Respiratory and general health impairments of ragpickers in India: a study in Delhi


Objective: This study attempted to assess the respiratory and general health of ragpickers who rummage through the garbage dumps and landfill sites in India to collect and sell recyclable materials for a living. Methods: 98 ragpickers and 60 controls from Delhi, matched for age, sex, and socioeconomic conditions, were examined. Health data were obtained from questionnaire survey, clinical examination, and laboratory investigations. Lung function was evaluated by spirometry. Results: After controlling for smoking as a confounder, respiratory symptoms and lung function decrement were recorded in 94% and 52% of the ragpickers, respectively, compared with 56% and 34% of controls. The ragpickers showed a higher prevalence of low hemoglobin, high circulating eosinophil and monocyte counts, unhealthy gums, frequent diarrhea, and dermatitis, when compared with controls. Their sputum showed an abundance of alveolar macrophages, siderophages and inflammatory cells, and a very high frequency of squamous metaplasia and dysplasia of bronchial epithelial cells, suggesting inflammation and cellular changes in the airways. Conclusion: The ragpickers suffer from a multitude of health problems which seem related to their occupation.

This is a preview of subscription content, access via your institution.


  1. Adeyeba OA, Akinbo JA (2002) Pathogenic intestinal parasites and bacterial agents in solid wastes. East Afr Med J 79:604–610

    CAS  PubMed  Google Scholar 

  2. ATS (1995) Standardization of spirometry. Am J Respir Crit Care Med 152:1107–1136

    PubMed  Google Scholar 

  3. Ayik SO, Basoglu OK, Erdinc M, Bor S, Veral A, Bilgen C (2003) Eosinophilic bronchitis as a cause of chronic cough. Respir Med 97:695–701

    Article  CAS  PubMed  Google Scholar 

  4. Bhoyar RV, Titus SK, Bhide AD, Khanna P (1996) Municipal and industrial solid waste management in India. J IAEM 23:53–64

    Google Scholar 

  5. Birring SS, Brightling CE, Bradding P, Entisle JJ, Vara DD, Grigg J, Wardlaw AJ, Pavord ID (2002) Clinical, radiologic, and induced sputum features of chronic obstructive pulmonary disease in nonsmokers: a descriptive study. Am J Respir Crit Care Med 166:1078–1083

    Article  PubMed  Google Scholar 

  6. Chestnut LG, Schwartz J, Savitz DA, Burchfiel CM (1991) Pulmonary function and ambient particulate matter: epidemiological evidence from NHANES I. Arch Environ Health 46:135–144

    CAS  PubMed  Google Scholar 

  7. Dacie JV, Lewis SM (1975) Practical hematology, 5th edn. Churchill, London

    Google Scholar 

  8. Grubb C (1994) Diagnostic cytopathology: a text and colour atlas. Churchill Livingstone, Edinburgh, pp 65–112

    Google Scholar 

  9. Hughes HE, Dodds TC (1968) Handbook of diagnostic cytology. Churchill Livingstone, Edinburgh, pp 607–618

    Google Scholar 

  10. Hunt C (1996) Child waste pickers in India: the occupation and its health risks. Environ Urbanization 8:111–118

    Google Scholar 

  11. Krajewski JA, Szarapinska-Kwaszewska J, Dudkiewicz B, Cyprowski M, Tarkowski S, Konczalik J, Stroszejn-Mrowca G (2001) Assessment of exposure to bioaerosols in workplace ambient air during municipal waste collection and disposal. Med Pr 52:417–422

    CAS  PubMed  Google Scholar 

  12. Patil AD, Shekdar AV (2001) Health-care waste management in India. J Environ Manage 63:211–220

    Article  CAS  PubMed  Google Scholar 

  13. Pearse AGE (1985) Histochemistry: theoretical and applied, 4th edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  14. Pope CA III, Dockery DW (1999) Epidemiology of particle effects. In: Holgate ST, Samet JM, Koren HS, Maynard RL (eds) Air pollution and health. Academic, San Diego, pp 673–705

    Google Scholar 

  15. Poulsen OM, Breum NO, Ebbehoj N, Hansen AM, Ivens UI, van Lelieveld D, Malmros P, Matthiasen L, Nielsen BH, Nielsen EM et al (1995) Sorting and recycling of domestic waste: review of occupational health problems and their possible causes. Sci Total Environ 168:33–56

    Article  CAS  PubMed  Google Scholar 

  16. Roy S, Ray MR, Basu C, Lahiri P, Lahiri T (2001) Abundance of siderophages in sputum: indicator of an adverse lung reaction to air pollution. Acta Cytol 45:958–964

    CAS  PubMed  Google Scholar 

  17. Sagel SD, Sontag MK, Wagener JS, Kapsner RK, Osberg I, Accurso FJ (2002) Induced sputum inflammatory measures correlate with lung function in children with cystic fibrosis. J Pediatr 141:811–817

    Article  PubMed  Google Scholar 

  18. TERI (1998) Waste disposal, Report No. 97/ED/52. Tata Energy Research Institute, India, pp 78–81

Download references


The authors wish to thank the National Productivity Council, New Delhi, for financial assistance.

Author information



Corresponding author

Correspondence to Manas Ranjan Ray.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ray, M.R., Mukherjee, G., Roychowdhury, S. et al. Respiratory and general health impairments of ragpickers in India: a study in Delhi. Int Arch Occup Environ Health 77, 595–598 (2004).

Download citation


  • Health
  • India
  • Ragpickers
  • Solid waste