Multiple morbidities and health conditions of waste-loaders in Mumbai: A study of the burden of disease and health expenditure.

Study assesses the effects of solid-waste loading on workers, the resultant development of occupational morbidities, and economic burden of these morbidities. A cross-sectional survey was conducted with 360 municipal workers from six of 24 municipal wards in Mumbai. The nearest neighborhood method of Propensity Score Matching (PSM) examined the impact of waste-loading on the development of morbidities and to identify the risk factors - multiple logistic regression analysis was performed. The prevalence of musculoskeletal disorders (MSDs), injury, eye and skin infections found significantly higher for waste-loaders compared to comparison group. The PSM method revealed that the occupation of waste-loading significantly raised the risk of injury (34%), MSDs (23%), eye (19%), skin infection (15%) and disability (15%), compared to comparison group. Significantly higher health expenditure is observed among waste-loaders who have sought treatment in private health facility than public. The study recommends to offer assistance the medical insurance for reducing the financial burden on waste-loaders.