Occupational Hazard Among Biomedical Waste Handlers in Low-Resource Settings: A Systematic Review and Meta-Analysis

Area of Science:

• Public Health
• Occupational Safety
• Infectious Disease Epidemiology

Background:

• Effective biomedical waste (BMW) management is a critical public health issue, especially in low- and middle-income countries (LMICs).
• Inadequate infrastructure and safety measures in LMICs heighten occupational hazards for BMW handlers.
• Understanding these risks is vital for improving worker safety and health outcomes.

Purpose of the Study:

• To systematically review and meta-analyze the occupational hazards faced by BMW handlers in resource-limited settings.
• To estimate the pooled prevalence of needle/sharp injuries and hepatitis B/C infections among BMW handlers.
• To assess the utilization rates of personal protective equipment (PPE) and hepatitis B immunization coverage.

Main Methods:

• Systematic review and meta-analysis conducted following PRISMA guidelines, registered with PROSPERO.
• Searched PubMed, Embase, and Scopus for studies published between January 2000 and October 2024.
• Used random-effects models to pool prevalence data for injuries, infections, and PPE use; quantified heterogeneity using I² statistic.

Main Results:

• Fourteen studies included, revealing a 26.4% pooled prevalence of needle and sharp injuries.
• Prevalence of hepatitis B and C among handlers was 5.8% and 2.4%, respectively.
• PPE usage varied: masks (76.9%), gloves (84.9%), gowns (55.4%), boots (19.0%). Hepatitis B immunization was low (15.3%), with 57.4% receiving BMW training.

Conclusions:

• Significant gaps exist in worker protection, evidenced by inconsistent PPE use, low hepatitis B immunization, and inadequate BMW training.
• Strengthening safety protocols, enhancing training programs, and improving PPE accessibility are essential to mitigate risks.
• Substantial heterogeneity across studies necessitates cautious interpretation of findings.