Determinants of Plastic Waste Awareness, Preventive Practices, and Health Symptoms: An Urban-Rural Comparative...

Plastic waste is an escalating environmental and public health threat, particularly in Bangladesh, where rapid consumption and inadequate waste management exacerbate associated risks. Evidence on urban-rural disparities in awareness, preventive practices, and related health outcomes remains limited. This study compared these differences and identified key determinants to inform context-specific interventions.

This comparative cross-sectional study was conducted in 2022 among 768 respondents from urban (Dhaka) and rural (Tangail) settings. Households were selected using random route sampling, and eligible participants (≥ 18 years, both male and female, ≥ 1-year residency) were selected through simple random sampling. Data were collected via face-to-face interviews using a pretested, semi-structured questionnaire (Cronbach's α = 0.71-0.83). Primary outcomes were awareness, preventive practices, and self-reported health symptoms within the past 12 months. Associations were examined using chi-square tests, and determinants were assessed using multivariable logistic regression (AOR, 95% CI; p < 0.05).

Urban respondents demonstrated higher adequate awareness of environmental (79.4% vs. 59.1%) and health effects (80.7% vs. 45.3%; p < 0.001) of plastic waste. Preventive practices were also more common among urban residents (waste segregation: 44.8% vs. 18.6%; recycling practice: 34.7% vs. 11.1%). Self-reported health symptoms comprised breathing difficulty (73.7% vs. 60.1%) and eye irritation (31.4% vs. 15.6%). In multivariable models, adjusting for age, sex, income, higher education, and urban residence was independently associated with greater engagement in recycling (AOR:3.13 and 3.57, respectively) and use of biodegradable alternatives (AOR:2.63 and 1.64, respectively; p < 0.001). They were also associated with a greater likelihood of avoiding polythene use driven by low cost or lack of alternatives (p < 0.05).

Despite higher awareness among urban and educated populations, preventive practices remain limited, reflecting a persistent awareness-practice gap shaped by structural and contextual constraints. Strengthening waste management infrastructure, regulating informal burning, and improving access to affordable alternatives are essential to mitigate plastic-related environmental and health risks in Bangladesh.