Urban informal waste recycling in Tehran: Knowledge, attitudes and practices towards health risks during recycling process

This study presents health risks-related perceptions during informal recycling of municipal solid waste in Tehran, Iran, associated with poor management. We developed a proved reliable and valid questionnaire which provided information of detailed evaluations from a total of 384 participants who agreed to be interviewed. The participants showed an acceptable knowledge and positive attitude towards waste picking related health risks. However, healthy and safe behaviors were not so common among them. The majority of respondents (33.6 %) not only showed continuing to work even with the knowledge of the existence of sharp objects and infectious waste in garbage bags. However, they were also weak to seek timely healthcare and medical check-up, as well as personal hygiene and healthy diet practices. These inappropriate garbage scavenging behaviors, evidenced by severe injuries, were most dominant among uneducated, low-income, and younger participants. Unsafe and lifethreatening practices were explained by lack of awareness or sense of need, oblivion, difficulty to access washing facilities at city-wide, work-related fatigue, time saving, as well as high cost of personal protective equipment (PPE) and screening tests. Socio-demographic factors predicting garbage scavengers' unsafe behaviors were also analyzed. Knowledge of garbage scavengers about exposure or outcomes of unsafe practices is unlikely to influence willingness to take safe and acceptable practices, leading to the idea that such practices are unavoidable. However, improving garbage scavengers' perception about health risks through experienced colleagues and development of effective behaviors-changing interventions may hold great promise for promoting their health.