ASSESSMENT OF COMPLIANCE WITH OCCUPATIONAL HEALTH AND

SAFETY PRACTICES AMONG WASTE HANDLERS DURING SOLID

WASTE MANAGEMENT IN KABALE MUNICIPALITY

BY

KATUMBA DAVID
REG. No 2019/A/KHS/1645/F

A RESEARCH REPORT SUBMITTED IN PARTIAL FULFILLMENT OF THE

REQUIREMENT FOR THEAWARD OF A BACHELOR'S DEGREE
IN ENVIRONMENTAL HEALTH SCIENCES
OF KABALE UNIVERSITY

MAY, 2023
i
 DECLARATION
I declare that this research report has been done to the best of my knowledge and has never
been presented to any higher learning institution for any award.

I, therefore, present it to the school of medicine department of community health Kabale

University for the award of a degree in Environmental Health Sciences.

……………………………………….
KATUMBA DAVID
(STUDENT)
Date…………………….…………

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 APPROVAL

This research report has been submitted in partial fulfillment for the award of a Bachelor's
degree in Environmental Health Sciences of Kabale University and has been done by the
student under my supervision.

……………….……………………… Date:…………………………..\
Nwankwo Mercy Chinenye (P h D)
(University Supervisor)
Community Health Department

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 DEDICATION
I dedicate this work to my family members most especially my Uncle Joseph Lubega, for the
love and support he has shown to me from day one, my beloved mums Debby, Casey, and
Rhonda who generously facilitated me to achieve what had been my dream undergraduate
degree, May the good Lord Jesus bless you abundantly.

iii
 ACKNOWLEDGEMENT
To my Lord and personal savior Jesus Christ who through his unmerited love has granted me
the gift of salvation, his grace to follow in his footsteps and hope unto eternity with him. His
wisdom and understanding have guided me through my life.

I acknowledge my research supervisors; Dr. Nwankwo Mercy and Mr. Bahati Amon for their
endless efforts and guidance through the process of my research report. Without your efforts
and advice, this research would have been a mess.

To Kabale school of medicine Administration and all Academic Staff for their efforts to make
my course a success.

To my brothers Isaac Mugerwa, Tonny Mukiibi, Mutebi Martin, Edson, Deo, Kagame
Ronald, Ivan, and my beloved sister Grace Namale. Thank you for your support throughout
my course.

I would like to extend my gratitude to my classmates BEHS 2019-2022, my friends Atamba

Holiness, Rwego George, Kembabazi Winnie, Ahimbisibwe Edward, Asiimwe Julius, Good
Aggrey, Bless, Josephine, Kaasim, Arnold, Benjamin, and Baguma Frank. Thank you so
much for your support and all your words of encouragement.

Special thanks go to my respondents for their time, contribution, and cooperation rendered
me during the research field study.

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 TABLE OF CONTENTS
DECLARATION........................................................................................................................i
APPROVAL..............................................................................................................................ii
DEDICATION..........................................................................................................................iii
ACKNOWLEDGEMENT........................................................................................................iv
TABLE OF CONTENTS...........................................................................................................v
LIST OF TABLES..................................................................................................................viii
LIST OF FIGURES..................................................................................................................ix
LIST OF ABBREVIATIONS AND ACRONYMS...................................................................x
OPERATIONAL DEFINITIONS.............................................................................................xi
ABSTRACT.............................................................................................................................xii
CHAPTER ONE: INTRODUCTION....................................................................................1
1.0 Introduction..........................................................................................................................1
1.1 Background to the study.......................................................................................................1
1.2 Problem statement................................................................................................................3
1.3 General Objective.................................................................................................................4
1.3.1 Specific Objectives............................................................................................................4
1.3.2 Research questions............................................................................................................4
1.4 Significance of the study......................................................................................................5
1.5 Scope of the Study...............................................................................................................5
1.5.1 Geographical scope...........................................................................................................5
1.5.2 Content scope....................................................................................................................5
1.5.3 Time scope........................................................................................................................6
1.6 Conceptual framework:........................................................................................................6
CHAPTER TWO: LITERATURE REVIEW.......................................................................7
2.0 Introduction..........................................................................................................................7
2.1 Available health and safety practices among waste handlers during solid waste
management.............................................................................................................................11
2.2 Factors influencing occupational health hazards among solid waste handlers in Kabale
municipality..............................................................................................................................13
2.3 Recommendation to be put in place to prevent occupational health hazards among waste
handlers....................................................................................................................................17
CHAPTER THREE: MATERIALS AND METHODS......................................................19
3.0 Introduction........................................................................................................................19
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3.1 Study Design......................................................................................................................19
3.2 Study Area..........................................................................................................................19
3.3 Study Population................................................................................................................19
3.4 Sample Size Determination................................................................................................19
3.5 Sampling Technique...........................................................................................................20
3.6 Inclusion Criteria for the selection of study participants...................................................20
3.7 Exclusion Criteria for the selection of study participants..................................................20
3.8 Sampling Procedure...........................................................................................................20
3.9 Data Collection Method.....................................................................................................20
3.10 Data Collection Tool (s)...................................................................................................21
3.11 Data Collection Procedure...............................................................................................21
3.12 Study Variables................................................................................................................21
3.13 Quality Control.................................................................................................................22
3.15 Ethical Consideration.......................................................................................................23
3.16 Study Limitations.............................................................................................................24
3.17 Dissemination of Results..................................................................................................24
CHAPTER FOUR: PRESENTATION OF RESULTS......................................................25
4.1 Demographic Characteristics of Study Participants...........................................................25
4.1.1 Study respondents’ job Specification..............................................................................26
4.2 Qualitative Data Results.....................................................................................................35
CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION........39
5.0 Introduction........................................................................................................................39
5.1. Demographic factors.........................................................................................................39
5.2. The Levels of available safety...........................................................................................39
5.3. The individual factors associated......................................................................................40
5.4. The Institution Factors......................................................................................................40
5.5. Qualitative study results....................................................................................................40
5.6. Summary of the study.......................................................................................................41
5.7. Conclusion.........................................................................................................................41
5.8 Recommendations..............................................................................................................42
5.8.1: To the Ministry of Health...............................................................................................42
5.8.2.: The district leadership...................................................................................................43
5.9. Recommendations for further study..................................................................................44
5.10: Contribution of the current study to learning..................................................................45
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5.11: Limitations and Delimitations.........................................................................................45
REFERENCES.......................................................................................................................46
APPENDICES........................................................................................................................49
APPENDIX I: Consent form for Participants (For Questionnaire).........................................49
APPENDIX II: Questionnaire for Village Health Teams (VHTs)...........................................50
APPENDIX III: Consent form for Participants (For Questionnaire).......................................54
APPENDIX IV: Questionnaire for Study Stakeholders...........................................................55
APPENDIX V: Authorization Letter to Conduct Research from Kabale University..............56
APPENDIX VI: PICTURES...................................................................................................57
APPENDIX VII: A MAP SHOWING KABALE MUNICIPALITY......................................58

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 LIST OF TABLES
Table 4.1: Study Participants Demographic Characteristics (n = 53)
Table 4.2: The study participants about their opinion of workplace hazards and safety
measures (n=53)
Table: 4.3 The Chi-square test on relationship between availability of safety measures and
respondents job specification.
Table 4.4: The human level associated factors to occupational hazards and health outcomes
(n-53)
Table 4.5 The relationship between the human associated factors and other study variables at
level of 0.05 significant).n = 57
Table 4.6: Distribution of participants’ responses on Health institution associated factors
influencing occupational hazards and health outcomes among waste handlers in Kabale
Municipality.
Table 4.7 The relationship between the job environment related factors and history of habits
at level of 0.05 significant).n = 57
Table 4.8: The proportion of the participant’s responses on measures that are put in place to
prevent occupational health hazards among waste handlers in Kabale municipality
Table 4.9. Result of test of relationship test with chi-square between measures to be taken to
prevent hazards and Respondent’s Job specification
Table 4.10. Result of on relationship between hazard mitigation and other study variables
Table 4.11: Summary of responses generated from different study stakeholders……………36

viii
 LIST OF FIGURES
Figure: 1.1. The assess compliance with occupational health and safety practices among
waste handlers during solid waste management in Kabale Municipality.
Figure.4.2: The study participants job specification (n = 53)

ix
 LIST OF ABBREVIATIONS AND ACRONYMS

CDC: Centre for Disease Control

HBV: Hepatitis B virus

HCAIs: Health Care-Associated Infections

HCV: Hepatitis C Virus

ILO: International Labor Organization

IPC: Infection Prevention Control

MSW: Municipal solid waste

OHS: Occupational Health and Safety

OSHA: Occupational Safety and Health Act

PPEs: Personal Protective Equipment

WHO: World Health Organization

OEL: Occupational exposure limits

O H H: Occupational health hazards

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 OPERATIONAL DEFINITIONS
Disease: any harmful deviation from the normal structural or functional state of an organism
generally associated with certain signs and symptoms.

Infection prevention and control: the set of measures that aim at preventing healthcare-
associated infections, thereby ensuring safe medical procedures and interventions.

Injuries: physical harm or damage to someone's body caused by an accident.

Knowledge; Information and understanding that is used in everyday life; it enables people to
cope effectively with daily tasks. Knowledge is acquired through learning, experience, and
self-reflection.

Occupational health and safety; means a multidisciplinary practice dealing with all aspects
of health and safety in the workplace with a strong focus on preventing workplace hazards.

Personal protective equipment; refers to equipment designed to protect employees from

serious workplace injuries or illnesses resulting from contact with chemical, physical,
electrical, mechanical, or other workplace hazards. In this current study, PPE included face
shields, goggles, gloves, safety shoes/boots, coveralls, and earmuffs.

Practices: emphasizing a concern; by both thought and action; that is directed towards
achieving some aim. It is dependent on the resources of time, skills, and material goods. In
this study, practices were actions of the carpenters and welders on the PPE.

Solid waste management: a process of collecting, treating, and disposing of solid material
that is discarded and no longer useful.

Personal protective equipment: special clothing equipment used for protection against
contact with potentially infectious material.

Waste: a material or substance that is no longer useful to the original user

A waste worker: is any person employed by a public or private enterprise to collect and
dispose of municipal solid waste.

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 ABSTRACT
Municipal solid waste disposal and management have complex problem especially with
regards to management solutions which must be sustainable, technically feasible, socially and
legally acceptable and environmentally friendly. Occupational exposure to health risks is very
common especially with limited resource that will drive hazards mitigation strategies. The
current study was carried out in Kabale Municipality in Kabale district. The study assess
compliance with occupational health and safety practices using cross sectional design
involving both qualitative and quantitative data collection approaches from November 2022
to April 2023, among 53 randomly selected solid waste handlers. Data were collected using
semi structured questionnaire and interview. Data was analyzed using simple proportion
percentages, confidence interval and chi-square test of association between study variables
statistically significant at 0.05 with result as follows: Study respondents predominantly
37(69.8%) males, 23(43.4%) of participants had less than three years’ experience and
21(39.6%) had worked between 4 to 8 years. About 6(11.3%) and 25(47.2%) had risks
behavior such as smoking and alcohol use. Also, 23 (43.4) of study respondents were solid
waste collectors; 16(30.2%) were segregators, while 7 (13.2%) were drivers, 5 (9.4%) were
incinerators. Chi-square test of association showed good workplace safety and job
specification significant with (p-value =0.002<0.05), as well significant is good workplace
and education status with (p-value = 0.022<0.05). Findings on opinion about the availability
of safety practices showed 21 (39.6%) agrees that workplace contains harmful chemicals,
gases and contaminated products while 12(22.6%) agree that workers are trained on safety
precaution and risk management. Another 14(26.4%) responses agrees that Vaccination of
workers and first aid treatment when necessary. Human level factors influence on
compliance to occupational health and safety was about 25 (47.2%) and 29 (54.7%) agreed to
negligence of safety procedure. Chi –square analysis result showed job specification
significant with human factors with (p- value = 0.019 < 0.05 and lastly multinomial
regression findings on relationship between work place factors and hazard mitigation showed
statistical significant relationship with (p – 0.005 <0.05, odd ratio .120, 95% C.I. .027
- .528). Qualitative findings revealed absence of evidence based practices, safety equipment
knowledge and report, training gap / information sharing and training evaluation records were
not seen. Recommendation made to the district administrators, supervisors and other
stakeholders in municipal solid waste management.

xii
 CHAPTER ONE:
INTRODUCTION
1.0 Introduction
The purpose of the study was to assess the compliance of waste handlers to occupational
health and safety measures in Kabale Municipality. This chapter covers the following
aspects: background to the study, statement of the problem, objectives of the study, research
questions, significance of the study, and scope of the study.

1.1 Background to the study

Occupational health risks in solid waste occur at every step in the process, from the point of
collection at homes, during transportation, and at the sites of recycling or disposal. Municipal
solid waste workers are exposed to occupational health and accident risks related to the
content of the materials they handled, emissions from those materials, and the equipment
being used. Several studies have reported that municipal solid waste workers have got a high
risk of occupational health hazards. The important morbidity that has been commonly
observed among workers are respiratory diseases, eye diseases, dermatological problems, nail
infections, musculoskeletal morbidities, and water-borne diseases. The common health
problem investigated among this working group includes respiratory symptoms, irritation of
the skin, nose, and eyes, gastrointestinal problems, fatigue, headache, allergies,
musculoskeletal injury, and risks such as strains of sprains, confusion, fractures, and
lacerations (WHO, 2020).

The world health organization estimates that annually about 270 million waste collectors
suffer from occupational injuries, accidents, and diseases with about 2.3 million estimated to
die from the hazardous effects of the job (WHO, 2017).

Globally, about 860,000 waste collectors are injured every day during solid waste
management (OSH, 2019). It is also estimated that work-related diseases and injuries among
waste collectors are responsible for the deaths of 1.9 million people. This has been attributed
to poor compliance with occupational health and safety practices like waste handlers not
embracing PPE usage and utilization and also employers not providing PPEs to their workers
(HEEPS, 2018).

In China, one of the most developed countries in the world, around 160 million waste
collectors suffer from occupational diseases and among them, 2 million waste collectors die

1
every year as a result of occupational accidents and related hazards (Bollyard, 2016). Other
sources indicate that such figures are underestimated nearly by 50% of workplaces never
reported (WHO, 2018).

ILO has further estimated that 5% of the world GDP is lost due to occupational diseases and
accidents among workers and waste collectors inclusive (ILO, 2020). Municipal solid waste
collectors in developing countries face occupational health problems such as muscle and
ligament sprains, cuts and lacerations, and various allergies (Lockley, 2019). They are
exposed to occupational health problems due to long working hours; frequent work accidents
and exposure to chemical, mechanical, and biological hazards which lead to physical and
psychosocial illnesses. The major reasons for the existence of occupational health problems
for municipal solid waste collectors in these developing countries include the lack of use of
protective equipment which is due to inadequate allocation of funds for the proper allocation
of solid waste collection (Lindquist, 2019). This leads to exposure to various health problems
including developing diseases, being exposed to harmful infections, microorganisms, and
musculoskeletal injuries including muscle damage and fractures (Mortise, 2016).

In most African countries like Ethiopia, solid waste is collected and sorted manually. The
lack of providing appropriate training for municipal solid waste collectors and supervisors on
occupational safety by the state leaves solid waste handlers at risk of several occupational
health hazards (Siegel, 2018).

In East Africa, it is estimated that every year over 1.1 million waste collectors die of
occupational injuries and work-related diseases. The risks that foster such ill health
challenges are evidenced when only 10% of waste collectors have access to occupational
health services (Vander, 2019).

In Uganda, 18% of the deaths of waste collectors are related to occupational safety gaps in
the workplace. Common occupational diseases include musculoskeletal disorders, circulatory
diseases, mental health illnesses like stress, and skin diseases caused by exposure to
biological agents (Edwinah, 2021).

In Kabale municipality, collection, and transportation of solid waste to the final disposal sites
from the communal disposal sites are done by local government authorities or appointed
private contractors (Daily monitor, 2022). The municipality is faced with numerous problems
like inadequate budgetary provisions, lack of institutional framework, and inadequate bylaws

2
and regulations but in particular, there have been few studies of the health and incidence of
solid waste workers (Berland, 2018).

Municipal Solid Waste (MSW) in Kabale Municipality-more commonly known as trash or

garbage-consists of everyday items we use and then throw away, such as product packaging,
grass clippings, furniture, clothing, bottles, food scraps, newspapers, appliances, paint, and
batteries. This comes from our homes, schools, hospitals, and businesses.

Some of the solid waste management practices used include the following: Source reduction
or waste prevention, is designing products to reduce the amount of waste that will later need
to be thrown away and also to make the resulting waste less toxic, Recycling is the recovery
of useful materials, such as paper, glass, plastic, and metals, from the trash to use to make
new products, reducing the amount of virgin raw materials needed, and composting involves
collecting organic waste, such as food scraps and yard trimmings, and storing it under
conditions designed to help it break down naturally. This resulting compost can then be used
as a natural fertilizer.

And more improved such as landfills are engineered areas where waste is placed into the
land. Landfills usually have liner systems and other safeguards to prevent polluting the
groundwater, Energy Recovery from waste is the conversion of non-recyclable waste
materials into useable heat, electricity, or fuel, and Transfer Stations are facilities where
municipal solid waste is unloaded from collection vehicles and briefly held while it is
reloaded onto larger, long-distance transport vehicles for shipment to landfills or other
treatment or disposal facilities.

No studies have been conducted in the municipality regarding occupational health effects
among waste collectors. It was against this background that this study assessed the
compliance of waste handlers to occupational health and safety measures in Kabale
Municipality.

1.2 Problem statement

Occupational safety and health hazards have worldwide occurrence both in developed and
developing countries resulting in more than 1.4 million deaths of waste collectors (WHO,
2018). The International Labor Organization estimates that occupational health hazards
among waste collectors accounted for an estimated 1.7 million health illnesses among waste
collectors and 9900 associated deaths each year (ILO, 2020).

3
Among those occupational health problems encountered by waste handlers include muscle
and ligament sprains, cuts and lacerations, and various allergies (Alsalama et al., 2021).
Despite efforts by the government to address OSH concerns among waste collectors,
accidents and other hazards still occur each year (World Bank, 2018). It is estimated that
every year, over 75,000 people die of occupational injuries and work-related diseases in
Kabale municipality (HMIS report, 2021). Such work hazards are biological, chemical, and
physical hazards as these find their way into the body, affecting normal functioning by
introducing different complications like cancer and other chronic effects (Nilgun, 2015).
Several measures to prevent and control occupational hazards like observance of laws such as
the Occupational Safety Health Act (OHSA) 2006, which calls for employers to protect
employees by ensuring that all possible measures to ensure that workers and the public are
free from danger at workplaces have been put in place to ensure safety and good health for
workers but all in vain (OHSA, 2006). Therefore this study assessed the compliance of waste
handlers to occupational health and safety measures in Kabale Municipality to generate
information that would be used by different stakeholders to overcome some of the health-
related effects through the use of good occupational health safety practices.

1.3 General Objective

To assess compliance with occupational health and safety practices among waste handlers
during solid waste management in Kabale Municipality.

1.3.1 Specific Objectives

1. To determine the availability health and safety measures in solid waste management in
Kabale municipality.
2. To identify the individual related factors among waste handlers leading to high rates of
occupational hazards in Kabale municipality.
3. To determine measures that would be put in place to prevent occupational health hazards
in solid waste management in Kabale municipality.

1.3.2 Research questions

1. What are the available health and safety practices among waste handlers during solid
waste management in Kabale municipality?
2. What are individual related factors among waste handlers leading to high rates of
occupational hazards in Kabale municipality?

4
3. What are the possible measures that would be put in place to prevent occupational health
hazards among waste handlers in Kabale municipality?

1.4 Significance of the study

Actual and potential losses due to occupational health and safety cause enormous problems in
the workplace globally. This study is therefore significant in addressing the health and safety
of the employee handling solid waste where its findings are hoped to alleviate or prevent
suffering to the specific group of solid sector individuals.

The health sector incurs expenses and loss of manpower as a result of health and safety
hazards, therefore the study is to help in reducing costs due to hospitalization, insurance
claims, and rehabilitation of solid waste workers. The results of the study are going to
provide evidence to improve strategies for integrating proper practices and management of
solid waste. The study too is going to add to existing knowledge about the impact of
occupational health and safety on workers in solid waste management and can serve as
reference material for further research.

Also, the study results is requirement for the award of a Bachelor’s degree in Environmental
Health Sciences from Kabale University.

1.5 Scope of the Study

1.5.1 Geographical scope
The study was carried out from Kabale municipality. It is a locality in Kabale, western
Uganda, and has an elevation of 1,805 meters. The municipal environment officer, Mr. Alfred
Ahimbisibwe, said between July 2021 and March 2022, a total of 3,139 tonnes of solid waste
were generated in the area. “With a population of about 65,072 people, Kabale Municipality
has about 12 garbage skips that have an average capacity of 4.5 cubic meters,” he said. (Daily
monitor 21 Sept 2022).

1.5.2 Content scope

The study was limited to determining the available occupational health and safety practices
among waste handlers, factors influencing waste handlers and possible recommendations to
be put in place to prevent occupational health hazards among waste handlers in Kabale
municipality.

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1.5.3 Time scope
The study is anticipated to be conducted in a period of four month

1.6 Conceptual framework:

The assess compliance with occupational health and safety practices among waste handlers
during solid waste management in Kabale Municipality.

The figure below illustrates conceptual framework: The independent variable is OSH
Practices and Management, whereas the dependent variable is Workplace environment
(Health and Safety.

INDEPENDENT VARIABLES
Available Health and safety practices DEPENDENT VARIABLE
 Incident case and reporting
 PPEs such as gumboots, masks, gloves
 Methods of solid waste management
 Training
 Vaccination Compliance to occupational
 Personal hygiene health and safety practices
by solid waste handlers
Factors influencing
- Proper use of PPEs such
 Habits / behavior (smoking/Alcohol)
 Ignorance as gloves, gumboots,
 Screening / Supervision masks/ eye protectors
 Supply of equipment - Reduced incidence
 Type of waste - Zero sickness
 Years of services, hours of work - Zero absenteeism

Possible recommendations
 Provision of PPEs
 Training of staff
 Recruitment of more staff
 Periodic check ups
 Reduced time of exposure.
 Vaccination of waste handlers
 Remuneration
 Improved infrastructure

Figure: 1.1. The assess compliance with occupational health and safety practices among
waste handlers during solid waste management in Kabale Municipality.

The presumed relationship is moderated by OSH Act 2007.

6
 CHAPTER TWO:
LITERATURE REVIEW
2.0 Introduction
In this section, a critical review of the issues connected to occupational health hazards are
explored through conceptual, theoretically and empirically in line with the specific study
objectives in order to identify the knowledge gaps in the existing research studies.

Occupational safety health constitutes an area of lively discourse across disciplines, but
Complementarities in the methodological or empirical findings have not yet been brought
together. The determinants of occupational health are multifaceted there are great need for
further collaboration among researchers of different disciplines on issues related to OSH.
Conformity to safety regulations entails compliance and obedience based on strong
influences which might be diverse and varied (Kassin, Fein, &Markus 2011).
This study explores the available medical, psychological, sociological and economic
literatures on the determinants and implications of OSH for individual workers, economies
and societies. Moreover, provides a useful guide to other researchers in investigating issues,
related to health and safety by employing an integrative analysis. In addition, it serves as a
useful source for the interested reader on information on the issue of OSH, in both academic
journals and official reports commissioned by major public bodies (such as the WHO, the
ILO and the EU). It equally explores the response strategies and consequences on the health
personnel and some of the theoretical/ empirical frameworks that are employed by
researchers in order to analyze issues of health and safety and to inform public policy.
Therefore this study focuses on available health and safety practices among waste handlers
during solid waste management in Kabale Municipality. Also it shows previous literature
written by other authors related to individual related factors, and possible recommendations
for waste handlers on compliance with occupational health and safety practices.

Solid Waste Management

The business of keeping our environment free from the contaminating effects of waste
materials is generally termed waste management. From a scholarly point of view, Gbekor
(2003) refers to waste management as involving “the collection, transport, treatment and
disposal of waste including after care of disposal sites”. Similarly, Gilpin (1996) has defined
waste management as “purposeful, systematic control of the generation, storage, collection,

7
transportation, separation, processing, recycling, recovery and disposal of solid waste in a
sanitary, aesthetically acceptable and economical manner” while Schubeller et al. (1996)
focus on municipal solid waste management which they define as “the collection, transfer,
treatment, recycling, resource recovery and disposal of solid waste in urban areas”. It can be
deduced from these definitions that waste management is the practice of protecting the
environment from the polluting effects of waste materials in order to protect public health and
the natural environment. Thus, the priority of a waste management system must always be the
provision of a cleansing service which helps to maintain the health and safety of citizens and
their environment (Cooper, 1999).

Different occupational hazards in workplace

Solid waste handlers are exposed to occupational diseases which are illnesses developed from
exposure to biological, chemical, physical and psycho- sociological factors that are present in
the work environment or are encountered in the course of their employment. However,
occupational diseases are preventable through occupation safety health, hazards mitigation
and risk reduction or aversion. Occupational medicine are designed to take care of different
health outcomes that might affect the workers’ productivity and reduce disability,
absenteeism and enhances the general wellbeing (Encyclopedia Britannica, 2009)

Mechanical Hazards risks; injuries, fall, cuts, abrasions, concussions, contusions. Ergonomic
Disorders like muscular and skeletal disorders (MSDs), Cumulative trauma-Disorders
(CTDs). Biological Hazards like bacterial infections that causes Tetanus, Tuberculosis,
Gonorrhea, Virus (Hepatitis, HIV), Protozoan and Parasitic infections including, Malaria,
Hookworms, tapeworms, Fungi Tinea-infections, Psittacosis. Chemical Hazards; inhalation,
ingestion and skin absorption of Chemical and gaseous gents:

Assessing aspects of the health situation of solid waste handlers in general, such as the effect
of various pathogenic behaviors (e.g. non- compliance to safety rules, smoking, and lifestyle
in work place etc.) and the health consequences. OHS hazards are examined from a broad
perspective; it relates workplace hazards with the direct and indirect impact on bodily
functions and contributes greatly to measure that are taken towards protecting workers health
from specific hazards.
Also occupational hygiene relates OHS activities that focus on the identification, evaluation
and control of physical, chemical, and biological hazards (Quinlan et al., 2010).

8
Some consequences of (Lack of) Health and Safety at Work
Accidents at Work: Gyekye and Salminen (2006) argue that the probability of work-related
accidents has its roots in two major causes, first; from the internal or innate dispositional
characteristics of workers, secondly; the external causal factors which include factors within
the working environment. Dembeet al. (2004) made mentioned of the broader social,
economic and cultural context.

Occupational Diseases: Indicators of occupational diseases refer to diseases which are

approved by the national authorities and therefore suffer from problems of comparability
among countries. Musculoskeletal disorders (MSDs) are related to physical, ergonomic and
psychosocial factors, such as vibrations from tools or machinery, painful or tiring positions at
work, repetitive motion, carrying or moving heavy loads, working with computers, high work
demand and fast pace of work, and other jobs involving physical exertion on the body (Cady
et al., 1979; Pickvance, 2005).

Psychosocial health problems: Factors of work organization such as job control, job
demand, work pace and hierarchical relations are involved in provoking or aggravating
psychosocial health problems, such as stress, anxiety and depression. So the working
environment of heat, noise, shift work, and precarious contracts contribute to rising stress
levels. Other important determinants of psychosocial health problems might include high
speed work, occurrence of unforeseen interruptions at work, lack of control over working
methods, mismatch between skills and workload and burnout. Wege et al. (2008) throws
more light to work-related stress given the high incidence of stress -related disorders reported
around the world.

An emerging theme in the literature is the study of the interaction of physical features of the
work environment with other psychosocial elements. Leather et al. (2003), further examined
the relationship between ambient noise levels and job stress, while Foppa and Noack (1996)
show that stress at work is associated with musculoskeletal pain. More research is required to
detect the underlying links and causalities associated with stress-related psychosocial
problems and the relationship with the work environment.

Sickness Absence: The causes of absenteeism are in general multi-faceted, and are
influenced not only by the health status of individuals, but also by the social insurance
system, the work environment, biological factors, attitudes and commitment to work,

9
macroeconomic conditions and other social and psychological determinants. (Fenn & Ashby,
2004; Heywood et al, 2008; Pouliakas & Theodoropoulos, 2010)

Factors associated with occupational hazards among solid waste handlers.

Agent: Biological chemical and Physical characteristics (e.g. biological, objects,
equipment’s, vapor pressure, pH level) and Process characteristics.

Ergonomic conditions: Bad ergonomic workstations and other adverse working conditions,
such as strenuous work postures, lifting of heavy loads, or repetitive movements during the
performance of job tasks could have many adverse consequences on health. Musculoskeletal
disorders constitute the most severe manifestation of an unsuitable work environment, and
are found to affect a significant portion of the workforce.

Worker characteristics: this include the following; working time arrangements, Job
activities or work techniques mobile or stationary and adverse working time arrangements.
Also long and irregular workdays (excess of 10 hours per day of 48hours per week) and shift
work have detrimental effects on both physical and psychological health of the workers.
Working long hours usually are likely to be associated with increased risk of ischemic heart
disease and myocardial infarction (Tochikubo, Ikeda, Miyajima, & Ishii, 1996; Liu &
Tanaka, 2002; Artazcoz et al., 2007) and hypertension (Nakanishi et al., 2001). Extended
work hours might interfere with the diurnal rhythm that results in decreased sleep, thus
magnifying the adverse effect of psychical tiredness forthwith (e.g. increased heart rate,
elevated blood pressure, lower cortical secretion) in relation to inadequate recuperation
(Dahlgren et al, 2006). Similar effects of disturbed biological rhythm are digestive disorders
and subsequent physiological disturbances among employees engaged in erratic shifts and
night work (Costa, 2003; Bjorvatn et al., 2007). Adverse working time arrangements could be
significant determinants of the sickness absence behavior of workers (Lusinyan & Bonato,
2007), the incidence of workplace injuries (Currington, 1986; Wooden, 1990),
musculoskeletal disorders (Wergeland et al, 2003) and of the risk of exhaustion and burnout.

Environmental characteristics: concerns like workplace Indoor and outdoor, temperature,

violence might manifests in a number of ways like physical or mental violence or bullying,
(sexual/racial) harassment and discrimination. Although the 13 extent of these phenomenon
are likely to be underreported, data from the ESWC indicated that about 2-3% of workers
suffer from sexual harassment, and 9% are exposed to bullying and victimization at work

10
with a close associated incidence of physical violence. Some identified adverse health effects
associated with workplace violence includes; psychopathologic, psychosomatic and
behavioural symptoms (Cassittoet al. 2003).

Social: Work relationship and social atmosphere of the workplace could have some
consequences on the worker. Especially atmosphere of constant fear and agitation, if
prolonged might upset the psychological wellbeing of workers and affect their work
performance and compliance.

Innate characteristics: personal health resources form an important component of the

person’s response mechanism, for instance, level of immunity, resistance and susceptibility to
disease, stress and workplace injuries. Sound Health is multicomponent that could demand
optimum nutrition, rest, physical and psychological aspects necessary for effective and
efficient functioning.

Knowledge: entails training on health safety standards and job activities of techniques in
service to ensure expertise in procedures, handling of equipment and proficiency in work
activities. Absence of training increases risk and poor compliance to set rule and safety
regulations and techniques.

2.1 Available health and safety practices among waste handlers during solid waste
management.
Standard PPEs used in solid waste include the following; Safety hats/helmets, which are used
to protect the employee’s head from impact and penetration of falling objects, hard hats
should be worn as standard practice. Ear protection, whenever noise levels are suspected to
exceed 85 decibels (dBA), hearing protection should be used. Hearing protection consists of
earplugs or earmuffs. Respirators and dust masks, to protect against airborne contaminants,
use of respiratory protection may be required. Particle masks are helpful with dust and large
grain contaminants, but are not effective for hazardous vapors or liquids. Safety coveralls,
covering full body, ends must fit closely around wrist and ankles, water proof, puncture proof
and Plugs must fit properly and remain correctly seated. Safety footwear, to protect the foot
against rolling objects and against the hazard of accidentally kicking or stepping on sharp
objects, adequate foot protection should be used. Foot protection should, as a minimum,
include steel-toed and/or steel mid-sole impermeable boots. Safety eye protection, eye
protection should be worn whenever there is danger of physical, biological or chemical injury

11
to the eyes. This type of PPE can include: safety glasses (prescription or non-prescription,
clear or tinted) and/or safety goggles. Safety hand protection, to prevent toxic or irritating
substances from coming into contact with the skin, adequate hand protection should be used.
Glove selection should be made based on chemical compatibility. (WHO 2020)

A study on occupational risks associated with solid waste management in the informal sector
in Zimbabwe showed that waste handlers had always reported high complaints of muscular
skeletal disorders due to handling heavy loads. The majority of the waste handlers who were
interviewed by the author showed that the repetition of similar movements of arms when
grabbing and loading waste was a major threat to their health (Stephen, 2021). This is similar
to a study by the findings on health and safety in the solid waste industry where waste
handlers complained about a lot of irritations arising from the handling of waste with hands
and also due to exposure to air pollution when sweeping on streets (Joseph, 2016).

A population-based study on awareness, and attitudes towards waste-related health risks in

Ghana by (Gira et al., 2017) revealed that the conditions in waste handlers were working
were not good. The study showed that the majority (85%) of waste handlers were observed
handling wastes with bare hands and according to the author though they knew it was an
improper practice of handling waste, the respondents never the health effects they would in
the short and long run of handling waste with bare hands. They complained that PPEs such as
heavy-duty gloves made them uncomfortable during work. The study recommended that
waste handlers should always be sensitized regularly about the use of PPEs. (Encyclopedia
Britannica 2010)

A cross-section study in Ghana about domestic waste collectors’ perceptions of occupational

safety and self-reported health issues revealed that waste handlers were not compiling with
proper occupational practices. The authors showed that 80% of the respondents interviewed
never wore personal protective equipment such as gloves, or face masks during waste
handling. It was found out that waste handlers who had worked in solid waste management
were always complaining of work related disorders such as stress and frequent burns. The
study recommended the lead agencies should always insure their waste handlers for social
and security benefits (Samuel et al, 2022).

Widad et al. (2022) in their study about solid waste management practices and perceptions in
East Malaysia found out that the majority of the waste handlers could not segregate waste at

12
the time of collection and transportation meaning that it would not be easy for the waste
handlers to know the types of waste they were handling. It was found out that the few who
would segregate it were mainly those who had spent experience in the same work.

A study on occupational health in solid waste management showed that most of the waste
handlers (72%) complained of heavy workload during working which was causing them
backache problems. The study showed that despite the fact that the waste handlers would
spend long hours working and that they would never be given enough PPEs to protect them
from occupational health hazards. The study identified gaps among different authorities who
were not minding on the health of their waste handlers thus recommending that employers to
always provide adequate PPEs and also revise other working strategies for waste handlers so
as to solve the problem heavy work load (Jorge and Bernal 2023).

A descriptive study on assessment of occupational health and safety among solid waste
workers in Abuja showed that waste handlers were not practicing putting on some PPEs even
when they would be provided by their employers. The study found out that about 45%
(171/380) of the waste handlers only practiced putting on PPEs such as heavy gloves. This
study recommended that training was necessary for the waste handlers to create awareness of
the use and utilization of PPEs before starting work (Oyelayo et al, 2018). This is in
agreement with a study done in Ethiopia about healthcare waste management among waste
handlers that revealed that waste handlers were full of inadequate training on occupational
health hazards to raise their awareness on the role of PPE that protects them from
occupational health hazards (Anayo, 2018).

Sandra (2020) in her study about occupation and environmental health issues of solid waste
management in middle and lower income showed that there was an infrequency supply of
PPEs to be used by waste handlers and also long-time distribution of individual masks. The
study also showed that even when such PPEs could be distributed could not see the waste
handlers with interest in putting them in due to a lack of awareness.

2.2 Factors influencing occupational health hazards among solid waste handlers in
Kabale municipality.
The Individual factor in Occupational Safety and health
The occupational safety and health is a reflective of the person’s attitude, beliefs, perception
and values placed on safety and hazards prevention. The Municipality management attitude

13
and approach to safety and health and towards accident and disease prevention in workplace
are shown in the supervisory force, safety regulation enforcement and hazard mitigation
strategies put in place and the level of cooperation and employee involvement in safety and
participation in safety programs.

Being healthy
The solid waste handlers are holistic being with physical, emotional, social, mental and
psychological aspects which could be affected when exposed to hazards. Occupational health
and safety aimed at promotion and maintenance of optimum degree of physical, mental,
psychological and social wellbeing of workers in any given institution. The OSH work
prevent hazards, eliminate workplace risks that may pose threat to the health wellbeing of
workers, proper job placement, and maintenance of hazard free environment and creation of
stress free atmosphere that allow workers to engage in productive services. (WHO 2018)

Safety knowledge
The individual is assumed to be responsible for his own health and wellbeing, he is to invest
in knowledge to gain enough information that is necessary for him to attain higher level of
safety and health. Safety culture entails an informed culture, where all concerned individual
are aware of human, technology, environment factors that can affect their safety and health in
workplace. Also important is reporting culture which entails liberty to freely report errors,
misses at workplace. It is obvious that safety measures are sometimes not static, but may take
different forms as to which to address a specific safety need. The individual willingness and
competences to draw right conclusion from safety information and the will to carryout of
reforms as the need arises are embedded in learning culture.

Training
Training guidance and supervision are perquisite for safety and health in workplace. The
motivation to perform job in safe manner is a function for individual commitment concern
and expressed concern of the management staff for safety, which gave rise to the practice’s
outcome including compliance to regulations.

Habits/ life styles

There are personal factors that could equally affect safety compliances like personal behavior
and habit such as smoking, alcohol but these are not tolerated in workplace under safety
regulations.

14
Institutional factors in Occupational Safety and health
Occupational Health and Safety Training
The OSH training is purposeful effort directed towards helping people to acquire specific
knowledge and skills for improve knowledge in operating of equipment, carrying out job
procedures, keeping safety regulations and information on risk aversion, containment and
elimination. Health and safety training helps in ensuring hazard prevention. An employer is
obliged to train workers on health and safety and correct use of equipment. The workplace
health and safety committee is responsible to provide advice on health and safety training
programmes, examines safety training documents to ensure its adequacy and attend to other
training details like logistics, timing, outcome evaluation.

Sometimes safety training are giving as induction course for new workers to help fully orient
them to the setting and the expectations. The training is used as a forum to discuss safety
rules, information about potential hazards and how to avoid them. The workers during safety
training are equally trained on certain routine practices like pre exposure and post exposure to
hazards precautionary measures and responsibilities. During the training, the workers are
made to know the institution hazards reporting system, hazards investigation procedures and
follow up expectations. (Baral, Y. R. (2018).

The labour code in Uganda require employer to provide free protective equipment (PPE) like
gloves, mask, eye protection goggle, gown special shoe to workers whose work entails some
form of hazard which the PPE stand to reduce the risk of exposure to accident and illness.
The employer has the mandate to train the workers on the proper use to avoid contamination
and spread of infection.

Occupational Health and Safety Inspection and sensitization

Most often based on safety regulations, routine inspection are carried out to ensure that the
working environment is safe for workers and that the employers are complying to the safety
regulations and workplace practices compliances by workers. The inspection are done using
check list to ensure compliance, strict assessment carried out on the all accidents and near
misses and report system check. Inspections are usually carried out by specially trained
agents of the department of Labour and their activities should follow strict and unbiased
procedure and visits are without prior notice.

15
The inspections are done in this order in most cases: They start with situation that involves
imminent danger in workplace. The next thing is to check the incidents resulting to fatalities
or hospitalization or disability. Follow up of employee complaint of unsafe and unhealthy
working condition. High hazard and risk jobs like areas that come into contact with blood /
blood product and other body fluids (especially the medical waste), areas where workers are
exposed to chemical and radioactive wastes. Then examine work environment and equipment
Note: information generated would be used for the implementation of reforms as the need
arises. The labour inspector informs and advises employers and workers concerning the most
effective means of safety regulation compliance. They also need to report all the activities
that are in non-compliance with the provision of the labour code and the social security
(Employment Act 2006: Law regulating Labour in Uganda, 2006).

Although some organizations provide waste disposal facilities for medical waste and safety
tools and equipment as control measures for occupational health hazards, the proportion of
waste handlers who utilize them is slightly lower mainly due to heavy workload. A study on
the prevalence and risk factors for occupational health hazards in the home healthcare sector
revealed that some individual workers mind less about the compliance and utilization of such
PPEs even when provides (Gershon et al., 2018).

According to a survey conducted by the Health Promotion and Social Development (HEPS,
2018) in Uganda, it was found that lack of training among waste handlers was a major factor
contributing to occupational hazards among handlers as they are more prone to accidents due
to negligence.

Berland et al (2018) in their study reported that waste handlers who worked overtime had an
increased likelihood of experiencing both biological and non-biological hazards. Long
working hours resulted in prolonged exposures to hazards and limited recovery time which
translates into physiologic depletion that continues to the next workday.

Negligence was another factor leading to occupational hazards among solid waste handlers.
For instance, a study done at two municipalities revealed that negligence among individual
healthcare workers was responsible for 23% and 26% of occupational hazards in their areas
of work (Lindquist, 2019).

Lockley et al (2019) in their study on quality and safety in health care conducted in the
United States established that low working experience predisposed waste handlers to various

16
occupational hazards while on duty. Furthermore, (Orji, Fasubaa, Onwudiegwu & Ogunniyi,
2019) in their study report that the nature of work also determines the risk of hazards faced
by an individual.

Time exposure by waste collectors determines their susceptibility to occupational health

hazards. Waste handlers who spent much time collecting waste in the field were found to be
highly exposed to an occupational health hazard. The report recommended working in shifts
and working for fewer hours to reduce contact time in getting risks related to occupation
hazards (WHO, 2023).

A study on occupational health in solid waste management showed three factors that
determine individuals' risk of occupational hazards. The study reported that awkward posture
during working, heavy workforce and high frequency increased the risk chances among waste
handlers during solid waste management (Jeorge, 2023).

Methods of waste disposal among waste collectors determine their risk of occupational health
hazards. A study on health risks of solid waste management practices revealed that the
majority (89%) of the waste collectors practiced poor waste disposal methods such as open-
air burning especially when the waste could accumulate. This exposed them to the inhalation
of toxic gasses arising from the burning of waste (Giovanni, 2023).

2.3 Recommendation to be put in place to prevent occupational health hazards among

waste handlers.
According to a study by Van der Hulst (2020) on measures to prevent occupational hazards,
personal protective gear such as aprons and face masks should be worn in procedures where
splash/spill of blood has taken place or is likely. The study recommended that gloves should
always be worn when dealing with high-risk areas.

Furthermore, training of staff and provision of personal protective equipment (PPE) was
recommended to reduce the risk of exposure to occupational hazards among waste handlers
(Siegel, E. Rhinehart, M. Jackson, and L. Chiarello, (2018).

All likely exposures to occupational hazards should always be notified, reported, and
documented by employers to their employees. Exposure and infection control policies
(standard operating procedures) should be regularly reviewed and updated by the hospital
management.

17
Employers to always endeavor to provide with their employees necessary medical supplies
like gloves, masks, and aprons among others to reduce their risk of occupational hazards,
(O’Dumas, 2017).

Another strategy recommended for preventing occupational hazards among waste handlers
would be to recruit more staff to reduce work overload. This could be mainly attributed to the
fact that overworked workers might be predisposed to occupational hazards like
musculoskeletal injuries like backache, (Mortsen, 2016).

Governments with the support of Donor agencies to increase funding to the health care
sector, especially through the regular provision of protective gear where such funds can be
allocated to training waste handlers on how to safeguard themselves during work (Ilhan,
Durukan, Aras, S. Türkçüoǧlu, and R. Aygün (2019).

A study by Raj Kumar (2016) on status and challenges of municipal solid waste management
in India suggested that vaccinating waste handlers inform of immunization against some
infectious diseases was paramount to the prevention of some highly infectious diseases. Such
diseases include Hepatitis B, Rota diarrhea, and tetanus. A study on health and safety in the
solid waste industry by Joseph (2016) suggested regular training and instructions to the waste
handlers before and during working times to ensure compliance with the use of PPEs. The
study showed that such PPEs help waste handlers to be protected from occupational health
hazards. The use of waste management hierarchies such as substitution, technical,
organizational measures, and personal behavior (STOP) was recommended by Stephen in his
study about occupational risks associated with solid waste management in the informal sector
of Guenru (Stephen 2021).

A population-based study in Ghana about population awareness and attitudes towards waste-
related health risks showed that medical examination of waste handlers should always be
carried out to identify early warning signs among the waste handlers and those found at risk
be eliminated or treated (Gira, 2017). Delegation of site supervisors is to be carried out
regularly. A study by Samwel (2022) on domestic waste collection recommended that site
supervisors should be in the field all the time to monitor compliance with the safety measures
among waste handlers such as the use of PPEs.

18
 CHAPTER THREE:
MATERIALS AND METHODS
3.0 Introduction
This chapter consists of study designs, Study Area, Study Population, Sample size
determination, Sampling Technique, Sampling Procedure, Data collection method, Data
Collection Tools, Data collection procedure, Study variables, Quality control, Data Analysis
and presentation, Ethical consideration, Study limitations and Dissemination of results.

3.1 Study Design

A descriptive cross-sectional study design involving quantitative data collection methods was
used. The study design was selected because it helped the researcher to measure different
variables in the population of interest at a single point in time.

3.2 Study Area

The study was carried out from Kabale municipality. It is a locality in Kabale, western
Uganda, and has an elevation of 1,805 meters. Latitude 1 015’46 south and longitude 29.98810
East. It has a population of 49,667 as per 2014 census. It is located in the Kabale district
about 142 kilometers by road in southwestern Mbarara.

3.3 Study Population

The study population consisted all varying cadres of waste handlers in Kabale municipality;
these workers are exposed to various hazards at the work place.

3.4 Sample Size Determination

Category Population Sample
Waste handlers 55 37
Supervisor/admin 4 3
Drivers 3 1
62

The sample was calculated using Slovene’s formula for calculation of sample size with the
formula. This gives us 62 as the sample size as shown below: n = N
1+ N (e) ²
Where; n - The sample size
N - The population size
e- The desired level of precision (0.05) at 95% confidence interval
19
Therefore; n = 62/ 1 + 62 (0.05) ²
n = 62/ 1 + 62 (0.0025)
n = 62/ 1+0.155
n = 62 / 1.155
n = 53

3.5 Sampling Technique

In a view of the nature of the research topic, participants were recruited into the study by
convenience sampling method after ascertaining their eligibility by the researcher.
Participants were selected based on how accessible, convenient, and present at the time of
data collection.

3.6 Inclusion Criteria for the selection of study participants.

The following are examples of waste handlers that were included in the study:
Waste handlers in the designated working stations for more than one year and are exposed to
all kinds of solid waste.
Also those that handle chemicals, radio-active materials during their routine duties.
Waste handlers who were willing to participate in the study.

3.7 Exclusion Criteria for the selection of study participants.

Waste handlers who were newly employed at any station for less than one year and those
working outside the scope of the study.
Waste handlers that were not willing to participate in the study.

3.8 Sampling Procedure

The waste handlers were approached as they came for duty in the municipal council to give
them a chance of participating in the study as long as they meet the inclusion criteria. This
was based on the fact that waste handlers on duty were not predictable and some cannot
attend duty at the same time. The estimated number of participants per day was eight and the
researcher was always reporting at their workplaces every morning for 11 days to ensure that
all waste handlers were given chance to participate in the study. Finally, those who meet the
criteria were requested to give informed consent by signing the consent form and then
enrolling in the study and data was collected.

20
3.9 Data Collection Method
A researcher used a questionnaire method to collect quantitative data on waste handlers’
knowledge of compliance to occupational health and safety practices during solid waste
management, individual related factors leading to high rates of occupational hazards, and
possible recommendations for waste handlers on compliance to occupational health and
safety practices.

3.10 Data Collection Tool (s)

In this study both primary and secondary data were collected. Primary data was collected
using semi-structured questionnaires, key informant interview guides, focused group
discussion guide and observational checklist. Secondary data was collected from policy
documents reviews. This study was designed based on information from existing literature
which was deemed necessary to help supply information on research question and within the
scope of the study.

3.11 Data Collection Procedure

After getting approval from the school research and ethics committee, it was taken to Kabale
municipality to obtain permission of collecting data from waste collectors. The municipal
council approved the researcher to collect data from the willing waste handlers after
consenting. Data collection begun. The researcher requested to work with waste handlers who
were eligible based on the inclusion criteria and all those who meet the eligibility criteria
were recruited into the study after giving information from the self-administered
questionnaire to obtain data. The study participants were requested to sign a consent form
confirming acceptance to participate in the study.
Finally, the researcher collected data from those who consented to the study using a
questionnaire which took 10-20 minutes. The researcher collected data for 11 days.

3.12 Study Variables

Independent variables
The independent variables in this study included: establishing the available occupational
health and safety practices by the solid waste handlers for example using of PPEs. Individual
related factors leading to high rates of occupational hazards that is the behavior, habits such
as smoking, alcohol. And recommendations to be put in place to prevent occupational health
hazards among waste handlers.

21
Dependent variables
In this study, the dependent variable was compliance with occupational health and safety
practices among waste handlers during solid waste management. These included the use of
PPEs, vaccination of solid waste handlers, limited time of exposure, training of workers, and
increased funding among others.

3.13 Quality Control

Data was collected by the researcher and entered into a data collection tool by two different
recorders to keep the data consistent. Pretesting of the data collection tool was done from
Kabale municipality where refining and evaluation was done among 10 waste handlers.

3.14 Data management and analysis

The data generated from the study was coded and entered into the computer programs EPI
data and exported to SPSS (version 21), the data were cleaned for consistency and quality
control. The analysis was guided with the data plan designed in line with the study objectives.
Data analysis for the variable of respondent background characteristics, the researcher used
descriptive statistics to determine the profile of the respondents in frequency and percentage
distribution and 95% confidence interval presented in frequencies tables, graphs and charts.
The variables were weighted using average score rating and the variables were further put
into categories of three. Test for the degree of association between independent and
dependent variables were done using Pearson chi-squared tests to assess whether there was a
significant difference for each independent variable at the level 0.05 significance.

Also regression analysis was equally used for testing association between variables. It
assesses the extent to which it becomes easier to know the predictive value for the dependent
variable from a known case’s value of the independent variable. Lastly, results of qualitative
data were used to support the quantitative findings and regression analyses were used for
conclusion and recommendation.

The Dependent variable includes; the workplace hazards experienced, Occupational hazard
health outcomes, compliance to safety standards and practices and waste management
practices. The independent variable comprised the Participants profile, awareness / opinion
on occupational hazards and safety, prevention strategies, individual and health facility
factors influencing workplace hazards and waste management system.

22
To determine the relationships and causal effects between variables, factor analysis and
regression analysis were used.

Description Very Low Interpretation

Strongly Agree Very High level
Agree High
Undecided Moderate
Disagree Low
Strongly Disagree Very Low

3.15 Ethical Consideration

In all health research; ethical consideration are very crucial and an important aspect that
focuses on the study participants. Strong considerations are given to the extent to which the
study participants are giving freedom to choose whether to participate or not. The researcher
observed ethical standards in professional practices during the research study by doing the
following: Ensuring accuracy in data collection and processing, using systematic procedures
to ensure that data collected and information processed were accurate.

The researcher in this study strictly ensures that the information’s obtained from the
respondents were handled with utmost confidentiality. And that the results of the study were
reported in a generalized manner and for the purpose of this study only. The participants were
given full information about the procedures, expectations and the role they would play as
well as the purpose of the study. They were given time to carefully deliberate on whether to
participate or not.

All the study participants remained anonymous; hence their individual identities were not
disclosed. The questionnaires were designed in a way that the initials of respondents were
only used. The reporting was done in a generalized manner. However, consent to participate
in the research was obtained from each study participants, also authorization to conduct the
study was obtained from Kabale University School of medicine The researcher ensured that
all respondents own their own consent to participate in the study by signing the consent form.
The researcher ensured that participants are respected and respect given to all their decisions
including decision not to participant and the less powerful groups of participants were
protected. The researcher ensured that no harm was allowed to the respondents in the course
of the study. Utmost consideration were given to the welfare of the respondents including;

23
mental, physical health safety. The researcher took all the necessary steps to avoid injury of
the respondents and persons who was involved in the research. The researcher avoided
questions or issues that would cause embarrassment, guilty, discomfort, or risks, where such
questions were inevitable. They were asked in a less sensitive manner with due respect and
the respondents were informed accordingly at the outset of the study. Study participants were
allowed to decline to answer any particular questions or sets of questions they don’t want to
answer and to withdraw from the study at any time, or decline to have their responses
recorded and access to the findings summary.

3.16 Study Limitations

Funds were inadequate and this hindered realization of satisfactory work as some of the
respondents requested for money and drinks which were not available. Rainy season made
transportation difficult and limited the time to gather all the information. The participants
were too busy to attend to the researcher’s questionnaire.

3.17 Dissemination of Results

The findings of the study was presented inform of a report submitted in partial fulfillment of
the requirement for the award of a bachelor’s degree in Environmental Health Sciences and to
be kept in the library as a reference for future reference. Also, a copy of the findings
(recommendations) was availed to the administrators of Kabale municipality.

24
 CHAPTER FOUR:
PRESENTATION OF RESULTS

4.1 Demographic Characteristics of Study Participants

The Study Participants Profiles in this study were described according to age, education level
and duration in service. Data was collected from total of 53 participants, consequently; out of
the 53 participants, 37 (69.8%) males and 16 (30.2) were female. In addition, 23(43.4%) of
participants had less than three years’ experience. Then out of 53 participants 21(39.6%) had
worked between 4 to 8 years and the remaining 9 participants (17%) had a duration of 9 years
and above. With regards to risks behavior such as smoking and alcohol use, about 6(11.3%)
were smokers while 25(47.2%), consumes alcohol and 22 participants (41.5%) do not take
any substance.

Table 4.1: Study Participants Demographic Characteristics (n = 53)

Study Question Variables Options Frequency %
Parish of Residence Northern Division 11 20.8
Central Division 26 49.1
Southern Division 16 30.2
15-35 20 37.7
Age Group of the participant 36 – 49 26 49.1
50 – above 7 13.2
Study Participants’ Gender Male 37 69.8
Female 16 30.2
Educational Status No formal Education 21 39.6
Primary / Secondary Level 25 47.2
Higher Education 7 13.
Christian 44 83.0
Religion None Christian 8 15.1
Others Specify 1 1.9
Marital Status Married 35 66.0
Single 18 34.0
Duration in service: Less than 3 years 23 43.4
4 to 8 years 21 39.6
9 Years and Above 9 17.0
Mode of appointment to Services Self-appointed (Voluntary) 21 39.6
Government Appointment 18 34.0
Contract Appointment 14 26.4
History of habits: Smokes Cigarette 6 11.3

25
 Takes Alcohol 25 47.2
Does not take any substance 22 41.5

4.1.1 Study respondents’ job Specification

Out of 53 study participants 23 (43.4) were solid waste collectors; 16(30.2%) were
segregators, while 7 (13.2%) were drivers, 5 (9.4%) were incinerators. Meanwhile, the least
proportion of job specification that participated in the study were the managers for 2 (3.8%).
(Figure 4.2).

Respondents Job Specification

43.4

40 30.2
30 23
13.2
20 16 Frequency
7 9.4 %
10 3.8
0 2 5
r
cto er
e n
col
l riv atio ge
r
n
D g a
te re an tio
as eg M er
a
w S in
lid In
c
So

Figure.4.2: The study participants job specification (n = 53)

Workplace contains harmful chemical, gases and contaminated products which workers must
be protected from
1. What are the available health and safety practices among waste handlers during solid
waste management in Kabale municipality?
The study findings from study participants about their opinion about the availability of
safety practices showed that about 21 (39.6%) agrees that workplace contains harmful
chemicals, gases and contaminated products. About 12(22.6%) responses agree that
Workers are trained on safety precaution and risk management. Another 14(26.4%)
responses agrees that Vaccination of workers and first aid treatment when necessary, while
about 5(9.4%) responses strongly disagrees that Work supervision and evaluation to
prevent hazards. Also about 21 (39.6%) agrees that Wearing glove / boots to reduce
damage to hands and foot. (Table 4.2).

26
Table 4.2: The study participants about their opinion of workplace hazards and safety
measures (n=53)
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

Workers opinion of safety measures in their workplace 5 4 3 2 1

Workplace contains harmful chemical, gases and 4 3 5 21 20
contaminated products which workers must be protected (7.5) (5.7) (9.4) (39.6) (37.7)
from
Workers are Provided with PPEs to work with 5 18 7 12 11
(9.4) (34) (13.2 (22.6) (20.8)
)
Wearing glove / boots to reduce damage to hands and 4 4 10 21 14
foot (7.5) (7.5) (18.9 (39.6) (26.4)
)
Collection and transportation of waste is done by 7 7 9 22 8
machines like vehicles and wheel barrow (13.2) (13.2) (17) (41.5) (15.1)
Odor at the workplace is managed 13 20 7 11 2
(24.5) (37.7) (13.2 (20.8) (3.8)
)
Workers are trained on safety precaution and risk 6 12 14 12
management (11.3) (22.6) (26.4 (22.6) 9 (17)
)
Workers are made to wearing apron and mask to reduce 4 24 7 14 4
physical damage (7.5) (45.3) (13.2 (26.4) (7.5)
)
Work supervision and evaluation to prevent hazards 5 21 18 8 1
(9.4) (39.6) (34) (15.1) (1.9)
Vaccination of workers and first aid treatment when 11 17 9 14 2
necessary (20.8) (32.1) (17) (26.4) (3.8)
Record of accident frequency and severity rates 7 10 16 14 6
(13.2) (18.9) (30.2 (26.4) (11.3)
)

27
Further statistical analysis to determine relationship between availability of safety measures
and respondents job specification in the study findings analysis showed two variables that are
statistically significant. It showed that good workplace safety and job specification
comprising of drivers, incinerators, waste collectors is significant with (p-value
=0.002<0.05), and also it showed that good workplace and education status is significant with
(p-value = 0.022<0.05) (table 4.3)

Table: 4.3 The Chi-square tests on relationship between availability of safety measures
and respondents job specification.
Available safety measures * Respondent's Job specification Cross tabulation
Respondent's Job specification
P –
Available Solid waste Segreg Man Inciner Chi- D. valu
safety measures collector Driver ation ager ation square F. e
Good
workplace 3 24.79 0.00
safety 13 (56.5) 1 (14.3) (18.8) 0 (0) 1 (20) 4a 8 2
Average
Workplace 10
safety 8 (34.8) 1 (14.3) (62.5) 0 (0) 1 (20)
Low 2
Workplace 3 (100
safety 2 (8.7) 5 (71.4) (18.8) ) 3 (60)

Education status
Available No formal Primary/ Higher
safety measures education Secondary education
Good
workplace 11.45 0.02
safety 11 (52.4) 7 (28) 0 (0) 7a 4 2
Average 6 (28.6) 12 (48) 2
Workplace (29.6)

28
safety
Low
Workplace
safety 4 (19) 6 (24) 5 (71)

2. What are the factors contributing to occupational hazards among waste handlers in Kabale
municipality?
2a.Human factors contributing to occupational hazards among waste handlers in Kabale
municipality;
The study findings indicated that out of 53 study participants about 25 (47.2%) and 29
(54.7%) agrees that negligence of safety procedure, hygiene rules and carelessness and Poor
knowledge on use of protective and safety equipment are part of human associated
influencing occupational hazards and health outcomes. Lastly, about 13(24.5%) and 19
(35.8%) participants responses agree that lacks of job motivation and Multiple job place to
improve earning are among the human associated factors influencing occupational hazards
and health outcomes in the study. (Table 4.3).

Table 4.4: The human level associated factors to occupational hazards and health
outcomes (n-53)
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)
Individual level factors contributing to occupational 5 4 3 2 1
hazards among waste handlers in Kabale municipality?
Negligence of safety procedure, hygiene rules and - 5 13 25 10
carelessness (9.4) (24.5 (47.2) (18.9)
)
Poor knowledge on use of protective and safety 2 6 7 29 9 (17)
equipment (3.8) (11.3) (13.2 (54.7)
)
Poor job training, knowledge, skill and experience 2 5 15 23 8
(3.8) (9.4) (28.3 (43.4) (15.1)
)
Body sensitivity and reaction to some PPEs 11 19 11 6 6
(20.8) (35.8) (20.8 (11.3) (11.3)

29
 )
Distraction with other personal issues 4 14 12 13 10
(7.5) (26.4) (22.6 (24.5) (18.9)
)
Lack of job motivation 4 15 13 13 8
(7.5) (28.3) (24.5 (24.5) (15.1)
)
Workers pre- existing disease 3 13 15 16 6
(5.7) (24.5) (28.3 (30.2) (11.3)
)
Multiple job place to improve earning - 14 7 19 13
(26.4) (13.2 (35.8) (24.5)
)

In addition, further statistical analysis was carried out to determine the real factor among the
study variables that influence the human associated factors in occupational hazards in the
study. In this case, the study findings from multinomial analysis showed only one variable
being statistically significant. Job specification with individual linked factors with (p- value =
0.019 < 0.05)

Table 4.5 The relationship between the human associated factors and other study
variables at level of 0.05 significant).n = 57
Individual linked factors * Respondent's Job specification Cross
tabulation
Respondent's Job specification
Solid
waste
Individual linked colle Driv Segreg Mana Inciner Chi- D.
factors ctor er ation ger ation square F. P - value
3
High Individual linked 3 (42. 9 1 18.340
factors (13) 9) (56.3) (50) 0 (0) a 8 0.019
Moderate Individual 13 1 5 1 1 (20)

30
 (56.5 (14.
Linked factors ) 3) (31.3) (50)
7 3
Low Individual linked (30.4 (42. 2
Factors ) 9) (12.5) 0 (0) 4 (90)

2b. Workplace factors contributing to occupational hazards among waste handlers in Kabale
municipality?
The Study findings on institution associated factors influencing occupational hazards and
health outcomes; indicated that out of 53 responses about 27 (50.9%) agrees that among these
influencing factors to be constant work over load and extended work time due to shortage of
staff. Another, 19(35.8%) agrees that Inadequate supply of waste management equipment.
Also about 15 (28.3%) agrees equally that poor safety information communication and
hazard reporting system and absence of Fire emergency drills and safety equipment’s 21
(39.6%) are among the health facility level influencing factor. (Table 4.5).

Table 4.6: Distribution of participants’ responses on workplace associated factors

influencing occupational hazards and health outcomes among waste handlers in Kabale
Municipality.
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)
Work place factors contributing to occupational hazards 5 4 3 2 1
among waste handlers in Kabale municipality?
Poor Job placement and job organization - 12 17 17 7
(22.6) (32.1 (32.1) (13.2)
)
Work overload and shortage of staff 1 6 3 27 16
(1.9) (11.3) (5.7) (50.9) (30.2)
Unclear procedure rules and absence of job supervision 1 5 18 24 5
(1.9) (9.4) (34) (45.3) (9.4)
Inadequate provision and maintenance of PPEs 1 5 6 26 15
(1.9) (9.4) (11.3 (49.1) (28.3)
)
Inadequate supply of waste management equipment 2 10 8 19 14

31
 (3.8) (18.9) (15.1 (35.8) (26.4)
)
Absence of Fire emergency drills and safety equipment’s 2 7 11 21 12
(3.8) (13.2) (20.8 (39.6) (22.6)
)
Inadequate provision of hazards prevention measures 9 (17) 13 20 11
(24.5 (37.7) (20.8)
)
Poor workplace safety communication and management 3 15 11 15 9 (17)
(5.7) (28.3) (20.8 (28.3)
)

Further analysis as far as Job environment related factors and history of Habits is concerned
showed one variable to be significant and that is work environment factors with (p-
value=0.015<0.05). (Table 4.7)

Table 4.7 The relationship between the job environment related factors and history of
habits at level of 0.05 significant).n = 57
Cross tabulation of Job environment related factors and History of Habits
History of Habits
Job environment related Smokes Takes Does not take Chi- D P -
factors Cigarette alcohol any substance square F value
Good Work environment 12.357a 4 0.015
factors 1 (16.7) 13 (52) 3 (13.6)
Moderate work environment 1 (16.7) 6 (24) 12 (54.5)
factors

32
Poor work environment
factors 4 (66.7) 6 (24) 7 (31.8)

3. What are the measures that are put in place to prevent occupational health hazards among
waste handlers in Kabale municipality?
At Kabale Municipality hazard risk prevention risk through engineering and safety
training is one of the measures in place and supported by as few as 8 (15.1%), Also very
few participants 10 (18.8%) agree that there is effective stress management. About 17
(30.4%) responses were neutral about the supervisors' assigned responsibilities to ensure
hazard control. On another note, about 25 (47.2%) responses disagree to the fact that Solid
waste handlers are provided with safety information (table 4.8).
Table 4.8: The proportion of the participant’s responses on measures that are put in
place to prevent occupational health hazards among waste handlers in Kabale
municipality
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

The measures that are put in place to prevent 5 4 3 2 1

occupational health hazards among waste handlers in
Kabale municipality
Hazard risk prevention risk through engineering and 2 19 17 8 7
safety training (3.8) (35.8) (32.1) (15.1) (13.2)
Solid waste handlers are provided with safety 25 6 15 7
information (47.2) (11.3) (28.3) (13.2)
Effective stress management 17 11 10 10 5
(32.1) (20.8) (18.9) (18.9) (9.4)
Supervisors' assigned responsibilities to ensure hazard 1 16 17 12 7
control (1.9) (30.2) (32.1) (22.6) (13.2)
Regular equipment maintenance and replacement 1 18 12 17 5
(1.9) (34) (22.60 (32.1) (9.4)
Regulation PPEs supply 4 17 12 16 4
(7.5) (32.1 (22.6) (30.2) (7.5)
0
PEP and POP administration to prevent infection risk 3 16 16 12 6

33
 (5.7) (30.2) (30.2) (22.6) (11.3)

Results from relationship test with chi-square between measures to be taken to prevent
hazards and Respondent’s Job specification revealed to be significant with (p-value=0.002)

Table 4.9. Result of test of relationship test with chi-square between measures to be
taken to prevent hazards and Respondent’s Job specification
Cross tabulation of Measures to be taken to prevent hazards and Respondent's Job
specification
Respondent's Job
specification
Measures to be Solid Incin
taken to prevent waste Drive Segregat Mana eratio Chi- D P -
hazards collector r ion ger n square F Value
Good prevention 1
strategies 13 (56.5) (14.3) 3 (18.8) 1 (50) 0 (0)
Moderate
24.292
prevention 1 8 0.002
a
strategies 7 (30.4) (14.3) 8 (50) 1 (50) 0 (0)
Poor prevention 5 5
strategies 3 (13) (71.4) 5 (31.3) 0 (0) (100)

Multinomial regression findings in the study on relationship between work place factors and
hazard mitigation showed statistical significant relationship with (p – 0.005 <0.05, odd
ratio .120, 95% C.I. .027 - .528)

34
Table 4.10. Result of on relationship between hazard mitigation and other study
variables
Parameter Estimates
95%
Confidence
Interval for
Exp (B)
Std. Exp Lower Upper
Available safety measures B Error Wald d.f. Sig. (B) Bound Bound
Good Intercept 3.227 1.799 3.218 1 .073
workplace Human factors -.436 .729 .358 1 .550 .647 .155 2.700
safety WORKPLACEFACTORS 1.457 .806 3.270 1 .071 4.292 .885 20.820
Hazards mitigation -
.755 7.869 1 .005 .120 .027 .528
2.119
Job -.478 .406 1.386 1 .239 .620 .280 1.374
Average Intercept 2.954 1.435 4.234 1 .040
Workplac Human factors -.129 .623 .043 1 .836 .879 .259 2.981
e safety Work place factors -.210 .627 .112 1 .737 .811 .237 2.768
Hazards mitigation -.610 .541 1.274 1 .259 .543 .188 1.568
Job -.241 .298 .656 1 .418 .786 .438 1.408
a. The reference category is: Low Workplace safety.

4.B Qualitative Data Results

From all solid waste management stalk holders in Kabale Municipality 8 individuals were
interviewed. Those interviewed included the managers, supervisors, head of each department
that is head of segregation, head of drivers and head of incineration, local leaders and
security.
Each stake holder was interviewed alone from their offices.
1. When the stake holders were asked what the types of strategies are and hazard
prevention equipment’s provided to ensure workers safety in Kabale municipal solid
waste point?

35
 Provision of safety protection equipment; the safety equipment’s like gloves, boots, mask and
gown are provided dominated with 6(75%) while pre job placement training on health and
safety took 3(38%) and training on occupational health and safety in waste management had
the least of 1(13%).
2. Also when they were asked if solid waste handlers are provided with enough PPEs for
their work? No had 3 count which is 38% out of the eight respondents, not enough to
cover all the activities had 4(50%) and a yes had 1(13%) out of the 8 respondents.
3. On another note; when the respondents (stalk holders) were asked what equipment
shortage do you think that solid waste handlers face? Out of the eight stake holders
interviewed, the main equipment in shortage in line with the question it was garbage
forks and wheel barrows corresponding to 5(63%) and gloves and garbage trucks with
2(25%) while coverall, gloves, masks and ear protection had 1(13%).
Lastly, when asked what is your suggestion for improved services of solid waste
management in Kabale municipal waste point? Motivation and improved pay had the
majority answer of 4(50%), provision of adequate personal protective equipment had
2(25%) and sensitization of waste handlers with 2(25%).

Table 4.11: Summary of responses generated from different study stakeholders

Themes of the questions Summary of responses generated from different study %
in line with study stakeholders
objectives
Types of strategies and Gumboots, gloves, overall, facemasks 75
hazard prevention Gumboots, gloves 38
equipment Placement of warning signs
Gumboots, gloves 13
Vaccination
Are handlers provided Yes 13
with enough PPEs No, once you lose it it’s your responsibility 50
No 38
Handlers given work Yes 13
training on safety Yes, sometimes they learn from their co-workers 25
prevention No 63
Handlers receive Vaccination received and first aid is individual 38

36
vaccination, first aid and responsibility
treatment when the need No 25
arise Yes 38
Challenges that might Inadequate PPEs, negligence and lack of motivation 38
contribute to hazards Sharp things 25
No masks
Poor use of PPEs 25
Lack of cooperation 13
Problem from waste Cuts and infections resulting in absenteeism 50
handlers and how it Low pay affects health service seeking behavior 13
affects their job and Lifestyle like over drinking of alcohol 38
health
Administrators and Yes, paid little money 13
district office contributing Yes, no training 13
to the undermining the No 75
safety of waste handlers.
Equipment shortage solid Improved wheel barrow 63
waste handlers face. Garbage forks
Gloves, garbage trucks 25
Coverall, gloves, masks, ear protection 13
Suggestion for improved Motivation and improved pay 50
services of solid waste Improved response to occupational hazards and safety
management of well and treatment of handlers in case of accidents.
Provision of adequate PPEs 25
Fencing of the site
Training of handlers 25
Sensitization
How handlers can Following guidelines, improved lifestyle like drinking 38
improve their work Putting on gloves and coming early 50
Following regulations
Have each other accountable 13
What government can do Supply PPEs to the municipality and improved 63
to improve solid waste payment

37
management Providing health insurance 13
Providing enough machinery 25
District community Sensitization about garbage sorting 38
support the waste Informing the community to pay taxes
management for improved By providing PPEs 50
services Putting up strict regulations
Cooperating with the solid waste handlers 13
Ways solid waste Yes, through mass sensitization 38
management operations Providing vehicles and machines
can be improved Encourage community to recycle, reuse
Providing enough PPEs 50
Improved payments
Supervision of workers 13

38
 CHAPTER FIVE:
DISCUSSION, CONCLUSION AND RECOMMENDATION

5.0 Introduction
This chapter presents the discussion of the study findings that was presented in chapter four
of this report. This study was conducted in Kabale Municipality among 53 waste handlers to
determine the availability health and safety measures in solid waste management, identify the
individual related factors among waste handlers. In like manner workplace inspection was
carried out to determine the workplace environment for safety mitigation strategies and waste
management practices. Information was obtained from waste management top ranked staff to
help boost information gap from questionnaire. The research was guided by the study
objectives and explanations of findings are discussed below;

5.1. Demographic factors

Study findings showed that gender ratio of the study participants; according to male to female
was 37:16. The predominant age category of the study participants were those in the age
cohort of 36–49. Majority of the study participants 25 (47.2%) possessed primary/ Secondary
certificates, while about 21 (39.6%) had worked for 4-8 years

A high number of study participant when asked about their opinion of workplace hazards and
safety measures 21(39.6%) agreed and 20 (37.7%) strongly agreed that workplace contains
harmful chemical, gases and contaminated products which workers must be protected from
therefore showing a high level of awareness on occupational health and safety. This finding is
in line with McGrowder D. Etal (2010) study on Knowledge, Awareness and Compliance
with Universal Precautions among solid waste handlers among West Indies.

5.2. The Levels of available safety

The study findings from study participants about their opinion about the availability of safety
practices showed that 39.6% agrees that workplace contains harmful chemicals, gases and
contaminated products. Another proportion 22.6% agrees that Workers are trained on safety
precaution and risk management and 26.4% admits vaccination of workers and first aid
treatment when necessary. Most respondents 39.6% admit to wearing glove / boots to reduce
damage to hands and foot. This agrees with a descriptive study on assessment of occupational
health and safety among solid waste workers in Abuja showed that waste handlers were not
practicing putting on some PPEs even when they would be provided by their employers. The

39
study found out that about 45% (171/380) of the waste handlers only practiced putting on
PPEs such as heavy gloves. This study recommended that training was necessary for the
waste handlers to create awareness of the use and utilization of PPEs before starting work
(Oyelayo et al, 2018).

5.3. The individual factors associated

Human linked factors in the study were negligence of safety procedure, hygiene rules and
carelessness and Poor knowledge on use of protective and safety equipment are part of
human associated influencing occupational hazards and health outcomes. Lastly, lacks of job
motivation. There was statistical relationship between human factors in occupational hazards
in the study and Job specification with (p- value = 0.019 < 0.05. This finding varies with the
findings of the study by Annalee Y. etal, (2007) on determinants of solid waste handlers’
Compliance with Infection Control Procedures a strong correlation was found between both
environmental and organizational factors.

5.4. The Institution Factors

The solid waste institution linked factors in the study were 50.9% constant work over load
and extended work time due to shortage of staff, inadequate supply of waste management
equipment and poor safety information communication and hazard reporting system and
absence of Fire emergency drills and safety equipment’s. Furthermore, statistical significant
relationship at (p-value=0.015<0.05) exist with work environment and history of Habits.

5.5. Qualitative study results

Most of the findings from the qualitative findings were in support of quantitative result
except where the administrators agrees to the provision of hazard prevention equipment’s to
ensure workers safety in Kabale municipal solid waste point, the safety equipment’s like
gloves, boots, mask and gown. There are weak responses with regards to pre job placement
training on health and training on occupational health and safety in waste management.
Therefore the ILO and WHO safety and hazards control in workplace were not strictly
adhered to based practices and incident investigations, report and follow up evidence,
Unfortunately, there are absence of evidence based practices and report.
Training gap / information sharing and training evaluation records were not seen. They
equally admit that garbage forks and wheel barrows, gloves, garbage trucks had limited
supply just as the supply of overall, gloves, masks and ear protection.

40
5.6. Summary of the study
- Available Occupational Health and Safety practices like awareness and training were
weakly enforced in the study and could be strengthened to improved work environment
boost morale and ensure workplace satisfaction among solid waste handlers in Kabale
Municipality.
- Human factors like poor knowledge, negligence and history alcohol intake, poor health
seeking behavior and so on exposure to hazards and risks need to be addressed among
solid waste handlers in Kabale Municipality.
- This study revealed major underlying employee and employers’ factors like non
motivation of workers, negligence.
- Weak enforcement of hazard risk prevention through engineering and safety training, and
poor safety information, effective stress management, supervisors' assigned
responsibilities to ensure hazard control, regular equipment maintenance and
replacement, Regulation PPEs supply, PEP and POP administration to prevent infection
risk.
- Occupational health and safety study like this would most likely provide moral, legal and
economic benefits to the society, when proper lesson are drawn.
- Adherence to set standards and guidelines in workplace not only promotes safety but
prevents disability, economic loss, meet job demand and with quality assurance.
- It equally throws light on the prevalence of health hazards occurrence among different
categories of solid waste handlers and short falls on hazard prevention and safety
practices which provide data that are useful for various purposes

5.7. Conclusion
This study has established number significant factors influencing the solid waste handlers
Kabale Municipality as given below;
1. Waste management practices among solid waste handlers in Kabale Municipality;
The solid waste management practices were: influenced by human related factors, the
Institution associated problems.
2. The Human level factors influencing occupational hazards and health outcomes exist
among the health care workers in Kabale Municipality. This could be mitigated by
regular workers training on safety, improved welfare, motivation and strict enforcement
of the safety compliances during the working hours.

41
 3. Institutions factors like weak enforcement of hazard risk prevention through engineering
and safety training, and poor safety information, effective stress management,
supervisors' assigned responsibilities to ensure hazard control, regular equipment
maintenance and replacement, Regulation PPEs supply, PEP and POP administration to
prevent infection risk.
4. OSH Policy compliance, Safety practices, and vaccination of the solid waste handlers
were among study finding.

5.8 Recommendations
5.8.1.: The district leadership Kabale Municipality District Administrators:

1. Promote pre job placement and regular training on workplace safety practices
2. Regular safety equipment’s supply and maintenance
3. Improvement in safety communication and hazards incident reporting
4. Strengthening the adherence to the available safety practices.
5. The administrators should engage in Human capacity development through safety
education, pre-employment training, and promotion of safety practices and immunization
of the workers
6. The district leaders should put in place the Occupational Health and Safety strategy
through; Rising awareness and building capacity for OSH and this can be achieved by
district level sensitization meeting for both political and technical leaders, building
capacity of OSH committee members, conducting CPD on OSH at least twice a year and
distribution of guidelines, SOPs and other IEC materials in Kabale district..
7. -District or health unit OSH training and inspection visits (backstopping Health Unit OSH
Teams), integrating health workplace accident, incident and occupational diseases
reporting into the HMIS reports and carry out quarterly district and health unit reviews of
workplace accident, incident and occupational diseases based on HMIS Reports in Kabale
district.
5.8.2: Government; Ministry of Health
1. Improve funding and logistic supply
2. Planned relocation of the disposal site
3. Stimulate more research by offering research grant in relevant area.
4. Putting in place structures/systems for preventing and managing ill health due to
occupational hazards and this can be done though forming a National OSH Committee,

42
 holding biannual meetings of the National OSH Committee, holding annual interagency
OSH meetings and integrating workplace accident.

5.9. Recommendations for further study

- There are needs for harmonization and international comparability of well-designed
study and properly identify the multiple factors in the etiology of occupational hazards
with closer attention to risks aggravated by job insecurity and poor training of workers in
the workplace.
- Also study on the effect of the hazards on job performance and consequences of the
hazards and worsening effect on human resources shortage. Others could carry out study
on the assessment of the effectiveness of safety training as measures countering
occupational health hazards in workplace.
- An investigation to assess the consequences of hazards exposure and illness outcome
may be helpful.
- Lastly, study on the barriers to effective communication of safety standard and practices
in workplace.

5.10: Contribution of the current study to learning

- This study revealed major underlying employee and employers’ factors like poor
involvement of workers in safety programs and non-motivation of workers,
negligence and weak regulations.
- It equally throws light on the occupational hazards among the waste handlers and the
factors that influenced it these could be used for policy reforms or could provide data
that are useful for various purposes and for risk reduction in work place.

5.11: Limitations and Delimitations

This study focused more on the operations with staff forming majority of the respondents.
- The study experienced limitation of time and financial resources due to the extent of
travels to cover project areas.
- Psychosocial assessments like trauma and other Psychological risk were purely based
on perception and observation.
- The research engaged three teams that enabled data collection to be done on time using
available resources without compromising on the quality of data collection and final
report.

43
 REFERENCES
Abila, B., & Kantola, J. (2013). Municipal solid waste management problems in Nigeria.
Evolving knowledge management solution. World Academy of Science, Engineering
and Technology International Journal of Environmental, Chemical, Ecological,
Geological and Geophysical Engineering 7(6).

Abur, B.T., Oguche, E. E., & Duvuna, G. A. (2014). Characterization of municipal solid
waste in the Federal Capital Abuja, Nigeria. Global Journal of Science Frontier
Research (H) Environment& Earth science: 14(2). Online ISSN: 2249-4626.

Adekiya, O. A. (2021). Assessment of occupational health risk and awareness of scavengers

to covid- 19 in Abuja Municipal Area Council, Nigeria American Journal of Health,
Medicine and Nursing Practice (AJHMN) 6(1), 18 - 31. ISSN 2520-4017 (online)

Adeyi, A. A., & Adeyemi, A. M. (2019). Potential occupational health effects of municipal
solid waste management in Nigeria, the case of Lagos and Ibadan. Ife Journal of
Science 21(2) https://dx.doi.org/10.4314/ijs.v21i2.15

Daily montor report (2022) “Report on Kabale municipality solid waste management plan”

Baral, Y. R. (2018). Waste workers and occupational health risks. International Journal of
Occupational Safety and Health, 8 (2) 1-3. https://www.nepjol.info/index.php/IJOSH

Cointreau-Levine, S. (2006). Occupational and Environmental Health Issues of Solid Waste

Management. Special Emphasis on Middle-And Lower-Income Countries. Urban
papers. Washington D.C: World Bank Group, Urban Sector Board. Available from:
http:// www worldbank.org/INTUSWM/Resources/up-2.pdf

Dorevitch, S., & Marder, D. (2001). Occupational hazards of municipal solid waste workers.
Occupational medicine (Philadelphia, Pa.). 16, 125-33.

Gebremedhin, F., Debere, M. K., Kumie, A., Tirfe, Z .M., & Alamdo. A.G. (2016).
Assessment of knowledge, attitude and practices among solid waste collectors in
Lideta Sub-city on prevention of occupational health hazards, Addis Ababa, Ethiopia.
Sci J Public Health 4:49-56.

44
Gizaw, Z., Gebrehiwot, M., & Teka, Z. (2014). . Assessment of occupational injury and
associated factors among municipal solid waste management workers in Gondar town
and Bahir Dar City, northwest Ethiopia. Journal of Medicine and Medical Sciences
5(9), 181–192.

Health Promotion and Social Development (HEPS,2018). The plight of Ugandan solid waste
handlers. Published in the monitor, Thursday march 3rd 2011. Retrived from
www.monitor.co.ug/magazines/health in may 2018.

HMIS report (2021), “Health management information system.

Ilhan, E. Durukan, E. Aras, S. Türkçüoǧlu, and R. Aygün (2019). “Long working hours
increase the risk of sharp and needle stick injury in nurses,” Journal of Advanced
Nursing, vol. 56, no. 5, pp. 563–568,

ILO (2020) “ International labour standards on occupational health and safety.

Jorge. R, Bernal (2023) “ Occupational health in the solid waste management.

Kathmandu. S. Babu (2017) “ Knowledge of occupational health hazards and practices

among the municipal solid waste handlers in metropolitan city.

Lindquist B: (2019). Factors influencing health service delivery. Asian Pacific Migration
Journal, 2(1):75-104.

Lockley, L. K. Barger, N. T. Ayas, J. M. Rothschild, C. A. Czeisler, and C. P. Landrigan,

(2019). “Safety and performance,” Joint Commission Journal on Quality and Patient
Safety, vol. 33, no. 11, supplement, pp. 7–18.

MortsenP(2016). Occupational risk of affective and stress-related disorders in the Danish

workforce. Scand J Work Environ Health,31(5):343–51.

Oyelayo. A. Adekiya, John. A, Kate Y. Magaj (2018) “ Assessment of occupational health

and safety among solid waste workers in Abuja municipal Area council”

Pensiri. A. Akkajit (2020), “Attitude and practices in respect of medical waste management
among health care workers, Thalang district.

45
Samwel. Y. Martin, Ayanore (2022) “Our works, our health, no ones concern. Domestic
waste collectors, perceptions, of occupational safety and self reported health issues in
urban town, Ghana.

Sandra. C (2020) “Occupational and environmental health issues of solid waste management
special emphasis on middle and lowere income countries.”

Seow T. Wee (2020) “ Occupational medicine and health affairs and safety health issues of
solid waste management in developing countries”

Stephen. J. (2021) “Occupational risks associated waste management in the informal sector of
Gueneru , Zimbabwe”

Teshiwa. D. Mohabao (2019) “ Knowledge of waste handlers about medical waste handling,
north west , Ethiopia.

O’Dumas, 2017). Risk of occupational hazards in health setting. JPMA (23)670-8

OSHA (2006) “ Occupational health hazards.

World bank report (2018), Guidelines on occupational health hazards.

Widard. F. Nor Iffah. H . (2022) “Household solid waste management practices and
perceptions among residents in the East of Malaysia”

Wikipedia (2020) “ Occupational health hazards.

WHO (2017) “ Occupational health hazards in the health sector.

WHO (2023) “Occupational hazards in the health sector.

Van der Hulst, (2020). “Long workhours and health,” Scandinavian Journal of Work,
Environment and Health, vol. 29, no. 3, pp. 171–188.

46
 APPENDICES
APPENDIX I
Consent form for Participants (For Questionnaire)

Complement!; I am Katumba David a student of student of Bachelor of Environmental health

Science of Community health department of Kabale University conducting study on the title:
Assessment of compliance with occupational health and safety practices among waste
handlers during solid waste management in Kabale municipality”

I am carrying out a study on the above topic and you have been selected to participate in the
study voluntarily by answering some questions regarding this topic. The information you give
will be very valuable and will be treated with maximum confidentiality. That is why you are
requested not to record your name on this paper. So please feel free to respond to the
questions as genuinely as possible. Taking part in this study is voluntary. If you agree to
participate, I will ask you the questions. I sincerely promised not take much of your time and
no problems would arise, but if you choose at any time not to continue, you are free to
withdraw from the interview at any point, you’re free.

There are no direct benefits for choosing to participate in this interview, but by participation,
you will be helping researcher, to drive future reforms for the good of the workers in the
waste management organization. Promised to ensure that your personal information is kept
private and record will not have your name, but only used for purposes of the study.

At this time, do you want to ask me anything about the study? If you have any questions at
any time even after the interview, feel free to question me through this number: 0778000460.
Now that the consent form has been read and explained and understood, further questions
addressed.
I therefore willingly agree to take part in the study.
______________ ______________ _ _ _ _ __
Name of adult participant Signature/Thumbprint of participant/ Date
Parent/Guardian/Next of Kin

__________________ ________________ ______

Name of person obtaining consent Signature Date

47
 APPENDIX II
Questionnaire for Village Health Teams (VHTs)

Study respondent; (Social demographic characteristics of respondent).

District of residence............................ Parish of residence...............................
Date of interview……..………………………………………………………..
Table: Study Participants Demographic Characteristics
Study Question Variables Options Tick what applies to you
15-35
Age Group of the participant 36 – 49
50 – above
Study Participants’ Gender Male
Female
Educational Status No formal Education
Primary / Secondary Level
Higher Education
Christian
Religion None Christian
Others Specify
Marital Status Married
Single
Duration in service: Less than 3 years
4 to 8 years
9 Years and Above
Mode of appointment to Self-appointed (Voluntary)
Services Government Appointment
Contract Appointment
History of habits: Smokes Cigarette
Takes Alcohol
Does not take any
substance

Respondents’ Job Specification Tick your responsibility

48
Solid waste collector
Driver
Segregation
Manager
Incineration

4. What are the available health and safety practices among waste handlers during solid
waste management in Kabale municipality?
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

Workers opinion of safety measures in their workplace 5 4 3 2 1

Workplace contains harmful chemical, gases and contaminated

products which workers must be protected from
Workers are Provided with PPEs to work with

Wearing glove / boots to reduce damage to hands and foot

Collection and transportation of waste is done by machines like

vehicles and wheel barrow
Odor at the workplace is managed

Workers are trained on safety precaution and risk management

Workers are made to wearing apron and mask to reduce

physical damage
Work supervision and evaluation to prevent hazards

Vaccination of workers and first aid treatment when necessary

Record of accident frequency and severity rates

49
5. What are the factors contributing to occupational hazards among waste handlers in Kabale
municipality?
2a. Individual level factors contributing to occupational hazards among waste handlers in
Kabale municipality?
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

Individual level factors contributing to occupational 5 4 3 2 1

hazards among waste handlers in Kabale municipality?
Negligence of safety procedure, hygiene rules and carelessness

Poor knowledge on use of protective and safety equipment

Poor job training, knowledge, skill and experience

Body sensitivity and reaction to some PPEs

Distraction with other personal issues

Lack of job motivation

Workers pre- existing disease

Multiple job place to improve earning

2b. Institutional level factors contributing to occupational hazards among waste handlers in
Kabale municipality?
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

Institutional level factors contributing to occupational hazards 5 4 3 2 1

among waste handlers in Kabale municipality?
Poor Job placement and job organization

Work overload and shortage of staff

Unclear procedure rules and absence of job supervision

Inadequate provision and maintenance of PPEs

Inadequate supply of waste management equipment

Absence of Fire emergency drills and safety equipment’s

50
Inadequate provision of hazards prevention measures

Poor workplace safety communication and management

6. What are the measures that are put in place to prevent occupational health hazards among
waste handlers in Kabale municipality?
Strongly Disagree (5), Disagree (4) Undecided (3) Agree (2) Strongly Agree (1)

The measures that are put in place to prevent occupational 5 4 3 2 1

health hazards among waste handlers in Kabale municipality
Hazard risk prevention risk through engineering and safety
training
Solid waste handlers are provided with safety information

Effective stress management

Supervisors' assigned responsibilities to ensure hazard control

Regular equipment maintenance and replacement

Regulation PPEs supply

PEP and POP administration to prevent infection risk

51
 APPENDIX III
Consent form for Participants (For Questionnaire)

Complement!; I am Katumba David a student of student of Bachelor of Environmental health

Science of Community health department of Kabale University conducting study on the title:
Assessment of compliance with occupational health and safety practices among waste
handlers during solid waste management in Kabale municipality”

I am carrying out a study on the above topic and you have been selected to participate in the
study voluntarily by answering some questions regarding this topic. The information you give
will be very valuable and will be treated with maximum confidentiality. That is why you are
requested not to record your name on this paper. So please feel free to respond to the
questions as genuinely as possible. Taking part in this study is voluntary. If you agree to
participate, I will ask you the questions. I sincerely promised not take much of your time and
no problems would arise, but if you choose at any time not to continue, you are free to
withdraw from the interview at any point, you’re free.

There are no direct benefits for choosing to participate in this interview, but by participation,
you will be helping researcher, to drive future reforms for the good of the workers in the
waste management organization. Promised to ensure that your personal information is kept
private and record will not have your name, but only used for purposes of the study.

At this time, do you want to ask me anything about the study? If you have any questions at
any time even after the interview, feel free to question me through this number: 0778000460.
Now that the consent form has been read and explained and understood, further questions
addressed.
I therefore willingly agree to take part in the study.
_________________ __________________ _____
Name of adult participant Signature/Thumbprint of participant/ Date
Parent/Guardian/Next of Kin

__________________ __________________ _____

Name of person obtaining consent Signature Date

52
 APPENDIX IV
Questionnaire for Study Stakeholders

QUESTION IN RELATION TO STUDY VARIABLES

1. What are the types of safety strategies and hazard prevention equipment’s provided to
ensure workers safety in Kabale municipal solid waste point
a) Do you think the solid waste handlers are provided with enough PPEs for their work

b) Are the solid waste handlers in Kabale municipal given work training on safety
prevention in your opinion?

c) Do workers in the Kabale solid waste management receive vaccination, first aid and
treatment when the need arise?

2. If you do not mind, kindly tell me different challenges that might contribute to hazards in
solid waste management in Kabale municipal

b. Tell me more about the problem from the waste handlers and how it affects their job
and health?

c. Are there ways that the municipal administrators and district office are contributing to
the undermining the safety of the waste handlers and how?

d. What equipment shortage do you think that solid waste handlers face

3. What is your suggestion for improved services of solid waste management in Kabale
municipal waste point?
b. How do you want the solid wastes handlers to improve their services?

c. What can government do to improve the situation?

d. How would the district and community support the solid waste management for
improved services delivery?

e. Are there other ways you think solid waste management operations can be improved?

53
 APPENDIX V:
Authorization Letter to Conduct Research from Kabale University

54
 APPENDIX VI: PICTURES
Picture 1.0

The researcher interacting with some of the solid waste handlers during the interview section.

Picture 2.0

The researcher and the group interacting with the supervisor at the solid waste management
site in Kabale Municipality.

Picture 3.0

One of the workers carrying waste in the wheel

barrow for disposal at the Municipality solid
waste management site.

55
APPENDIX VII: A MAP SHOWING KABALE MUNICIPALITY

56