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Review
The effects of handling solid waste on the
wellbeing of informal and organized recyclers:
a review of the literature
Eric Binion, Jutta Gutberlet
The Community-based Research Laboratory, University of Victoria, British Columbia, Canada
Previous research has identified health issues in the formal, regulated solid waste collection sector, located
primarily in the global North. Conversely, less information is available with regard to the health
predicaments of informal, unaffiliated, and organized recyclers operating in regions of the global South.
Estimated at 15 million people operating globally, informal recyclers perform a vital public service while
working individually or within cooperatives.
1
This review assesses, discusses, and compiles the physical
and emotional health issues of individuals who are operating in this stigmatized sector. The study highlights
the self-assessed and observed health risks. Findings were coded into a number of reacquiring themes:
chemical hazards, infection, musculoskeletal damage, mechanical trauma, emotional vulnerabilities, and
environmental contamination. The review showcases the encouraging significance of working as a member
in a recycling cooperative as a means of alleviating health issues. The findings suggest the need for further
qualitative research with informal recyclers and solid waste policy enforcement with public, commercial,
and industrial cooperation in source separation.
Keywords: informal recycling, occupational health, health perceptions, risks, policy, cooperatives, literature review, solid waste
Introduction
Informal recycling, a ubiquitous activity, is defined
as individuals collecting, separating, classifying, and
selling solid waste as a means of subsistence or sup-
plementation of income. The solid waste is recovered
from residential, commercial, and industrial sectors.
The occupational title is linguistically diverse, identi-
fied colloquially in Brazil as catadores or carrinheiros,
in Argentina as cartoneros or recuperadores urbanos,
as Binners in North America, or as Zabaleen in
Egypt. Consequently, the term ‘informal recycler’
used in this review will generalize all individuals
involved in the informal solid waste recovery sector,
which employs an estimated 15 million individuals.
1
Solid waste, viewed as a salient resource, can sub-
sequently be extracted as a source of income and as a
means of sustaining a livelihood. This livelihood is
operated as an unregulated public service that is
performed under precarious or hazardous working
conditions. Hence, solid waste, which would typically
accrue in landfills or be incinerated, is commoditized,
creating further use as a recycled or reused good. The
people involved in the activity construct their
livelihood on resource recovery, mostly unassisted
and without adequate health protection measures in
place. However, some recyclers in countries such as
Brazil and Argentina mobilize to form cooperatives.
The cooperatives allow collection, separation, and
commercialization of the materials recovered from
the solid waste stream in an organized and equitable
fashion.
The knowledge that solid waste may pose a
serious risk to both the environment and human
health is well known.
2
Investigations from Denmark
have demonstrated how sanitation workers in the
regulated sector of waste management were 5.6 times
more likely to incur a workplace injury and were 1.5
times more inclined to contract a waste-related
occupational disease in comparison to the national
average.
3,4
A subsequent study in Canada demon-
strated how employees in formal recycling plants
reported higher job-related illnesses and injuries
more often than other sectors.
5
As a result of these
inherent risks associated with the regulated waste-
management sector in high-income countries, there
has been discourse with regard to the unregulated
informal recycling and solid waste management
sectors.
Correspondence to: J. Gutberlet, Department of Geography, University of
Victoria, PO Box 3060 STN CSC, Vicotira, BC, VSW 3R1 Canada. E-mail:
juttag@uvic.ca
ßW.S. Maney & Son Ltd 2012
DOI 10.1179/1077352512Z.0000000001 International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1 43
Owing to the demonstrated formal waste-manage-
ment risks, ethnographic studies have established the
process of defining health and occupational risks
associated with informal recycling. A majority of
these studies have applied mixed-method approaches,
utilizing standardized surveys, invoking perceptions
through interviews and focus groups, using researcher
observation, or comparing national referents. The
studies with informal recyclers and health have
been completed worldwide, particularly in Brazil,
6
Vietnam,
7
the Philippines,
8
Argentina,
9,10
and South
Asia.
11,12
Further research in global North regions
have yielded similar results, such as in the United
States
13
and Canada.
14
Only a few investigations, such
as in India
15
and Brazil,
16,17
have performed quanti-
tative analytic approaches using national and regional
census information and community referent groups in
order to determine reoccurring health problems of
informal recyclers based on comparisons of indivi-
duals in similar socioeconomic status.
Objective
This article summarizes the literature on the subject
of informal recycling and the reported health risks—
both observed and perceived—by the recyclers
themselves. There has been some research undertaken
to determine the overall health and occupational risks
of informal recycling. However, this research bridges
a 20-year divide of knowledge that has never been
systematically brought together. Hunt
18
published a
brief review, yet there has been much data accumu-
lated since, particularly emanating from Latin
America. This literature review is an accumulation
of existing studies, followed by a collection of the
nascent work being developed by researchers parti-
cularly in the South.
Methods
The qualitative and systematic review included a
search of the online electronic databases Academic
Search Elite, EBSCO, and SCIENCEDIRECT. Each
database was searched from its inception through
January 2011. University library searches were uti-
lized to further access books, journals, and media.
The review consists of articles published in peer-
reviewed English, Spanish, and Portuguese journals.
Key words used in the search included but were not
limited to: waste pickers, scavenger, recycler, infor-
mal waste, recycling, perceived health, risks, occupa-
tional health, policy, hazards, and environment.
Relevant references from the bibliographies of iden-
tified papers were analyzed. There are numerous
articles with regard to the health of sanitation
workers in regulated sectors in low-, mid-, and
high-income nations. Only a few of these articles
were chosen to exemplify the above-average risk of
regulated waste-management workers. The articles
chosen were deemed to be the leading works in their
field. This report does not discuss specific epidemio-
logical and toxicological diseases associated with
informal recycling, as it would go beyond the scope of
this review. Last, the paper includes some original
insights and research that have been carried out by
both authors of this article.
Results
Berthier, as cited by Medina,
19
revealed that informal
recyclers at one dumpsite in Mexico City were
reported to have a life expectancy of merely 39 years.
An ensuing study in India found that children
involved in informal recycling had a 2.5 times higher
potential of morbidity than the national average.
3
A
1981 study performed by Environmental Quality
International of the Zabaleen exemplified the mor-
tality rate of infants at a rate of 240 deaths per 1,000
live births when the national average at the time was
98 deaths per 1,000 live births.
3
Furthermore, in
Vietnam, 51% of recyclers rated their health as poor,
or worse than what they considered typical of the
national average.
7
The lifespan of the informal
recyclers, risk of childhood death, larger-than-aver-
age infant mortality rate, and perception of being
unhealthier than nonrecyclers raises a salient concern
with regard to occupational health issues surrounding
informal recycling: Is the drastically shortened life-
span—the injuries, accidents, deaths—a direct out-
come of the informal occupation or is it a result of the
variables of inhabiting a marginalized socioeconomic
living standard?
Attempting to identify and remove the occupa-
tional health risks from hazards associated with living
in marginal or impoverished socioeconomic condi-
tions is an arduous task as there may be an inordinate
amount of variables that affect the health of informal
recyclers. Gutberlet
21
demonstrates that many of the
recyclers live under precarious housing conditions,
often without reliable water or sewage access. In da
Silva et al.,
22
it was found that the majority of recyclers
lived in substandard housing, having little or no
running water, and at times were lacking electricity.
Recyclers may spend the night on the streets guarding
collected waste, thus exposed to adverse weather
conditions.
23
More so, the period of time between
direct contact and manifestation of a disease, or other
chronic illness, may be unknown or, if known, may be
classified wrongly.
24
These points of contention bring
forth credibility and bias quandaries associated with
research and demonstrates how operating with a
control group is not without its own set of problems.
Nevertheless, the studies reviewed conclusively reveal
that informal waste collection does negatively affect
wellbeing. These findings were demonstrated through
observation and self-assessment.
Binion and Gutberlet The effects of handling solid waste on recyclers
44 International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1
A few studies included in this review are presented
in Table 1. These studies were chosen to demonstrate
the immense global breadth of informal recycling and
the health implications. These and other samples
have been reviewed and classified into six subthemes
that will be addressed: chemical hazards, infection,
ergonomic and musculoskeletal damage, mechanical-
trauma, emotional wellbeing and vulnerabilities, and
environmental contamination. Evidently, a number
of themes coalesce, but for sake of organization and
convenience, they have been left in the most relevant
category. Finally, this report addresses the benefits of
operating within a cooperative when recycling and
will conclude with recommendations for alleviating
hazards.
Chemical Hazards
Chemical exposure is associated with physiological
poisoning and dermatitis injuries, such as burns and
respiratory illnesses. The injuries include sudden or
long-term exposure to toxic chemical substances.
Industrial, pharmaceutical, and hospital waste may
or may not be regulated in a number of countries.
Hence, these toxic chemicals can differ widely accord-
ing to their composition and region. Furthermore,
protective measures, such as safety equipment and
governmental policy vary greatly. High levels of lead
have been found in the blood of recyclers working in
landfills, leading researchers to associate their work
with increased bioaccumulation.
8,12
Lead and dioxin
related-compounds were discovered in higher con-
centration within the breast milk of women neigh-
boring landfills of recycler communities.
25,26
In
addition to lead, mercury and cadmium are of
serious concern.
27
While collecting, informal recy-
clers may occupy landfills or city streets where, in
addition to unknown chemical solvents, they may
be inhaling burning waste or vehicle and heavy
machinery emissions. There have been numerous
documented self-reported respiratory ailments,
such as decreased lung function, lung infections,
and eye irritation, as a result of diesel fuel exhaust
and burning waste.
28,29
The constant exposure to
exhaust is thought to be correlated with a higher
level of bronchitis reported by recyclers,
6
as well as
headaches and nausea.
25
An example of failed policy with regard to
chemical waste mismanagement is the Goiaˆnia
accident. In 1987, radioactive poisoning occurred in
Goiaˆ nia, Brazil, when recyclers dismantled nuclear
medicine equipment used in a hospital, which was
carelessly discarded as waste. The recyclers took this
material home to be sorted and dismantled, allowing
radiation to leak and infect themselves, their families,
and their friends. The event lead to four deaths and
radioactive contamination of 249 other individuals.
30
In addition to radioactive hospital waste, pharma-
ceutical rejects may be illegally disposed of in landfills
or left in the streets to be picked or sorted through by
children.
31
In some countries, such as Brazil, recyclers
work directly on landfills, collecting recyclable and
recoverable materials. These landfills may contain
hazardous hospital waste. Recyclers can occasionally
make more money buying and selling these pharma-
ceuticals. Such medical waste is concurrently a cata-
lyst for infection.
Table 1 A sample of studies on the health, hazards, and vulnerabilities of informal recyclers
Author(s)
(publishing year) Country
Sample of additional researchers
working in the region Method (n)
Associated symptoms
and other findings
Parizeau (2011)
10
Argentina Martin et al. (2007)
9
Surveys
Interviews
397 30 Traffic accidents, broken bones,
cuts from glass and metals found
in the trash, tiredness and fatigue,
burns, aches and pains, breathing
problems, circulatory problems,
diseases and infections.
Gutberlet & Baeder
(2008)
6
Brazil Velloso et al. (1997/1998),
63,66
Porto et al. (2004),
32
da Silva et al. (2006a/2006b),
16/17
Sousa & Mendes (2006),
45
Santos (2008),
41
Tremblay & Gutberlet (2010)
46
Surveys 47 Self-reported body pain and soreness
in back, legs, shoulders, and arms,
lacerations to the hands, along with
ulcers, high blood pressure, influenza,
and bronchitis
Hunt (1996)
11
India Sarkar (2003),
12
Kunisue et al., (2004),
26
Ray et al. (2004),
29
Parveen & Faisal (2005)
15
Interviews 100 Worm infestation, upper respiratory tract
infection, lymph node enlargement,
suspected tuberculosis, xerophthalmia,
and dental caries
Nguyen et al.
(2003)
7
Vietnam Gunn & Ostos (1992),
31
Suplido & Ong (2000)
8
Interviews 41 Back pain, coughs, headaches,
stomachaches, sore muscles, and
rashes; nearly all respondents suffered
cuts to hands, feet, and limbs
Rendleman & Feldstein
(1997)
13
USA Lavoie (2005),
5
Tremblay (2007),
67
Gutberlet et al. (2009)
14
Surveys 96 Lacerations, infections, needle sticks,
and blunt trauma
Binion and Gutberlet The effects of handling solid waste on recyclers
International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1 45
Infection
Pathological waste may be generated by the improper
disposal of medical waste, solid household waste,
human waste, and decaying organic matter. Typically
working without adequate protection, recyclers
inadvertently come into contact with a variety of
biological by-products of waste. These biological
hazards can be classified by contamination via vi-
ruses, fungi, protozoa, and other bacteria. Infections
may occur by direct contact with biological patho-
gens, such as hepatitis-B. Mishandling solid waste,
such as medical waste and syringes, is one of the
higher perceived occupational threats for the infor-
mal recycler.
9
Notwithstanding, there is limited
knowledge of long-term data with regard to infec-
tions and correlation with occupation, lifestyle, and
precarious living conditions. An example of this was
the research conducted in the United States that
encountered one confirmed case of hepatitis-B and
a potential case of HIV thought to have been con-
tracted by an accidental needle stick.
13
Determining
whether the virus was acquired through informal
recycling or lifestyle is the unknown factor.
In Metro Manila’s main dump site, 974 children
were examined, 24% of which had chronic cough,
25% wheezing, and 19% a shortness of breath.
3
At the
same dump site 10 years earlier, out of 750 informal
recyclers, 70% had upper-respiratory ailments.
3
These
respiratory diseases include tuberculosis, pneumonia,
asthma, and bronchitis.
32
A similar study in Ma-
nagua, Nicaragua, demonstrated that waste-picking
children exhibited a decrease in lung function and
wheezing due to a higher exposure to particulates.
33
Kennedy et al.
34
discovered that individuals working
in bottle return stores were exhibiting similar res-
piratory ailments. They found that there was mea-
surable inhalable particulate matter, including fungus
and endotoxins (toxic substances released from the
cell wall when Gram-negative bacteria are damaged
or destroyed). The study concluded that these ail-
ments, which showed signs of nasal infections and
acute chest symptoms, were associated with endotox-
ins derived from decaying waste growing in bottles,
which is consistent with other studies.
33,35
These toxic
reactions are thought to be caused by endotoxins and
substances excreted by Gram-positive and Gram-
negative bacteria.
24
The study by Kennedy et al.
33
reiterates the perceived risks from biological con-
tamination, as modelled by other studies which cite
respiratory ailments as being a leading complaint
perceived by informal recyclers.
6,7
Microorganisms and organic dust present other
pathogens, such as bacteria, yeasts, protozoa, and
intestinal diseases such as worms, flukes, and viruses.
36
Toxoplasmagondii, a parasite that may lead to se-
vere infection during pregnancy, is typically acquired
through food contamination. The parasite antibodies
were discovered in recyclers operating in Durango City,
Mexico.
37
Diseases such as typhoid fever, tuberculosis,
dysentery, poliomyelitis, malaria, and various skin
disorders have been identified in Manila in informal
recycling communities.
19
Economic hardship occasion-
ally pushes recyclers to consume recovered food, risking
stomach infections and parasites.
9,22,32,38
Food poi-
soning may cause diarrhoea, parasite infection, and
nausea. Furthermore, stomach infections are com-
mon, as recyclers inadvertently come into contact with
human and animal excreta.
6,7,12,28
One such study
found that the incidence of acute diarrhoea was 10
times greater in informal recyclers than in the general
population.
3
In stool samples taken from children
working in Manila, it was confirmed that 98% had
parasites, either Trichuris trichiura, Ascaris lumbri-
coides, or both.
3
Furthermore, proximity and contact
with flies as a consequence of infestation led to a
higher correlation of diarrhoea in children.
39
Other
diseases, such as plague and leptospirosis may be
present from the exposure of rodent urine.
3,6,40–42
Helminths, such as schistosomiasis were prevalent in
Egyptian recyclers.
42
In Colombia, recyclers perceived
themselves as having a higher proportion of infectious
diseases, such as acute diarrhoea and respiratory
infections, than neighboring populations.
28
In addition
to infection, recyclers must be weary of the physical toll
inflicted upon their musculoskeletal system.
Ergonometric and Musculoskeletal Damage
Ergonometric injuries consist of musculoskeletal
illness, the direct result of repeatedly moving and
lifting heavy objects, such as carts and bags filled with
solid waste. These issues may lead to sprains, fatigue,
muscle pain, and back problems. In Brazil, a study
demonstrated how informal recyclers are prone to
squatting, vibration, awkward postures, and repeti-
tive movements.
16
Frequent kneeling occurs while
sorting and collecting solid waste and is thus
associated with lower-extremity pain.
16
In the regu-
lated sector of waste management, heavy lifting leads
to higher rates of back and shoulder pain, lumbar
disc prolapse, disorders of the neck, tendon disease,
and increased pulmonary ventilation.
34
Formal solid
waste workers in Brazil report injuries that are
consistent with the informal workers, such as cuts,
sprains, or breaks to the lower limbs, followed by
upper limbs, including the hands and the spine.
43
All
informal recyclers interviewed in the studies by
Gutberlet and Baeder
6
and Nguyen et al.
7
reported
some sort of pain or discomfort in the limbs and
back. Further reports from a US study on formal
sanitation workers revealed that arthritis was four
times more common in sanitation workers than in
general laborers,
3
which coincides with self-assessed
Binion and Gutberlet The effects of handling solid waste on recyclers
46 International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1
reports from informal recyclers in Brazil.
14
Da Silva
et al.
16
prepared a quantitative analytic approach
using a comparison study between informal recyclers
and a control group from the same socioeconomic
standing. They found that back pain incidents were
similar to individuals from the same population, but
still higher than that of the general population.
Children working on a waste disposal site in
Nicaragua complained of upper- and lower-extremity
pain that was correlated to them jumping onto
moving dump trucks as they proceeded to the
landfill.
27
Long days, repetitive movements, heavy
lifting and loading present itself as short-term pain
and discomfort. However, what is currently un-
known, is the long-term musculoskeletal physical
effects on the body over a lifetime of such manual
labor. In addition to ergonometric risks, recyclers
deal with mechanical accidents on a daily basis.
Mechanical Trauma
These hazards to informal recyclers consist of cuts,
blunt trauma, fractures, falls, lacerations, and traffic
accidents.
6,10,32,34,41
Recyclers work at all hours of
the day, collecting in the streets or at landfills. In
Buenos Aires, the majority of the recyclers operate in
the evening, thus putting them at risk of working in
the streets while it is dark. Traffic accidents were
demonstrated as being high as a perceived risk for
informal recyclers in both Argentina and Brazil.
6,9,44
Pursuing this further, informal recyclers, who work
around landfills, are exposed to high risks of
accidents during their work. In Vietnam, for example,
it was cited that the community knew of two recyclers
who had been buried accidently in the landfill that
year and that another individual had been killed in an
accident with a garbage truck.
7
Recyclers at dump
sites in Brazil furthered these concerns with knowl-
edge of injured and killed recyclers.
45
Frequent acci-
dents caused by trucks and tractors are reported by
the local recyclers, which are constantly moving the
waste deposits at the landfill Gramacho, which serves
the metropolitan region of Rio de Janeiro.
46
Si-
milarly, 17% of the recyclers in Vietnam mentioned
being involved in either a minor or major collision
with garbage trucks.
7
The perceived and real threat of
vehicular accidents is justified.
Recyclers often prefer to work barehanded, as it
allows for greater tactility, to quickly sort paper and
plastics. They tend to tear open bags of waste or dig
quickly through bins in order to find specific items,
such as cardboard, paper, aluminium cans, or
plastics. This task is risky as the waste may contain
broken glass, construction materials, or hospital
waste, such as syringes. In tropical areas, informal
recyclers may wear shorts and T-shirts, thus having
little to no protection for their arms or legs.
47
At
times, recyclers acquire discarded gloves from hospi-
tals, which they wash and then reuse in a futile
attempt to remove the risk of chemical burns and
infection.
40,48
In Brazil, recyclers occasionally wear
gloves, but complain that they are still useless to
needle punctures or cuts from glass.
49
Indeed, a lack
of safety equipment leads to a common occurrence of
lacerations to the hands, arms, and legs.
6
Small
cooperatives, that may be operating on micro credit
in combination with inadequate local government
resources, have difficulty providing employees gloves,
masks, or other safety-related equipment. Moreover,
studies inquired as to how waste pickers deal with
injuries, typically lacerations. Martin et al.
9
discov-
ered in Buenos Aires, that recyclers were unwilling to
seek professional medical care, even if it was free of
charge, and in some cases, when asked, the response
was that they did not know where the nearest health
care provider was located. Only 32% of the recyclers
in Colombia went to see the doctor when they were
ill, citing lack of health coverage as the issue.
28
Further answers ranged from doing nothing about
the injury, finding rags in the trash to wrap around
cuts, using lemon juice, or licking at the wound.
7
In
Portland, medical records confirmed that the major-
ity of recyclers arriving with lacerations had cuts in
such poor states that medical officials were often
unable to stitch them.
13
Regardless of high- or low-income countries, the
informal recyclers appear to wait too long before
seeking medical help thus increasing the likelihood of
infection.
9,13,14
In light of this, studies in South Asia
exemplified how health waste was picked and then sold
to informal medical practices. Recyclers who were
injured collecting medical waste, and who could not
afford suitable medical care, would go to unscrupu-
lous doctors who employ used medical equipment,
pharmaceuticals, and syringes.
50
Although informal
recyclers may have access to health care, it may be
impossible to receive the care, as at times, they are
requested to take work off, which is not fiscally
feasible when living on day to day pay.
51
Un-
doubtedly, the issue of medical care can be deemed a
social issue, a lack of knowledge of hazards, and an
absence of medical opportunities.
Emotional Wellbeing
Social issues encompass malnourishment, undernour-
ishment, low education, high birth rates, physical and
emotional abuse, no training of basic health care and
first aid, a lack of access to health care facilities, and
precarious living arrangements. Furthermore, access
to clean sources of water and sanitation for informal
recyclers can be as much of a problem in the global
North as in the global South.
13,14,52
Social stigma and
marginalization create unnecessary stress. The public
Binion and Gutberlet The effects of handling solid waste on recyclers
International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1 47
may perceive the informal recyclers in a variety of
ways; some assist the recyclers by pre-sorting their
materials from the garbage or by providing food,
while others socially exclude and marginalize them.
9
The insecurity, coupled with social exclusion, per-
ceived shame, and humiliation, leads to a higher self-
assessed degree of vulnerability.
9,44,49
Constant occu-
pational threats, such as being robbed, harassed, or
bullied, are mentioned as problems by informal
recyclers.
14,52
Admittedly, the precariousness of
work, the stigmatization, and the lack of financial
security can lead to stress.
45
Recyclers in Guatemala
reported avoiding health clinics and hospitals when
injured or sick for fear of discrimination.
53
Granted,
stigmatization may form a self-fulfilling prophecy
with the self-perception of recyclers. When inquired
in Kathmandu, Nepal, 73% of informal recyclers
revealed that they would not wash their hands with
soap upon returning home after work and that 65%
would not change out of their work clothes.
3
These
examples highlight that the social stigma attached
to working in a dirty job and the self-perceived
reiteration continue to the home, where people lose
the sense of dignity that comes with being clean.
Kennedy et al.
33
identified additional factors of
high psychosocial stress of recycling and sorting,
which they deemed to have been contributing to
fatigue, nausea, and headaches. Stress-related symp-
toms, such as ulcers, high blood pressure, and
stomach problems were self-assessed by informal
recyclers.
6,12
In Brazil, the majority of recyclers did
not perceive a major health change between their
previous and current activity; yet, 31% cited specific
health issues, such as recurring high blood pressure
and ulcers, that had commenced since becoming a
recycler.
6
A subsequent study in Brazil demonstrates
that patterns of minor psychiatric disorders occurred
44.7% more in recyclers than within the average
neighborhood referent group, signaling signs of
depression and anxiety.
17
Consequently, this was
hypothesized to be because of constant injuries and
monotonous work.
17
Recyclers in Buenos Aires self-
reported depression, anxiety, and nervousness in the
prior year.
10
As mentioned, recyclers may consume food from
the waste, risking infection. Further nutrition issues
are addressed as social problems. According to
Sarkar,
12
malnutrition, infant growth retardation,
and anaemia are more prevalent in individuals and
families who work in informal recycling; however,
this study is not conclusive because control group
studies in similar low-income areas were not con-
ducted. Oppositely, improper nutrition can also lead
to obesity, as demonstrated in BMI comparisons with
recyclers in Colombia.
28
Recyclers living in commu-
nities near landfills, or collecting in the streets, may at
times, need to bring their children along due to a lack
of social support. Therefore, it is not uncommon to
witness young toddlers to pre-teen children working
with or alongside their guardians.
31
It is known that
intensive working environments and heavy lifting at a
young age can have life-long negative effects on
general health
54
or may have growth-stunting effects.
31
Positively, the act of informal recycling removes and
challenges the waste stream that would typically allow
waste to be deposited, buried, or incinerated. This
aspect of recovering resources makes informal recy-
clers important players in the global challenge of
environmental stewardship, addressing consumption,
and raising awareness on recycling. However, certain
parts of the environment can be affected by informal
waste collecting, depending on how the materials are
collected, sorted, and transported.
Environmental Contamination
Admittedly, by now, one can agree that solid waste
and informal recovery have direct negative effects on
the physical and emotional health of those who work
in the recovery of those materials. Nevertheless, the
long-term effects of working with solid waste in
certain environments may affect not only individual
health, but also the environmental health of the
surrounding community. Mishandling waste allows
the waste stream to propagate into other areas, such
as in the previously mentioned Goiaˆ nia accident.
It may degrade environmental conditions, clogging
sewers, creating stagnant water, and thus produc-
ing breeding grounds for pathogenic organisms,
facilitating the spread of diseases vectors such as
dengue.
3,39,55
As waste is collected, it is sorted in situ,
or in specific sorting areas, such as depots, recycling
centers, cooperatives, or even in homes. Recyclers may
move collected waste to be sorted, leaving it placed on
river banks or in vacant lots, thus risking human
health and further degrading the environment.
1
As is
the case with rural to urban migration or populations
of unemployed or underemployed individuals, they
often lack the resources to buy property and may
become illegal squatters in areas close to landfills or
marginalized areas with waste disposal.
56
Therefore,
waste may inadvertently be brought into the commu-
nity or homes of the recyclers, creating potential health
implications. Indeed, waste is transported, along with
all negative aspects of it, such as chemical and
biological pathogens, and therefore needs specific care
when handled and transported.
Moreover, incorrect storage of organic waste can
create dangerous molds, toxins, and gases, such as
methane,
3
which can put these locations (often
households or organizations, such as cooperatives)
in danger. Animals, such as livestock, birds, or rats,
may feed on waste at landfills or informal dump sites,
Binion and Gutberlet The effects of handling solid waste on recyclers
48 International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1
thus potentially transmitting diseases, such as trichi-
nosis and taeniasis, which is spread by pigs.
3
Insects,
such as ants and lice, compete with rats, snakes, dogs,
and vultures for scrap and territory at dump sites.
53
Hence, untreated and unregulated waste-streams
have the potential to create and continue to spread
infectious diseases to informal recyclers and their
immediate community.
36
The possibility of hazar-
dous impacts from landfills in high- and low-income
countries has repeatedly become a matter for
scrutiny. Findings that demonstrate the spread of
increased risks of adverse health issues, such as
certain cancers, from landfills have been discredited
through biases and numerous confounding factors
regarding variables, thus the absolute danger of living
in the vicinity of a landfill is still disputed.
57
However,
there is generally verified literature that points to self-
reported symptoms of headaches and general fatigue
of individuals living near landfills.
57
Likewise, at a
landfill in Rio de Janeiro, only 27.4% of the recyclers
believed that the landfill generates environmen-
tal problems for the surrounding communities and
workers.
32
In summary, terminal diseases, such as
cancer, have long latency periods. As a result of this,
it would be extremely difficult to correlate various
types of cancer with periods of time when individuals
have worked or lived near landfills, especially in
lower-income areas. Further research in toxicological
and epidemiologic studies are necessary.
57
Health and the Cooperative
A number of initiatives worldwide have led to
the self-organization of informal recyclers. Forming
cooperatives, recyclers are able to create advanta-
geous situations, legitimatizing and formalizing their
employment, empowering their members with deci-
sion making, and generating greater selling power
with direct negotiations with the industries. The
various networks of organized recyclers, as they have
been formed in Latin America, have created a
conjoined voice for the recyclers when discussing
policy matters with local and regional governments.
Furthermore, cooperatives strengthen the organiza-
tional base of the recyclers, opening up discourse
between groups and individuals in other regions, thus
facilitating knowledge transfer and mobilization on a
wider scale; generating awareness, and providing
areas for educational training.
6,58
The cooperative,
although not a means or end-product to alleviating
all health issues, can be perceived as an organic
process that creates both place and space for the
informal recyclers.
Repressing the informal sector to address the
occupational health implications of informal recy-
cling is not a viable resolution. By legitimizing the
employment, cooperatives allow a tangible space to
be constructed or rented. This space can then be used
to bring collected solid waste for sorting and resale.
Da Silva et al.
22
found that 86% of the recyclers were
sorting and separating the solid waste in their homes.
The cooperative thus inhibits the solid waste from
propagating into the environment, and curbs illegal
dumping.
19
It allows the waste to be in a controlled
state, allowing preventative measures to be imple-
mented, thus diminishing potential injuries.
6
Fur-
thermore, working together in a cooperative can
reduce overexhaustion and overworking, which are
factors in musculoskeletal damage, stress, anxiety,
and depression.
The cooperative can allow easier access to legal
protection and health care.
19
A case in point is the
recycling cooperative El Movimiento de Trabaja-
dores Excluidos (Movement of Excluded Workers,
MTE). This cooperative was formalized as a se-
condary means of solid waste collection and recycl-
ing in a number of neighborhoods in Buenos Aires.
As part of Argentina’s workers union, it currently
has access to Obras Sociales, a social security
network that allows extended health insurance.
Cooperative members are also provided durable
uniforms with reflective strips, and are able to
register with the city, thus accessing free gloves and
vaccinations, such as tetanus. Whether or not they
choose to wear the items provided is up to them.
This program is open to all informal recyclers in
Buenos Aires. By February 2004, the city had
vaccinated 12,000 informal recyclers for tetanus
and hepatitis.
51
Thus, the formation of a coopera-
tive, working alongside the government, can pro-
gressively move the informal employment into the
formal sector.
22
Creating cooperatives is typically
done under organic grassroots situations. It is a
difficult process. The activity of informal recyclers
has been noted as being individualistic,
59
and there-
fore, creating cooperatives is not without its set of
challenges. Nonetheless, there have been numerous
successful cooperatives, such as the aforementioned
MTE in Buenos Aires, and scores of others in Brazil,
Colombia, and throughout Latin America. A Bra-
zilian researcher, Yunes,
60
worked alongside the
cooperative COOPERMYRE in Brazil. Together,
Yunes and the members of the cooperative devel-
oped a framework that would assist in alleviating
risks and injuries while working.
60
Evidently, the
creation and use of cooperatives and associations
create a working environment that fosters emotional
and financial support for their members.
Conclusion
Further research is necessary in utilizing more ade-
quate methods that can move to alleviate the majority
of preventable accidents and illnesses associated with
Binion and Gutberlet The effects of handling solid waste on recyclers
International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1 49
the unaffiliated informal recycler. As mentioned by
Wilson et al.,
61
there needs to be additional data
collection on accidents and vulnerabilities in order to
make a significant contribution to the health of the
workers. Wilson et al.
61
notes that most studies suffer
from methodological flaws, and that studies with
control groups have difficulty linking the data to the
population understudy and the referent group.
As demonstrated, the informal recycler is exposed
to a wide variety of hazards. The chronic diseases
typically associated with operating in these situations
arise, but the time frame used for a study makes it
difficult to determine if the recyclers were affected
through occupational conditions or if the disease was
acquired due to the genetics, lifestyle, or lack of
medical access. Hence, these studies have difficulties
in defining these effects of long-term exposure, and
as a consequence, diseases may also be wrongly
classified.
8,24
However, there is an opportunity to
further research some risk aversion methods, such as
the role a cooperative plays in the self-reported health
and injuries of an informal recycler. The environment
of organized recyclers (cooperatives or associations)
has not yet been studied sufficiently in terms of the
health implications and risks for the workers.
Moreover, early detection of musculoskeletal dis-
orders, childhood labor, hearing loss, respira-
tory illnesses, and gastrointestinal diseases must be
addressed
65
to understand long-term issues. Sanita-
tion workers in Rio de Janeiro refer to work-related
injuries as an issue from the process itself and the lack
of training, equipment, and preventative measures.
63,66
Most recyclers cite ergonometric issues with lifting and
carrying waste. More participatory studies can be done
to determine further perceptions of hazards and risks
and grasp a better understanding of the problems
and future solutions. Furthermore, addressing poor
working conditions, the lack of recognition for their
profession, and the fatigue from long days will create
more knowledge on how profession affects the in-
formal recycler physically and emotionally.
45
Emphasizing the importance of workplace health
promotion in worker-run cooperatives and collectives
is imperative.
68
The creation of cooperatives and
associations by informal recyclers has proven to be
effective in alleviating hazards. The cooperatives
build to legitimize the work as a public service,
allowing social programs, such as extended health
care and child care, to be funded. Not only does this
method assist in limiting the physical strain on the
recyclers, it is seen to be emotionally beneficial to self-
esteem through empowerment and capacity building.
Rather than merely looking at risks and vulnerabil-
ities, the cooperative helps to alleviate the causes,
hence creating an environment more conducive to
better wellbeing. It is necessary to strengthen these
cooperatives and group networks, allowing knowledge
to transfer while expanding on health education,
proper waste handling, and hygiene. Furthermore,
by registering and working alongside government,
injuries and illnesses that require medical care can now
be compiled and noted, thus allowing policy makers, if
they so wish, a greater opportunity to see the outcomes
of injuries and, thus, look toward preventions.
Additionally, it is necessary that tacit and experi-
ential knowledge be shared by recyclers with industry,
consumers, and policy makers. This knowledge
mobilization would optimistically demonstrate experi-
ential wisdom, working to raise awareness in proper
waste separation. By notifying consumers of the
proper way to dispose of materials, particularly those
that are prone to lead to injuries, such as broken glass,
syringes, chemicals, or infectious materials, recyclers
can further legitimize their employment as a necessary
public service while working toward creating a safer
work environment. However, Furedy
59
discovered
that most recyclers were unaware of some of the
infectious hazards associated with waste collection.
When asked, recyclers defined health simply as their
ability to work.
32
Hence, it is necessary, through
associations and cooperatives, to facilitate discussion
surrounding the merits of wellbeing and occupational
health. The recycler must be as equally informed about
the future consequences of long-term exposure to
waste collection and their health.
44,62,63
The nature of chemical and biological injures are
preventable and happen because of a failure in policy
enforcement regarding commercial and industrial
regulation and residential knowledge awareness. To
enhance safety measures during collection and separa-
tion, states and organizations should monitor both the
public and private sectors, ensuring they adhere to
sustainable solid waste management practices and
policies. In fact, health promoting policy must be
addressed and enforced at all government levels.
64
As
exemplified governments, such as in Buenos Aires,
have already moved forward to creating branches that
work with recyclers. Furthermore, education of both
the public and informal recyclers and appropriate
signage, with regard to chemicals, could certainly
cut down on injuries associated with chemicals and
contaminants.
44,60
Informal recyclers are an unpaid public service
necessary for our current state of mass consumption.
They are typically pushed into this livelihood and
most see it as a temporary means of employment. The
importance of their work is typically unacknow-
ledged, when in fact, they are assisting in reducing
solid waste and working toward a more recyclable
and reusable society. Assisting and legitimizing their
employment is crucial for economies struggling to
cover the costs of formal waste management. In
Binion and Gutberlet The effects of handling solid waste on recyclers
50 International Journal of Occupational and Environmental Health 2012 VOL.18 NO.1
summary, further effective preventative measures
include: knowledge mobilization between recyclers,
the community, and policy makers; adherence to
household source separation of solid waste; support
from both the public and private sector toward the
proper disposal of solid waste; and continued fi-
nancial assistance to burgeoning cooperatives and
worker-run collectives for personal protective equip-
ment and workplace health promotion.
Disclosures: The authors declare no conflicts of
interest.
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