Occupational Safety and Health Risks of Informal Waste Workers in Nepal: A Mapping Review

Informal waste workers (IWWs) are a crucial yet under-protected worker population. IWWs in low- and middle-income countries encounter numerous occupational safety and health (OSH) hazards but are without regulatory protections. In Nepal, rapid urbanization and inadequate waste management systems have led to thousands of IWWs. The objective of this mapping review is to synthesize the existing literature on OSH hazards encountered by Nepalese IWWs. Evidence on this worker population in Nepal has yet to be summarized and this review highlights practice and research gaps that can inform future evidence-based policies and interventions.

Inclusion criteria included English language research (1996-2024) exploring OSH risks in Nepalese IWWs. Studies focusing on formal workers, non-Nepalese, or non-OSH outcomes were excluded. Five databases (MEDLINE, Embase, Global Health, CINAHL, and Journals@Ovid) and grey literature (WorldCat, Dimensions, OpenAlex, and Google Scholar) were searched, compiled, and analyzed using Covidence .

A total of N = 6 studies were included in the study (four cross-sectional and two mixed methods) with a total 2,860 participants, predominantly from the Kathmandu Valley in Nepal. High prevalence of physical injury (66.2%), respiratory symptoms (69.9%), elevated blood lead levels (mean: 11.68 μg/dL), and mental health issues (27.4% depressive symptoms) were reported. Similarly, personal protective equipment (PPE) use was limited (32.4%), with IWWs citing cost and discomfort as primary reasons for not using it. Women IWWs were subject to higher mental health risks and social stigma.

Nepalese IWWs are exposed to severe OSH risks driven by systemic neglect. Prioritized interventions include formalization of work, increasing PPE access, and gender-inclusive policies.