RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES. BANGALORE, KARNATAKA. ANNEXURE-2 PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION. 1. NAME OF THE CANDIDATE MS.BELINA BENCY .B ADDRESS I YEAR M.SC NURSING STUDENT ST.JOHNS COLLEGE OF NURSING SARJAPURA ROAD BANGALORE – 34 2. NAME OF THE INSTITUTION ST. JOHNS COLLEGE OF NURSING. BANGALORE 3. COURSE OF STUDY SUBJECT MASTERS DEGREE IN NURSING COMMUNITY HEALTH NURSING 4. DATE OF ADMISSION OF COURSE 02. 05. 2012 5. TITLE OF THE TOPIC KNOWLEDGE AND CURRENT PRACTICE OF SOLID 1
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES.
BANGALORE, KARNATAKA.
ANNEXURE-2
PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION.
1. NAME OF THE CANDIDATE MS.BELINA BENCY .B
ADDRESS I YEAR M.SC NURSING STUDENT
ST.JOHNS COLLEGE OF NURSING
SARJAPURA ROAD
BANGALORE – 34
2. NAME OF THE INSTITUTION ST. JOHNS COLLEGE OF NURSING.
BANGALORE
3. COURSE OF STUDY SUBJECT MASTERS DEGREE IN NURSING
COMMUNITY HEALTH NURSING
4. DATE OF ADMISSION OF
COURSE
02. 05. 2012
5. TITLE OF THE TOPIC KNOWLEDGE AND CURRENT PRACTICE OF
SOLID WASTE MANAGEMENT AMONG WOMEN
RESIDING IN A RURAL COMMUNITY
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6. Brief Resume of the Intended Work
6.1 Need for study:
“The study of disease is really the study of man and his environment”, the key of
man’s health lies largely in his environment. Being a way of life it must come from
within people. The term “Environmental sanitation” has been defined by WHO as “The
control of all those factors in man’s physical environment with exercise or may exercise a
deleterious effect on his physical development, health and survival”. The purpose of
environmental health is to create and maintain ecological conditions that will promote
health and thus prevent disease. However man’s mastery over his environment is not
complete. As old problems are being solved, new problems are arising .The term
Environmental sanitation is now being replaced by Environmental health. The output of
daily waste depends upon the dietary habits, life styles, living standards and the degree of
urbanization and industrialization.1 The per capita daily solid waste produced ranges
between 0.25 to 2.5kg in different countries. There is a correlation between improper
disposal of solid wastes and incidence of vector-borne diseases. Therefore, in all civilized
countries, there is an efficient system for its periodic collection, removal and final
disposal without risk to health.
Per capita waste generation ranges between 0.2 kg and 0.6 kg per day in the
Indian cities amounting to about 1.15 lakh Metric tons (MT) is of waste per day and 42
million MT annually. Also, as the city expands, average per capita waste generation
increases. The waste generations rates in India are lower than the low-income countries in
other parts of the world and much lower compared to developed countries However,
lifestyle changes, especially in the larger cities, are leading to the use of more packaging
material and per capita waste generation is increasing by about 1.3 percent per year. With
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the urban population growing at 2.7 percent to 3.5 percent per annum, the yearly increase
in the overall quantity of solid waste in the cities will be more than 5 percent. The Energy
and Resources Institute (TERI) has estimated that waste generation will exceed 260
million tones per year by 2047—more than five times the present level. Cities with
100,000 plus population contribute 72.5 percent of the waste generated in the country as
compared to other 3955 urban centers that produce only 17.5 per cent of the total waste.2
In Karnataka, amongst the 3 types of waste generated in 2003 the largest amount
of waste is generated by municipal solid waste at 21,43,280 metric tones followed by
hazardous waste at 86,137 metric tones and bio-medical waste is 27,095 metric tones.2
Disposal of waste is the most neglected area of Solid Waste Management (SWM)
services and the current practices are grossly unscientific. Almost all municipal
authorities deposit solid waste at a dump yard situated within or outside the city
haphazardly and do not bother to spread and cover the waste with inert material. These
sites emanate foul smell and become breeding grounds for flies, rodent, and pests. Liquid
seeping through the rotting organic waste called leachates pollutes underground water and
poses a serious threat to health and environment. Landfill sites also release landfill gas
with 50 to 60 per cent methane by volume. Methane is 21 times more potent than carbon
dioxide aggravating problems related to global warming. It is estimated by TERI that in
1997 India released about 7 million tones of methane into the atmosphere. This could
increase to 39 million tons by 2047 if no efforts are made to reduce the emission through
composting, recycling, etc.3
Dengue infections have the potential of rapid spread leading to an acute public health
problem, social attention is required to be paid for its surveillance, prevention and control. In
our day today life we generate various types of waste like, food waste, paper waste, plastics and
sharps. However, either due to resource crunch or inefficient infrastructure, not all of this waste
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gets collected and transported to the final dumpsites. If at this stage the management and
disposal is improperly done, it can cause serious impact on health and problems to the
surrounding environment. The unhygienic use and disposal of plastics and its effects on human
health has become a matter of concern. Coloured plastics are harmful as their pigment contains
heavy metals that are highly toxic. Some of the harmful metals found in plastics are copper, lead,
chromium, cobalt, selenium, and cadmium. In most industrialized countries, colour plastics have
been legally banned. In India, the Government of Himachal Pradesh has banned the use of
plastics and so has Ladakh district. Other states should emulate their example.3
Proper methods of waste disposal have to be undertaken to ensure that it does not
affect the environment around the area or cause health hazards to the people living there.
At the household-level proper segregation of waste has to be done and it should be
ensured that all organic matter is kept aside for composting, which is undoubtedly the
best method for the correct disposal of this segment of the waste. In fact, the organic part
of the waste that is generated decomposes more easily, attracts insects and causes disease.
Organic waste can be composted and then used as a fertilizer.4
The municipal workers are most affected people by the occupational danger of
waste handling; they suffer from illness like eye problems, respiratory problems, gastro-
intestinal and skin problems. Many times the animals like the cows, buffalos eat up the
plastics along with the food and due it the death of animals ensues. Due to eating up of
waste generated food it affect the quality and quantity of the milk products of the animals.
Poor waste disposal practices lead to:
The accumulation of harmful substances
A breeding ground for bacterial diseases
A place where pathogenic parasites can grow
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The spreading of infections
The spreading of harmful toxic contaminants into the air and soil4
The improper management and lack of disposal technique of the domestic waste
pollutes to the environment. It affects the water bodies. It also changes the physical,
chemical and biological properties of the water bodies. Uncollected waste is scattered
everywhere and reaches to the water bodies through run-off as well as it percolate to
underground water. The toxics contain in the waste, contaminates water. It also makes
soil infertile and decrease the agricultural productivity.
Due to uncollected waste and improper disposal techniques drains also get
clogged which lead to mosquitoes by which various diseases like malaria, chickun-gunya,
viral fever, dengue etc. arise and affect the health of people adversely. Poor Domestic
waste management also displays an ugly scenario of the environment. This can affect the
tourism industry, as the tourist may not get attracted to visit the country. The Composition
of average domestic dustbin can be broken down as follows
Some of the waste on the other hand may be poisonous substances like Mercury,
lead, cadmium from batteries, old medicines, household cleaning & Decorating chemicals
and garden chemicals. Few decades ago the food and vegetable waste was made as fodder
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for cattle’s, but in the present scenario milk is been brought to the door step due to
technological development 5
In Urban area the government is trying to bring waste management system, which
is slow in process and still not implemented. Whereas it is still not planned in the rural
area, were it is needed. In the rural area there is no proper segregation, collection and
disposal because people in rural area are not aware about the health problems related to
improper waste segregation and disposal.
In India we produce 300 to 400 gms of solid waste per person per day in town of
Normal size but exceptionally about 500 to 800gms of solid waste is generated per capita
per day in metro cities like Delhi and Bombay. According to the energy Research
Institute (TERI). “Our limited analysis suggests that unclean air and water may be taking
a toll in terms of over eight lakh deaths in the country each year and morbidity costs
amounting to 3.6% of GDP,” the report said.6
The urban population of 285 million is concentrated in a few large cities and 32
metropolitan cities are accounting for 34.5 percent of the urban population that is
expected to reach 341 million by 2010 (census of India, 2001). The waste quantities are
estimated to increase from 46 million tons in 2001 to 65 million tons in 2010.The waste
characteristics are expected to change due to urbanization, increased commercialization
and standard of living. The present trend indicates that the paper and plastics content will
increase while the organic content will decrease. In keeping with the present practices and
estimates of waste generation, around 90% of the generated wastes are land filled
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requiring around 1200 hectare of land every year with an average depth of 3 m.
Due to rapid urbanization, prevailing land use regulation and completing demands for
available land, it is desirable that adequate land be earmarked at the planning stage itself
for solid waste disposal. The larger quantities of solid waste and higher degree of
urbanization will necessitate better management involving a higher level of expenditure
on manpower and equipment. In the rural areas before cattle’s were grown at home and
the food waste given as fodder so waste didn’t come to environment.6
Bruhat Bangalore Mahanagara Palike (BBMP) has issued a public notice that is
applicable to bulk garbage generators. The BBMP has exercised power conferred to it
under sections 256, 257 and 260 of the Karnataka Municipal Corporations Act, 1976. The
regulations specified in the public notice will come into effect from october1st
The Karnataka Municipal Corporations Act, 1976 allows a fine of only Rs.10; The
BBMP may up it to Rs.100 under the Municipal Solid Waste Management and Handling
Rules, 2000.
The BBMP is now looking to involve non-governmental organizations, school and
colleges students to create awareness via the information, education and communication
(IEC). The Karnataka high court directed BBMP to take strict punitive action against the
citizens as well as garbage contractors, who violate the waste segregation norms.
Therefore, the researcher wants them to practice waste management program, as
researcher I will teach them about waste segregation and reinforce to practice. From my
personal experience I have seen people as well as the municipality in segregating,
collecting the waste and disposing and following waste management.
During community postings in the villages around mugalur and in mugalur itself it
was noticed that the domestic and animal waste are dumped near the habitats. The non
biodegradable wastes like polythene covers have become a threat to both human beings
and other live stock.
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6.2 REVIEW OF LITERATURE
SECTION 1: Literature related to current practice of solid waste management
SECTION 2: Literature related to knowledge of women regarding associated health
hazards
Literature related to solid waste management and its health hazards
This review evaluates current epidemiologic literature on health effects in relation to
residence near landfill sites. Increases in risk of adverse health effects (low birth weight,
birth defects, and certain types of cancers) have been reported near individual landfill
sites and in some multisided studies, and although biases and confounding factors cannot
be excluded as explanations for these findings, they may indicate real risks associated
with residence near certain landfill sites. A general weakness in the reviewed studies is
the lack of direct exposure measurement. An increased prevalence of self-reported health
symptoms such as fatigue, sleepiness, and headaches among residents near waste sites has
consistently been reported in more than 10 of the reviewed papers. It is difficult to
conclude whether these symptoms are an effect of direct toxicological action of chemicals
present in waste sites, an effect of stress and fears related to the waste site, or an effect of
reporting bias. Although a substantial number of studies have been conducted, risks to
health from landfill sites are hard to quantify. There is insufficient exposure information
and effects of low-level environmental exposure in the general population are by their
nature difficult to establish. More interdisciplinary research can improve levels of
knowledge on risks to human health of waste disposal in landfill sites.6Research needs
include epidemiologic and toxicological studies on individual chemicals and chemical
mixtures, well-designed single and multisite landfill studies, development of biomarkers,
and research on risk perception and sociologic determinants of ill health. Key words:
epidemiology, hazardous waste, health effects, landfill, residence, review near landfill
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sites. Increases in risk of adverse health effects (low birth weight, birth defects, and
certain types of cancers) have been reported near individual landfill sites and in some
multisite studies, and although biases and confounding factors cannot be excluded as
explanations for these findings, they may indicate real risks associated with residence
near certain landfill sites. A general weakness in the reviewed studies is the lack of direct
exposure measurement.7
An increased prevalence of self-reported health symptoms such as fatigue,
sleepiness, and headaches among residents near waste sites has consistently been reported
in more than 10 of the reviewed papers. It is difficult to conclude whether these
symptoms are an effect of direct toxicological action of chemicals present in waste sites,
an effect of stress and fears related to the waste site, or an effect of reporting bias.
Although a substantial number of studies have been conducted, risks to health from
landfill sites are hard to quantify. There is insufficient exposure information and effects of
low-level environmental exposure in the general population are by their nature difficult to
establish. More interdisciplinary research can improve levels of knowledge on risks to
human health of waste disposal in landfill sites7.
Research needs include epidemiologic and toxicological studies on individual
chemicals and chemical mixtures, well-designed single- and multisite landfill studies,
development of biomarkers, and research on risk perception and sociologic determinants
of ill health. Key words: epidemiology, hazardous waste, health effects, landfill,
residence, review. This is the first report of an Epidemiological cross-sectional study of
solid waste scavengers, called Zabaline, in Egypt7. The Zabaline communities provide an
important solid waste collection service throughout Egypt's urban sector. Their economic
viability depends entirely on salvaging solid waste for recycling. Intestinal parasites were
common among the Zabaline examined; 48% were found with one or more protozoan or
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helminthes infections. Either Schist soma haematobium or S. mansoni or both infections
were found in 19% of the sample although there was an apparent lack of a local
transmission focus. Ascaris lumbricoides was the most frequently seen parasite (26.0%)
and Entamoeba histolytic was seen infrequently (1.6%). Physical hazards of sorting solid
waste were assessed and general illness occurring during the previous month recorded.
Estimates of infant mortality showed elevated measures (IMR = 205/1000). The results
indicate a need for the improvement of environmental conditions and health care in the
Zabaline community and suggest that other similar scavenger groups may be at risk as
well8
Another review evaluates current epidemiologic literature on health effects in
relation to residence near landfill sites. Increases in risk of adverse health effects (low
birth weight, birth defects, and certain types of cancers) have been reported near
individual landfill sites and in some multisite studies, and although biases and
confounding factors cannot be excluded as explanations for these findings, they may
indicate real risks associated with residence near certain landfill sites. A general weakness
in the reviewed studies is the lack of direct exposure measurement. An increased
prevalence of self-reported health symptoms such as fatigue, sleepiness, and headaches
among residents near waste sites has consistently been reported in more than 10 of the
reviewed papers. It is difficult to conclude whether these symptoms are an effect of direct
toxicological action of chemicals present in waste sites, an effect of stress and fears
related to the waste site, or an effect of reporting bias. Although a substantial number of
studies have been conducted, risks to health from landfill sites are hard to quantify. There
is insufficient exposure information and effects of low-level environmental exposure in
the general population are by their nature difficult to establish. More interdisciplinary
research can improve levels of knowledge on risks to human health of waste disposal in
landfill sites. Research needs include epidemiologic and toxicological studies on
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individual chemicals and chemical mixtures, well-designed single- and multisite landfill
studies, development of biomarkers, and research on risk perception and sociologic
determinants of ill health.10
Waste is an inevitable byproduct of our economy and must be managed in an
environmentally sound and health protective manner. Few studies have compared in
most developing countries, solid waste components are generally commingled. Sorting of
solid waste is one of the most important activities in the material recovering process of
the integrated solid waste management system. If solid waste is sorted, about 30% of the
work is done. Several methods exist for sorting coming led solid waste. The work
presented in this paper involved the study of solid waste source sorting alternatives in
Nigerian Universities. A site-specific study was carried out to characterize the solid waste
generated in the University of Benin. Alternative concepts for sorting of solid waste were
considered and evaluated. Source sorting was then selected for this study. The study
revealed that about 14.56% of biodegradable, 42.26% of plastics, 39.62% of paper waste
and 3.56% of metal waste are generated in the office and classroom areas of University of
Benin. The study also showed that there is poor attitude to solid waste issues as the
maximum cooperation realized on source sorting of solid waste was only about 50% for
the waste-bin designated for plastic. The results obtained from the study also indicated
that intensive sensitization of the generators on the benefits of source sorting is required
for effective source sorting and evaluated the health risks of landfills and waste
combustion.10
Furthermore, experts continue to debate whether landfill disposal or waste
combustion poses less risk to human health and the environment. As most of New York
City’s (NYC) municipal solid wastes are sent to landfills and some to waste-to-energy
(WTE) facilities, it is of interest to assess the health risks of these two waste management
options. The present study attempts to compare the inhalation health risks of landfill
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disposal and WTE combustion in a NYC setting using principles of risk assessment and
on the basis of a critical review of the literature on the respective emissions of these two
methods. In addition to landfill and WTE combustor emissions, this study considers the
health impacts from transporting wastes to waste transfer stations (WTS) and landfills.
Both of these technologies have been improved in the last twenty years, landfills by
means of the EPA Subtitle D rules and WTE facilities through the implementation of
EPA Maximum Achievable Control Technology (MACT) standards.
Therefore, this study assumes the use of modern landfills and WTE combustors.
In addition to the health impacts from landfill and WTE combustor emissions, this study
also considers the impacts from waste-transfer stations for landfill disposal and truck
transportation of both MSW and WTE ash to landfills. The overall individual non-cancer
and cancer risks for landfill disposal and WTE combustion were 1.18E+01, 4.14E-05,
2.30E+00, and 8.33E-06, respectively. Impacts from truck transportation were found to
be an important contributor to increased health risk. These results suggest that WTE
combustion may pose less health impacts than landfill disposal and provide an initial
estimation of the relative inhalation health risks from landfill disposal and WTE
combustion.10
In this study was design to determine the effects of the dumpsite on the
surrounding human settlement in the Mangwaneni area of the Golf Course dumpsite in
Manzini city. The effects that were assessed were the possible impacts of the dumpsite
on the health and the environment and also the residents view regarding the location of
the dumpsite. Data were collected from 78 household heads, through the use of self-
administered questionnaires. Households heads were divided into strata, with 39 nearby
(<200m) and 39 far away (>200m) of the Mangwaneni area. In order to achieve its
objectives, a comparison between the nearby and far away residents was done. The result
shows that both residents were affected by the location of the dumpsite closer to their
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settlements. It was also noted that the residents whose houses are less than 200 meters
from the dumpsite are victims of malaria, chest pains, cholera, and diarrhea. However,
residents whose houses are more than 200 meters are also affected with the chest pain and
bad smell from the dumpsite, but mainly when wind is blowing in their direction. The
study concludes that dumpsites should be located at least 200 meters away from human
settlements. Therefore, the study recommends that dumpsites should be properly located
and managed to minimize its effects on the environment. The government and
municipalities should revise laws regarding the locations of the dumpsites. 11
Literature related to knowledge of women regarding associated health
hazards:
A symptom prevalence survey was conducted of a neighborhood exposed to airborne
hazardous wastes. Resident’s responses were compared to those of a nearby control
population. The results revealed that the exposed group had more self-reported
complaints referable to the respiratory system (wheezing, shortness of breath, chest
