners and 5.5% male, the mental health
of cleaners was worse by 9% than the total German labor force ,and their physical health
worse by 7% .Furthermore, cleaners suffered more from so called psychosomatic disorders
than the German labor force(50.9%) above the average. Back pain, neck and shoulder pain,
heavy legs, high sleep need and restlessness were the most common disorder and complaints
found under the category of psychosomatic disorders.

In Nigeria, the Ekitit state government assesses the nature and challenges of street sweeping on
103 sweepers and the results obtained; joint pain (in the form of twisted backs, sprained wrists,
pains in arms, necks, hips, and knees) was the commonest health challenge by almost all
(96.1%) of the sweepers. The sweepers explained that the pains were caused by the awkward
postures they assume when sweeping, bending down for long and very low because of the short
brooms they used. Catarrh (91.3%), cough (83.5%) and respiratory disorder or asthma (46.6%)
are the second, third and fifth common health challenges of the sweepers resulting from
inhalation of dust and dirt, and sometimes unexhausted chemicals inside cans of pesticides and
insecticides that are mixed with ordinary wastes dumped on the streets. Eye irritation and
infection (70.8%) was the fourth and malaria the least (31.1%) of the sweepers’ health problems.
Noise from moving vehicles, motorcycles, record stores and at market areas distracted and
frightened them while a few complained about the working hours of 6am-8am as a disruption of
family responsibility and an exposure to the risk of violence and hit-and-run accident.

Many workers are unaware of potential hazards present in their working environment, which let
them to be more vulnerable to injury and other work related diseases (32). There are few good
statistics on the occupationally related diseases/illnesses/ and injuries in developing countries, or
on the magnitude or degree of health and safety hazards at work. This inadequacy is a function of

13
the inadequate infrastructure and human resource for occupational health and safety in
developing countries as well as the inherent difficulty in diagnosing and obtaining data on work
related health problems. In that situation for which data are available, there is evidence that the
occurrence of occupational illness and injuries in developing countries is much higher than
developed countries (33).

In some case informal waste worker belongs to religious, or ethnic minorities and social
discrimination as a factor which obligates them to work under completely unhygienic conditions
as well as waste collectors or sweepers, also their family is subjected to economic insecurity,
health hazards, lack of access to normal social services such as health care, schooling for
children and absence of any form of social security (34).

In developing countries including Ethiopia where a wide range of insecurity jobs, in which the
worker does not have any formalized relationship with an employer. Some of the tasks are
inherently hazardous, for example the manual collection and recycling of wastes. More generally
informal worker tend to have a poor working environments and very unsatisfactory welfare
facilities (35).

To avoid exposure from work place hazards personal protective equipment’s can be applied to
individual worker and they should be provided with protective helmets, goggles, safety shoes,
protective clothing and respirators (36). Personal protective equipment is anything used or worn
by a person to minimize risk to the persons health and safety, include a wide range of clothing
and safety equipment ,where in any factors or work place ,workers are employed in any process
involving exposure to any injuries (37).

The acute respiratory health effects can presumed by reduced by proper dust control measure
such as personal protective devices, respirator, training and education and maintaining machine
at work places (38). Because most dust is hazardous to the lung, respirators are common methods
of primary/secondary/ protection. Respirators are appropriate as primary control during
intermittent maintenance or cleaning activities when fixed engineering controls are not
feasible/available (39).

Personal protective equipment such as gloves, that do not fit can increases the risk of accidents
and increase the strength requirements for the tasks. For women, it is often difficult to find

14
manufactures which make equipment’s in women’s size ,often small, medium and large size of
equipment’s are available, but even small size is designed for small man not for small women
and this may actually contributing it the risk of work place injuries (33).

In order to take care of their own health and safety, workers must have to understand
occupational risk and dangers. A large proportion of occupational hazards in work places can be
prevented or controlled through different measures such as safe work practices and appropriate
tools, work organization and provision of information to the workers to enables them to
minimize risk while performing duties. Workers should therefore be well informed of hazards
and adequately trained to carry out their tasks. Training enables workers not only to perform their
jobs but also to protect their lives and health, as well as that of their co-workers (40).

15
 CHAPTER THREE: OBJECTIVES
3.1. General objective

To assess the type of occupational hazards to which street sweepers working in the municipality
of Dessie town are exposed from January to June, 2017G.C.

3.2. Specific objectives

 To assess the utilization of personal protective equipment’s among street sweepers

 To determine status of personal hygiene among street sweepers

 To determine specific type of occupational hazards among street sweepers

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 CHAPTER FOUR: METHODS AND MATERIALS
4.1. Study area

The study was carried out in Dessie town, which is a town in north central Ethiopia; found in
South Wollo zone of Amara region. It is located 401 km away from Addis Ababa. It also sits at
latitude and longitude of 11◦8’N39◦38’E/11.133◦N39.633◦,with an elevation of 2470 and 2550
meters above sea-level. Based on the 2007 national census conducted by the Central Statistical
Agency of Ethiopia, Dessie has a total population of 151,174 of whom 72,932 are men and
78,242 are women, among this population the majority of the inhabitants are Muslim, with 58.62
%, while 39.92 % are Ethiopian orthodox Christianity and 1.15 % are protestant. The city has an
average temperature of 15.2◦ c and mean annual rainfall of 1145mm.

4.2. Study design and period

A Cross- sectional study design was carried out to assess the types of occupational hazards to
which street sweepers are exposed in the municipality of Dessie town and the study was
conducted from January to June, 2017.

4.3. Source population

All street sweepers which are found in Dessie town

4.4. Study population

All street sweepers working in the municipality of Dessie town since municipality has hired 94
street sweepers.

4.5. Study unit

Each street sweeper working in the municipality was included.

4.6. Sample size and sampling technique

All street sweepers, 94, hired by the municipality of Dessie town were included and all of them
were directly interviewed by data collectors with checklist.

4.7. Study variables

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4.7.1. Dependent variables

 Work related hazards

4.7.2. Independent variables

 Service year

 Age

 Educational status

 Utilization of PPEs

 Habit of personal hygiene after work

4.8. Operational definition

 Street sweepers: - persons who clean the street.

 Utilization of PPEs: - accessibility and wearing of personal protective equipment.

 Road dust: - dust generated from the road during sweeping.

 Accidents: - something that happens unexpectedly or by chance during work.

 Injury:- any harm or damage to workers caused by sharp materials and needle pricks.

 Respirator:- a device to protect the worker from inhalation of harmful contaminants.

 Helmet:- a device that shields the face, neck and other parts of the body.

 Goggles:- materials used for eye protection from exposure to dust particles has potential
to enter the eye and damage it.

 Availability of PPEs:-PPEs those were given by the municipality to sweepers and can be
used now.

4.9. Data collection methods

The data was collected by using close-ended structured questioner.

4.10. Data quality control

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Before data collection we have get some training from our advisor in order to fill the questioner
properly and to minimize bias. We have checked the questioners for completeness before leaving
each study participant. To make the questioners clear and understandable by all respondents,
questions prepared in English were translated into Amharic language.

4.11. Method of data analyzing and processing

After data collection, data processing was conducted by sorting, tallying and calculating for
necessary figures. Quantitative data analysis was done by creating frequency table, it was
corrected after reviewing the original data, and then it was analyzed using calculator and
presented with pie chart, graph & frequency percentage table.

4.12. Ethical consideration

An official letter was written to Dessie town municipality from Wollo University College of
medicine and health science, department of environmental health and permission was asked from
the responsible body of the administrator in a written form and each study participant have been
adequately informed about the purpose and the anticipated benefit of the study by the data
collectors. Confidentiality was informed about the objective of the study and privacy was
ensured. Always, the willingness of the respondents was asked.

4.13. Information dissemination

The findings of this study will be submitted to Wollo University College of Medicine and Health
science, department of Environmental health and it will be also disseminated to Dessie town
municipality to recommend the existing problems.

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 CHAPTER FIVE: RESULTS
5.1. Socio-demographic characteristics of respondents
There were a total of 94 street sweepers, 88 (93%) female and 6 (7%) male, who are employed in
dessie municipality and all of them have responded for the questionnaire. Concerning the age of
respondents, about 13 (14%) were in the age group of 18-32, and 62 (66%) were in the age group
of 33-47. Among 94 street sweepers, 49 (52%) were married and 25 (26%) were divorced.

Table 1: Socio-demographic characteristics of street sweepers in dessie town municipality, may,

2017
Variable Frequency %
Age 18-32 13 14
33-47 62 66
>47 19 20
Total 94 100
Sex Male 6 7
Female 88 93
Total 94 100
Marital status Single 6 7
Married 49 52
Divorced 25 26
Widowed 14 15
Total 94 100
Educational status Illiterate 40 42
1-4 35 37
5-8 14 16
9-12 5 5
Total 94 100

Concerning the religion of respondents, 42(45%) were orthodox, 39(41%) were Muslims and the
remaining 13(14%) were Protestants.

Fig 1: Religion of street sweepers in dessie town municipality, may, 2017

20
 Religion

Muslim Orthodox

13

protestant

39

42

5.2. Working status of study participants

Out of 94 participants who were involved in the study, 39 (41%) had working experience of one
to five years and 68 (72%) of street sweepers worked for one to five hours per day.

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Table 2: Working status of street sweepers working in the municipality of dessie town, May 2017
Variable frequency %
Service year 1-5 39 41
>5 55 59
Total 94 100
Working hours per day 1-5 68 72
>5 26 28
Total 94 100

5.3. Community and street sweeper’s attitude towards the job

Regarding the community attitude towards the job, among 94 street sweepers, 40(42%) of them
responded that they were ignored by the community, 20(21%) of them responded that the job
was stigmatized by the community and 34(37%) of them responded that they had low status in
the community because of the job they are performing. Furthermore, 20(21%) street sweepers
responded comfortable, 34(37%) sometimes stressed and 40(42%) of them responded their job is
not comfortable.

Table 3: Response of street sweepers on the community and their own attitude towards the job in
dessie town municipality may 2017

Variables frequency %
Community attitude Ignored 40 42
Stigma of the job 20 21
Low status in the community 34 37
Total 94 100
Street sweepers attitude Comfortable 20 21
on their job Sometimes stressed 34 37
Not comfortable at all 40 42
Total 94 100

5.4. Types of waste street sweepers were exposed during their working hours
According to the study finding, all street sweepers were exposed to dust particles during their
working time, 41 (44%) were exposed to sharp materials, 79(84%) were exposed to left over
foods of garbage related waste,39 (42%) were exposed to dead bodies of animals and
52(55%)were exposed to paper and chat leaves.

22
Table 4: Response of street sweepers about types of wastes they were exposed during sweepingin
dessie town municipality, may 2017.

Types of wastes Frequency %

Dead bodies of animals 39 42
Sharp materials 41 44
Paper, chat leaves 52 55
Left over foods 79 84

5.5. Knowledge of street sweepers about occupational hazards and PPE

Of 94 street sweepers, 58 (62%) of them were know about safety devices used during work time,
its method of usage and 85 (90%) know health impacts associated with street sweeping And
about 58 (62%) know the purpose of using PPEs.

Table 5: Knowledge of street sweepers about safety devices used during sweeping, method of
usage of PPEs, health impacts associated with street sweeping and purpose of using PPEs, in
dessie town municipality, may 2017.

Variables/characteristics Response in frequency and percent

Yes (%) No (%) Total
Knowing safety devices used 58(62%) 36(38%) 94
Knowing how to use safety 58(62%) 36(38%) 94
devices
Knowledge about health 85(90%) 9(10%) 94
impacts associated with
street sweeping
Knowing the purpose of 58(62%) 36(38%) 94
using PPEs

5.6. Availability and utilization of PPEs for/by street sweepers

Out of 94 street sweepers, who were asked about the availability of PPEs, 39(41%) were
responded that gloves, boots/safety shoes and gowns were available for them and only 15 (35%)
of them were utilize gloves, 11(28%) utilize safety boots and13 (33%) of them were utilize
gowns. None of them responded the availability and utilization of respirators, nose and mouth
mask, face shields, ear muffs, hats and helmets.

Table 6: Response of street sweepers on availability of PPEs in dessie town municipality, may
2017.

23
 S.No Types of PPEs Availability of PPEs
Yes % No %
1 Nose/mouth mask 0 0 94 100
2 Glove 39 42 55 58
3 Respirator 0 0 94 100
4 Gowns 39 42 55 58
5 Face shields 0 0 94 100
Safety
6 boots/shoes 39 42 55 58
7 Hats 0 0 94 100

Availability of PPEs
70

60 58 58 58

50
42 42 42
40
Yes
percent

30 No
20

10

0
glove safty boots/shoes gown

type of ppe

24
Figure 2: Availability of PPEs for street sweepers in dessie town municipality May, 2017.

Utilization of PPES
80
72
Yes
70 65 67
Colum
60 n1
50
percent

40 35 33
30 28

20

10

0
glove safty boots/shoes gown
TYPE OF PPES

Fig 3: utilization of PPEs by street sweepers in dessie town municipality May 2017

Regarding their personal hygiene, 64(68%) of street sweepers wash their hands only and
30(32%) sweepers take shower after finishing their daily job and none of them were having
training about proper waste collection and handling. As the study finding, during cleaning the
street, none of them used any wetting substance, they practice dry cleaning. According to the
findings of this study none of the respondents had worked for any other dusty job and none of
them were exposed to gas or chemical fumes in any other job. Regarding time of sweeping; all of
the respondents worked both in the morning and afternoon and responded as they were exposed
to cold weather and sun heat.

5.7. Health condition of street sweepers before and after starting street sweeping
Before they were started this job, all of them responded that they had not any health problem but
after starting this job, 63(67%) of sweepers had develop asthma, 71(76%) cough, 6(6%) had
shortness of breath and 13(14%) bronchitis already confirmed and diagnosed.

Table 7: Response of street sweepers on health problems they faced during their working years in
dessie town municipality, which is identified by physicians, may 2017.

25
Variables Response Frequency %
Asthma Yes 63 67
No 31 33
Cough Yes 71 76
No 23 24
Shortness of breath Yes 6 6
No 88 94
Bronchitis Yes 13 14
No 81 86
Eye infection Yes 62 66
No 32 34
Skin Yes 23 25
disorder(specially on
hands not confirmed No 71 75
by a physician)
Musculoskeletal Yes 73 78
disorder No 21 22

According to the study finding, all the street sweepers responded that they did not have water
supply in the municipality for shower and hand washing after completing their daily work and
none of them were having training about proper waste collection and handling mechanisms.
Furthermore, all the sweepers responded that there was no health and safety personnel in the
municipality.

26
 Chapter Six: Discussion
To avoid exposures from work place hazards, personal protective devices can be applied to
individual workers. They should be provided with protective helmets, goggles, safety shoes,
protective clothing and respirators (33). But the result of this study indicated that, majority
79(84%) of street sweepers did not use complete personal protective equipment’s. Only 15(16%)
of them practiced to wear personal protective devices. This may be probably due to the lake of
availability of PPEs for all workers, lack of awareness about the importance of using PPEs and
absence of health and safety personnel for them.

A large proportion of occupational hazards in work places can be prevented or controlled

through different measures such as safe work practices and appropriate tools, work organization
and provision of information to the workers to enable them to minimize risk while performing
duties. Workers should therefore be well informed about hazards and adequately trained to carry
out their tasks. Training enables workers not only to perform their jobs but also to protect their
lives and health, as well as that of their co-workers (39). But according to the response of
sweepers, the findings of this study indicated that, they did not have meeting to discuss about use
of safety measures in the work place and did not get adequate training to carry out their tasks.
This might be due to lack of commitment by the municipality towards creating safe working
condition of the workers i.e. street sweepers.

Regarding type of wetting substances used, the result of this study indicates that all of the street
sweepers practiced dry cleaning, which might expose them to dust materials. Paved road dust

27
which is a complex mixture of soil dust, deposited motor vehicle exhaust particles, tire dust and
plant fragments is a major cause for higher prevalence of respiratory symptoms among street
sweepers (OKU,2005). The reason behind lack of wetting activity might be due to absence of
adequate water supply and lack of awareness among street sweepers regarding the importance of
wetting activity before cleaning.

Hand washing practice is the single most important means of preventing spread of infection
(Abash s, Ohimain E, 2011). Among the respondents of this study 64(68%) had the habit of hand
washing after sweeping, this is low when compared to the study done among 400 street sweepers
in Addis Ababa that 350 (88%) of them wash their hands after sweeping (21). This might be due
to the absence of water supply service in the municipality.

All of the study participants in this study responded that they are exposed to dust and 44 % of
them responded that they had exposure to sharp materials, this result is comparable with the
study done in Dhaka city, Bangladesh that almost all the participants reported routine exposure to
dust particle and 40 % were exposed to sharp materials (22).

In some case informal waste worker belongs to religious, or ethnic minorities and social
discrimination as a factor which obligates them to work under completely unhygienic conditions
as well as waste collectors or sweepers, also their family is subjected to economic insecurity,
health hazards, lack of access to normal social services such as health care, schooling for
children and absence of any form of social security (31). Based on the response of sweepers, our
study result also showed that 40(42%) of them respond that they are ignored by the community
and 34(37%) respond that they have low status in the community. This might lead them to
psychosocial hazard.

Concerning the health problems they faced during their working years, this study revealed that,
most of the street sweeper’s responded problem of respiratory systems like cough (76%) and
asthma (67%), musculoskeletal disorders (78%) and eye infection (66%). This is supported by a
study done in Nigeria, the Ekitit state government on 103 sweepers and the result obtained; joint
pain (in the form of twisted backs, sprained wrists, pains in arms, necks, hips, and knees) was the
commonest health challenge by almost all (96.1%) of the sweepers. cough (84%), eye irritation
and infection (71%), respiratory disorder or asthma (47%) (29).

28
A study done in Egypt on 138 street sweepers showed that about 13.8 % of them complained of
skin irritation, but in this study greater number of respondents 25% complain the problem of skin
disorders especially on hands, which might be due to the direct contact with wastes while using
no protective devices (22).

CHAPTER SEVEN: CONCLUSION AND RECOMMENDATION

CONCLUSION
From the results of the study we can conclude that, most of street sweepers did not use personal
protective devices during their working times. Hence majority of them exposed to deferent types
of waste such as dust, sharp materials, garbage, feces and dead bodies of animals. The cleaners
did not use any wetting substance they practiced dry cleaning. None of them got proper training
concerning waste handling practices. Regarding attitude towards the job, most of them thought
that the job was ignored and have low status in the community and they have low acceptance in
some social issues in the community due to these reasons most of them responded that, the job
was not comfortable for them and they stressed. Most of the sweepers have low level of personal
hygiene after completing their daily work. According to this study, Cough and asthma were the
major health defects encountered by the sweepers. They also faced musculoskeletal and skin
disorder especially on hands and eye infection.

RECOMMENDATION
Based on the study findings the following recommendations were forwarded.

 The provision and utilization of protective devices such as: gowns, respirators, shoes, hat,
and goggles during their routine activities should be provided by the municipality in
order to reduce their occupational exposure to hazards.

29
  Regular and continuous training to street sweepers about proper waste handling, usage of
personal protective devices and on proper personal hygiene should be given by
professionals.

 The community should show respect ion to street sweepers and minimize the improper
disposal of wastes on the roads.

 The sweepers themselves should increase the habit of wearing the available PPEs during
working times.

References
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associated with municipal waste collection and management. International journal of
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university. 2004
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respiratory symptoms in female sweepers.IJBR.2004; 05(06): 408-410.
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morbidities among street sweepers and waste collectors at Beni-suef, Egypt. Egyptian journal
of occupational medicine.2013.
5. Smilee JS, Dhanyakumar G, Vivian ST, Ajay KT, Suresh YB. Acute lung function response
to dust in street sweepers.2013.
6. Ajay KT, Vatsala AR, Danyakumar G, Suresh YB.A study of impairment of lung functions in
adult sweepers J Pharm Sci and Res.2014.
7. American lung association state of lung disease in diverse communities 2010.
8. Mannino DM, Braman S. The Epidemiology and Economics of chronic obstructive
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13. Williams BMD. Occupational respiratory disease. The new England journal of
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14. Asnani PU, Cris Z, Ebastian A .Improving municipal solid waste management in india.2008
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to organic dust associated with municipal waste collection and management.2002
16. Bogal et el .Assessment of occupational injuries among Addis Ababa city municipal solid
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17. O.Donnell, P.M.Health promotion in the work place,USA.2002
18. Tamara S,DorotheeS,UerenceR,Beete Ulrich Ursula Contribution of smoking and air
pollution exposure in urban areas to social differences In respiratory health, BMC public
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19. Ethiopian demographic and health survey 2010.
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21. Science journal of public health, published online February 23, 2016.
22. Kabir A et al .int J community med. Public health 2015 Aug
23. Egyptian, journal of occupational medicine, 2013
24. Ng,T.P; Hong, C.Y; Goh, L.G; M.L; Koh, K.T and ling. Risk of asthma associated with
occupations in a community based case control study, Amjind med 25.(1994)
25. Sopan TI, Bhutan GP, Nilesh DW. exposure to vehicular pollution and respiratory
impairment of traffic policemen in flagon city, India industrial health.(2005)
26. Moeller, W,H. Environmental health (3 ed).USA: Harvard university press.(2005)
27. Oijja K, Yihuang A. A study of available dust collectors and their efficiency, course dust
around mining areas. (2008).
28. Levy, S.B; Wegma , H.D ;Baron, L,S and Sokas, K.R. occupational and environmental
health, recognizing and preventing disease and injury(5thed).(2006)
29. Emmanuelle brun, European agency for safety and health at work. The occupational safety
and health of cleaning workers.(2009)
30. Tiwari,R.R., Occupational health hazards in sewage and sanitary workers.(2008)
31. Charles, R.L, Loomis D and Demise Z. Occupational hazards experienced by cleaning
workers and janitors. (2009)
32. Simon LB, Anne B, Ericblokel L. Individual level social economic status is associated with
workers asthma morbidity in patient with asthma.(2009)
33. Levy , S.B; Wegman, H.D. occupational health, recognizing, preventing work related
disease(3rded)USA.(1995)
34. United Nations Development Program(1996)

31
35. International labor organization. Action towards prevention of occupational non-
communicable disease.(2003)
36. Frumkin,H. Environmental health from global to local, USA(2005)
37. Environmental health services (2010)
38. Zeyed JP. Multiple occupational hazards in a large service sectors occupational and
environmental medicine.(2010)
39. Ehlers, C.E and victor, municipal and rural sanitation USA.(1992)
40. Lugah ,V; Ganesh,B;Darus,A ;Retneswari,M;Rosnawati,M.C. and sujath, D. Training of
occupational safety and health.(2010)

Annex II: prepared to interview street sweepers

Wollo University
College of Medicine and Health Science
Department of Environmental Health Science
A research questionnaire prepared to interview street sweepers to assess the type of occupational
health hazards to which street sweepers working in the municipality of Dessie are exposed.

Consent form
How are you, good day! I am ….. I with my colleague are students from Wollo University
College of medicine and health science, department of environmental health to conduct research.
The aim of the study is to assess the type of occupational health hazards among Dessie town
street sweepers .I assure you that the information that you are going to give will kept strictly
confidential. Therefore you are free to respond or not to respond the questions. Your support and

32
willingness in responding the questions will be very important for the identification of
occupational health hazards among you in this town and to set recommended solutions.

Having the above information, I honorably invite you to participate in the study.

Thank you for your cooperation.

Part One
Socio-demographic characteristics
1. Sex: 1 Male
2 Female
2. Age: A.30-35 year B. 36-40 years C. >40 years
3. Religion: 1. Muslim 2. Orthodox 3. Protestant 4. Other
4. Marital statuses: 1. Single 2. Married 3. Divorced 4. Widowed 5.cohabited
5. Educational statuses: 1. Illiterate
2. Literate 1. Elementary School A. 1-4 B. 5-8
2. Secondary school A. 8-10 B. 10-12 C. above
6. Service year of respondents A.1-3 years B.4-5 years C.8-10 years d. Above 10 years
7. How many working hours per week? A. 14hours B. 21hours C. 28hours
8. What is your monthly income due to this job? A. 450-600 birr B. 601-900 birr

PART TWO
HEALTH RELATED QUESTIONS
1. Types of waste to which you are exposed during working hours
A. Dust B. Sharp materials (needles, broken glasses)
B. Leftover foods D. Dead bodies of animal, E. Feces of human or animal F. paper, chat
leaves G. other(specify)
2. Knowledge about use of personal protective equipment’s
2.1 Do you know the safety devices used during collection and handling of wastes?
1. Yes 2. NO
2.2 Do you know how to use safety devices during collection and handling of wastes?
1. Yes 2. No
2.3 Do you know the street sweeping could have also associated with health impact on the
sweepers?
33
 1. Yes 2. No
2.4 Do you know the purpose of using personal protective equipment’s?
1. Yes 2. No
2.5 If yes for Q no_2.4 what is the purpose? A. Protects exposure from dust
B. Keeps safe from injury C. minimizes risks to health and safety
3 Attitude of street sweepers on their jobs and activities
3.1 Communities attitude towards your job?
1. Ignore
2. Stigma of the job
3. Low status in the community
4. Accepted by the community
3.2 Your attitude towards the job you are performing?
1. Comfortable 2. Sometimes stressed 3. Not comfortable at all
4. Availability and utilization of personal protective equipment’s
4.1 Is the personal protective equipment available for you?
A. yes B.NO
4.2 If yes for Q.no 4.1 which one of the following is available for you?
s.no Type of PPEs Availability of PPEs
ANSWER

YES NO 5. Practice of
street sweepers
on the use of
1 Nose/mouth masks
2 Respirators personal
3 Gloves
4 Goggles protective
5 Safety boots/shoes equipment’s
6 Ear muffs
7 Gowns 5.1 Do you use
8 Face shields safety
9 Hats equipment’s
10 Helmets
during working
time? A. yes B. No
5.2 If yes for Q no 4.1 which one of the following do you use?

34
 Types of PPEs Wearing of PPEs during working
Answer
Yes No Explanations
s.no
1 Nose/mouth mask
2 Respirators
3 Gloves
4 Face shields
5 Ear muffles
6 Safety boots/shoes
7 Gowns
8 Aprons
9 Helmets
10 Hats
11 Reflectors
12 Others

Explanation means if NO indicate the reason why they do not use/wear the PPEs? E.g. feel not
so important, uncomfortable, not durable, careful when carry duties, not ready available
6. Do you always wear it during working? A: Yes B: NO
7. If you don’t wear it always what is your reason?
A. Not available B. Not durable C. careful when carry duties D. uncomfortable
8. Do you wash your body after finishing your daily activities?
1. Yes 2. No
9. If yes for Q no 8 which part of the body?
A. Wash hands only B. Take shower/both
10. Do you have water supply services in the municipality for shower and hand washing after
sweeping? A. yes B.NO
11. Did you get training about proper waste collection and handling? 1. Yes 2. No
12. What types of wetting substance or solution will you use for cleaning?
1. Water 2. Dry clean
5. Occupational history
5.1 Have you ever worked for any other dusty jobs? 1. Yes 2. No
5.1.1 If yes in which job? 1. Wood work 2. In the garage 3.factories 4 other (specify)
5.2 What perceived level of dust you exposed in that job? A. Mild B. moderate C. sever

35
 5.3 Have you ever been exposed to gas or chemical fumes in any other work? 1. Yes 2. No
5.3.1 If yes for Q no 5.3, for which one? A. Naphtha B. Varnish C. Benzene D. Oil
6. What are the difficulties that you have encountered due to the nature of your jobs?
1. Exposure to sun radiation 3. Violence
2. Exposure to cold weather
7. Did you have any health problems you were faced before starting this job?

7.1 If yes for Q no 7, for which type

A. respiratory problem E. psychosomatic disorder
B. abdominal pain F. skin condition
C. eye condition G. musculoskeletal disorder
D. cardiovascular problem H. other
8. What is your health condition now? A. Good B. Not good C. sometimes sick, if not good
what is your health problem now?
9. Do you have the health problem that you believe (confirmed by a doctor) may be related to
working as the street sweeper? A. yes B. No
10. If yes for Q no 9, describe the health problem?
10.1 respiratory problem
1. Asthma A. yes B. No
2. Cough A. yes b. No
3 .shortness of breath A. yes B. No
4 .sinus problem A. yes B. No
5 .Bronchitis A. yes B. No
10.2 Skin disorders
1. Whole body A. Yes B. No 3. Face A. Yes B. No
2. Hands A. Yes B. No

36
10.3 Eye infections A. Yes B. No
10.4 Musculoskeletal disorders A. Yes B. No
10.5 psychosomatic disorders A. Yes B. No
11. Does the municipality have health and safety personnel?
A. Yes B. No
12. If yes, does the municipality follow written health and safety plan for action in the work
place? A. Yes B. No
13. Does the municipality have meeting to discuss safety and health factors with you?
A. Yes B. NO
14. At what time do you sweep the street? A. Morning B. evening C. afternoon D. morning and
afternoon
15. How many times you sweep the street within a day? A. Once B. Twice c. more than two