Occupational Exposure to Domestic Waste and Oral Mucosal Lesions: a Cross-Sectional Study / Exposição Ocupacional a Resíduos Domésticos e Lesões de Mucosa Oral: Estudo Transversal

This study aimed to evaluate the occurrence of oral mucosal lesions (OML) in domestic waste collectors and their association with occupational exposure to domestic waste. This cross-sectional study included 295 adult men who worked in a waste management company: 129 men were exposed to domestic waste during their labor of waste collection, and 166 were not. The waste collectors used personal protective equipment. The lips, buccal mucosa and sulcus, gum, alveolar ridge, tongue, the floor of the mouth, and soft and hard palate were evaluated. The chi-square or Fisher's exact test assessed the variables associated with OML (P ≤ 0.05). Twenty-five OMLs were observed in 22 volunteers, 8 in the exposed and 17 in the non-exposed group. Actinic cheilitis in the lips and candidiasis were the most common lesions in both groups. OML was not associated with waste exposure (OR= 0.72, 95% CI = 0.29-1.77, P = 0.47). There was no association between domestic waste exposure and actinic cheilitis (OR = 0.70, 95% CI= 0.23-2.15, P = 0.37), candidiasis (OR = 0.42, 95% CI= 0.08-2.12, P = 0.24) or leukoplakia (OR = 0.99, 95% CI= 0.97-1.01, P = 0.32). Actinic cheilitis in the lips and candidiasis were the most common lesions in both exposed and non-exposed groups. Occupational exposure to domestic waste was not related to OML. Proper use of personal protective equipment may have prevented the development of OML in domestic waste collectors. (AU)

Este estudo teve como objetivo avaliar a ocorrência de lesões de mucosa oral (LMO) em coletores de lixo doméstico e sua associação com a exposição ocupacional a resíduos domésticos. Este estudo transversal incluiu 295 homens adultos que trabalhavam numa empresa de gestão de resíduos: 129 homens foram expostos a resíduos domésticos durante o seu trabalho de coleta de resíduos e 166 não. Os coletores de lixo usavam equipamentos de proteção individual. Foram avaliados lábios, mucosa bucal e vesticulo, gengiva, rebordo alveolar, língua, assoalho da boca e palato mole e duro. O teste qui-quadrado ou exato de Fisher avaliou as variáveis associadas à LMO (P ≤ 0,05). Vinte e cinco LMO foram observadas em 22 voluntários, 8 no grupo exposto e 17 no grupo não exposto. Queilite actínica nos lábios e candidíase foram as lesões mais comuns em ambos os grupos. A LMO não foi associada à exposição a resíduos (OR = 0,72, IC 95% = 0,29-1,77, P = 0,47). Não houve associação entre exposição a resíduos domésticos e queilite actínica (OR = 0,70, IC 95% = 0,23-2,15, P = 0,37), candidíase (OR = 0,42, IC 95% = 0,08-2,12, P = 0,24) ou leucoplasia ( OR = 0,99, IC 95% = 0,97-1,01, P = 0,32). A queilite actínica nos lábios e a candidíase foram as lesões mais comuns nos grupos expostos e não expostos. A exposição ocupacional a resíduos domésticos não esteve relacionada com LMO. O uso adequado de equipamentos de proteção individual pode ter evitado o desenvolvimento de LMO em coletores de lixo doméstico. (AU)

Metal levels in waste pickers in Brasilia, Brazil: hair and nail as exposure matrices.

The aim of this cross-sectional study was to compare workplace conditions and metal exposures in 431 waste pickers who worked nearby at the Estrutural Dump in Brasilia utilizing hair (n = 310) and nail (n = 355) as matrices of exposure. Waste pickers were grouped according to their workplace (open waste dump: G1 and sorting plants: G2). Hair and nail samples were collected and analyzed using ICP-MS. The work duration in the facilities was significantly different between the groups with averages of 16.46 (8.48) yrs and 9.26 (6.28) yrs for hair donors in G1 and G2, and 15.92 (7.72) yrs and 8.55 (5.77) yrs for toenail donors in G1 and G2, respectively. The arithmetic means (µg/g) of cadmium, copper, lead, and manganese in hair were significantly higher in G2 (0.076 ± 0.133; 19.61 ± 18.16; 2.27 ± .56 and 3.87 ± 5.59, respectively) compared to G1 (0.069 ± 0.235; 15.72 ± 15.18; 1.72 ± 4.04 and 3.65 ± 5.5, respectively). Concentrations of arsenic, barium, cadmium, copper, cobalt, lead, manganese, and molybdenum in nail were significantly higher in G2 (0.57 ± 0.39; 22.74 ± 42.06; 0.1 ± 0.08; 22.7 ± 51.60; 0.48 ± 0.45; 4.69 ± 9.43; 19.07 ± 20.75; 1.80 ± 1.76, respectively) compared to G1 (0.40 ± 0.28; 15.32 ± 22.31; 0.08 ± 0.11; 11.91 ± 16.25; 0.37 ± 0.37; 3.94 ± 15.04; 13.01 ± 19.08; 1.16 ± 1.80, respective. Our findings suggest that the studied population was exposed to toxic metals and indicates the need for chemical exposure prevention policies to monitor chemical risk exposures in waste pickers.

Unveiling microbial worlds: exploring viral metagenomics among waste pickers at Latin America's largest dumpsite

ABSTRACT Waste pickers constitute a marginalized demographic engaged in the collection of refuse, facing considerable occupational hazards that heighten their susceptibility to contract infectious diseases. Moreover, waste pickers contend with societal stigmatization and encounter barriers to accessing healthcare services. To explore the viral profile of waste pickers potentially linked to their occupational environment, we conducted a metagenomic analysis on 120 plasma specimens sampled from individuals employed at the Cidade Estrutural dumpsite in Brasilia city, Brazil. In total, 60 blood donors served as a comparative control group. Specimens were pooled and subjected to Illumina NextSeq 2000 sequencing. Viral abundance among waste pickers revealed the presence of significant pathogens, including HIV, HCV, and Chikungunya, which were not detected in the control group. Additionally, elevated levels of anelloviruses and Human pegivirus-1 were noted, with a comparable incidence in the control group. These findings underscore the utility of metagenomics in identifying clinically relevant viral agents within underserved populations. The implications of this study extend to informing public health policies aimed at surveilling infectious diseases among individuals facing socioeconomic disparities and limited access to healthcare resources.

Stop treating waste pickers like garbage: An autoethnography on informal waste picking in Brazil.

There are almost 8 billion people on the planet with every single one of them producing some type of waste. The cost of recycling and money made by selling recyclable products has created a strong foundation for informal waste picking to exist. Waste pickers sort through garbage to find recyclable material; it is estimated that there are around 20 million waste pickers worldwide. In 2022, I went to experience life as a waste picker in Brasilia, Brazil for a day to understand issues that may continue to exist in this informal industry. I worked in a triage center and used this experience to inform my autoethnography; even though I have worked in waste picker research for almost a decade, this experience led to a different conclusion. The most interesting issue that I found while working as a waste picker was the lack of uniformity in waste picking, which led to people working on the streets or in co-op triage centers. This population is vulnerable which is worsened from exposure to hazards by nature of the informal environment; this situation contributes to ongoing poor working conditions through lack of governmental oversight, policy development, and change. Ultimately, informality needs to be addressed.

Cytotoxic and oxidative changes in individuals occupationally exposed to recyclable municipal solid waste.

aste collectors are exposed to a wide variety of bacteria, endotoxins, fungi, allergens, particulate matter, irritating inhalants, and vehicle exhaust, making them more prone to development of chronic diseases. Although several studies described the impact of occupational exposure on the overall health of waste collectors, few investigations were conducted regarding cellular and molecular changes that may occur due to exposure. The aim of this study was to assess biomarkers of oxidative stress such as levels of reactive oxygen species (ROS), lipoperoxidation, total antioxidant capacity (TAC), apoptosis, butyrylcholinesterase (BChE) activity and mitochondrial function (MitoTrackerTM Green FM and MitoTrackerTM Red) using the peripheral blood from individuals occupationally exposed to recyclable solid waste in Southern Brazil. The study included 30 waste collectors and 30 control individuals, who did not perform activities with recognized exposure to biological and chemical substances. Waste collectors were found to exhibit in peripheral blood leukocytes (PBL) higher rates of apoptosis, increased production of ROS, and reduced mitochondrial membrane potential (MMP), associated with decreased total antioxidant capacity (TAC) and elevated activity of BChE in plasma. Therefore, evidence indicates that cytotoxicity, oxidative stress, and inflammatory responses may be involved in the multiplicity of adverse health outcomes related to contaminant exposure in waste collectors. It is thus necessary to implement and/or improve occupational health programs aimed at workers as well as mandatory inspections for the use of personal protective equipment.

Herança da catação: um estudo sobre famílias de catadores de resíduos sólidos de Caxias do Sul/RS / Inheritance os waste picking: a study os families of solid waste pickers from Caxias do Sul/RS / Herancia del recliclaje: un estudio sobre familias de clasificadores de residuos en Caxias do Sul/RS

O objetivo deste trabalho é identificar possíveis expressões de reprodução das relações capitalistas nas famílias de catadores de materiais recicláveis. Para sua realização, foram analisadas entrevistas semiestruturadas com treze catadores associados do município de Caxias do Sul/RS. Seus resultados indicam que a dinâmica da família dos catadores é condicionada pelo trabalho que essa desempenha, devido à morfologia da população sofrer pressões para adequar-se ao movimento do capital. No caso dos catadores, é a catação, enquanto trabalho precário, que tece a conexão entre a geração passada, a presente e a futura, sendo primeiramente como herança e depois como negação. Evidenciou-se que grande parte dos catadores das gerações passadas iniciou na catação junto de seus familiares quando ainda eram crianças, configurando trabalho infantil. Para com as gerações futuras, predominou-se a intenção de romper com a catação tida como herança, evidenciando não só um descontentamento com o trabalho, mas o desejo de superação da catação por parte dos descendentes.(AU)

The objective of this work is to identify possible expressions of reproduction of capitalist relations in the families of waste pickers of recyclable materials. Semi-structured interviews with thirteen associated waste pickers from the municipality of Caxias do Sul/RS were analyzed. Their results indicate that the dynamics of the waste picker family is conditioned by the work it performs, due to the morphology of the population under pressure, to adapt to the movement of capital. In the case of waste pickers, it is the collection, as a precarious work, that weaves the connection between the past, present and future generations, first as inheritance and then as denial. It was evidenced that most of the waste pickers of past generations started in the collection with their families when they were children, configuring child labor. For future generations, the intention to break with the collection, seen as an inheritance prevailed, evidence not only a discontent with work, but the desire to overcome the collection from the part of the descendants.(AU)

El objetivo de este trabajo es identificar posibles expresiones de reproducción de las relaciones capitalistas en las familias de clasificadores de materiales reciclables. Para su realización, fueron analizadas entrevistas semiestructuradas con trece clasificadores asociados del municipio de Caxias do Sul/RS. Sus resultados indican que la dinámica de la familia de los clasificadores está condicionada por el trabajo que ésta desempeña, debido a la morfología de la población, que sufre presiones para adecuarse al movimiento del capital. En el caso de los clasificadores, es la clasificación, como trabajo precario, que teje la conexión entre la generación pasada, la presente y la futura, siendo, en un primer momento, como herencia y después, como negación. Quedó en evidencia que gran parte de los clasificadores de las generaciones pasadas inició en la clasificación junto a sus familiares, cuando aún eran niños, lo que configura trabajo infantil. En cuanto a las generaciones futuras, predominó la intención de interrumpir la clasificación recibida como herencia, evidenciando no solamente descontentamiento con el trabajo, sino el deseo de superación por parte de sus descendientes.(AU)

COVID-19 e as catadoras de materiais recicláveis: precarização da vida e saúde frente ao medo da fome ou o risco do contágio / COVID-19 and waste pickers: precariousness of life and health in the face of fear of hunger or the risk of contagion

Este artigo aborda as experiências das catadoras de materiais recicláveis diante das implicações provocadas pela pandemia da COVID-19 em uma associação no Distrito Federal (DF). O objetivo principal foi compreender a situação de vida precária das mulheres catadoras inseridas em uma desigualdade sistêmica e institucional do capitalismo. Para tanto, foi realizada uma etnografia que combinou técnicas de observação, interação e escuta (conversas informais e entrevistas semiestruturadas). Através disso, permitiu-se o acompanhamento do cotidiano de vida dessas mulheres, desde a instauração de uma das maiores crises sanitária da humanidade até o período do retorno às atividades laborais. Os resultados revelaram que as catadoras estão inseridas na lógica de precarização da vida sendo que as condições foram agravadas com a chegada do novo coronavírus quando aumentou a vulnerabilidade relacionada ao vínculo de trabalho informal, a insalubridade e os riscos à saúde inerentes à ocupação e às dificuldades de acesso aos serviços de saúde e assistência social. O contexto mostra uma lida complexa relacionada ao medo do desemprego, às dificuldades e às barreiras do ingresso no mercado de trabalho e de manutenção da própria subsistência. Sobretudo, isso agravou-se de forma mais intensa diante da ausência de políticas e programas voltados para elas: o Estado fez pouco para a redução dos impactos da pandemia em suas vidas. Assim, a crise sanitária instaurada refletiu a fragilidade delas em face ao ciclo da reciclagem. Este fato demonstra a necessidade urgente de ações governamentais que abarquem esse grupo social tanto no momento da pandemia quanto pós-pandemia da COVID-19, visando superar a invisibilidade social

This article addresses the experiences of women waste pickers in the face of the implications caused by the COVID-19 pandemic in an association in the Distrito Federal (DF). The main objective was to understand the precarious life situation of women waste pickers inserted in a systemic and institutional inequality of capitalism. For that, an ethnography was carried out that combined observation and listening techniques (informal conversations and semi-structured interviews). Through this, it was possible to monitor the daily life of these women, from the onset of one of the greatest health crises in humanity until the period of return to work activities. The results revealed that the waste pickers are inserted in the logic of precariousness of life, and the conditions were aggravated with the arrival of the new coronavirus when the vulnerability related to the informal work bond, the unhealthy conditions and health risks inherent to the occupation and the difficulties increased. access to health and social assistance services. The context shows a complex deal related to the fear of unemployment, the difficulties and barriers to entering the labor market and maintaining one's livelihood. Above all, it worsened more intensely in the face of the absence of policies and programs aimed at them, the State did little to reduce the impacts of the pandemic on their lives. Thus, the established health crisis reflected their fragility in the face of the recycling cycle. This fact demonstrates the urgent need for government actions to embrace this social group, both during the pandemic and post-pandemic of COVID-19, aiming to overcome social invisibility

A Perspective of the COVID-19 Pandemic in the Plastic Waste Management and Cooperatives of Waste Pickers in Brazil.

Brazil is the fourth largest producer of plastic waste in the world. Among all the challenges the country had faced in the development of public policies for the banning of single-use plastics, the new coronavirus pandemic scenario determined the suspension of these laws indefinitely. In 2020, Brazil became the global epicenter of COVID-19. This scenario changed the habit and behavior of Brazilian consumers, who increased the consumption of plastics due to their importance in applications as protective material. The country also has social problems related to waste management that depend mainly on waste pickers. These workers need social visibility and protection not only to face the current health crisis but also to guarantee their income and survival. This work aims to discuss the increase in single-use plastics that are not intended for recycling and the respective environmental, economic, and social impacts for the country. We demonstrate the lack of data on waste management in Brazil and highlight the importance of the social inclusion of waste pickers for a circular economy. Especially after the change of scenario with the COVID-19 pandemic, the country must have adequate planning and improvements in waste management, recycling programs, and political intervention to raising awareness among the population and guaranteeing social rights for waste pickers.

Application of a 'Recycling Exchange' instrument to compensate waste pickers in Brazil via a first payment for urban environmental services programme.

This article presents an approach to compensate waste pickers in the informal sector of Minas Gerais state, Brazil, via a Payment for Urban Environmental Services (PUES) instrument, called 'Recycling Exchange'. The aim is to evaluate the effects of this instrument on the amount of waste diverted from landfill and reintroduced into the production chain, and to increase recognition of waste pickers' contributions to the state's economy. It was found that the 'Recycling Exchange' met the fundamental objectives of a PUES: the double social and economic benefits of the social inclusion of waste pickers in the execution of the public policy for solid waste management, and inducing (in the case of glass), ensuring and stabilising (plastic and paper) continuity of the activity of selling recyclables in times of wide price fluctuations for these recyclables. The instrument enhanced the provision of this environmental service and the positive externalities associated with recycling.

Hepatitis B and C prevalence in waste pickers: a global meta-analysis.

BACKGROUND: The objective of this research was to use a meta-analysis to understand the prevalence of hepatitis B or C in waste pickers worldwide. METHODS: Epidemiological studies on hepatitis B and C in waste pickers were included adopting a systematic review with meta-analysis. Each selected article had its quality scored by all authors, evaluated according to the Loney's criteria, and evaluated for quality and bias verified with a funnel plot. RESULTS: After employing Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, there were 12 studies used for this meta-analysis. The rate of hepatitis B seropositivity was 0.15 (95% CI 0.10-0.20), and hepatitis C was 0.08 (95% CI 0.04-0.12). This information suggests that waste pickers are exposed to many risks associated with poor quality of life working conditions as well as low health literacy rates. CONCLUSION: The results of this meta-analysis confirm the vulnerability of waste pickers to hepatitis B and C infection and reinforce the importance of using personal protective equipment and immunizing workers.

Environmental Justice and Circular Economy: Analyzing Justice for Waste Pickers in Upcoming Circular Economy in Fortaleza, Brazil.

Sustainable development (SD) presents three pillars: environment, equality, and economy. Many scholars agree that circular economy (CE) currently displays a social gap, as most studies so far focus mostly on economic aspects and, occasionally, environmental too. Although some developed countries and especially the EU heavily promote it, there is little possibility of developing countries accepting CE unless it can fill what it is lacking. This study suggests the use of Schlosberg's tripartite environmental justice (EJ) perspective to complete the concept of CE, bringing it closer to that of SD. Due to their significant contribution to both circularity and the environment, and, likewise, due to their poor social conditions, this paper focuses on the social group of WPs, mainly in Brazil. After conducting 19 semi-structured interviews, EJ was applied to the case of the Ecopoints in Fortaleza (northeastern Brazil) and each element-recognition, distribution, and participation-detected conflicts, such as underappreciation, continuously reduced access to recyclables, distrust, and miscommunication. If CE is successful in LMCs, it will heavily rely on WPs. The analysis suggests that it is necessary to recognize their contributions in order to value their work and consequently, promote their social inclusion.

A Qualitative Study on Noncommunicable Diseases in Waste Pickers in Brazil.

BACKGROUND: Noncommunicable chronic diseases are associated with multiple risks factors and negative outcomes that are long-lasting and difficult to treat. Some populations may be at greater risk because of their socioeconomic status, lack of healthcare, environment, and poor work and living conditions. Informal waste pickers may experience higher levels of chronic diseases and often do not have access to care to manage symptoms. OBJECTIVES: The aim of the present study was to understand the prevalence of chronic diseases in waste pickers, along with perceived associated risks and available treatments. METHODS: A qualitative study was conducted, using interviews with 24 waste pickers who worked at Estrutural dumpsite in Brasilia, Brazil which was historically the second largest open-air dumpsite in the world. RESULTS: Participants believed their commonly experienced chronic diseases were a result of working in the open-air dumpsite. Chronic diseases commonly noted in the interviews included hypertension, chronic pain, respiratory disease, diabetes, and kidney problems. Participants discussed self-medication or prescribed medication used to treat their conditions. Most participants had varying beliefs regarding prevention strategies to reduce disease; some ideas for prevention focused on religion, fate, and God when discussing outcomes related to illnesses. When answering questions regarding ideal working conditions to help prevent diseases, participants responded by expressing a desire for protective gear (e.g. PPE) which could help mitigate hazards associated with the dump. CONCLUSIONS: Recyclable collectors were aware of occupational hazards to which they were exposed and associated noncommunicable chronic diseases but lacked education on the importance of preventive measures and access to healthcare services. The findings of the present study confirm the need to strengthen intersectoral actions to protect and uphold the health rights of this vulnerable population. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: This study was approved by the Research and Ethics Committee of the Health School of Brasília University under Opinion n. 1.517.670/2016. COMPETING INTERESTS: The authors declare no competing financial interests.

Social metabolism and material flow analysis applied to waste management: A study case of Autonomous City of Buenos Aires, Argentina.

Waste Management in megacities is one of the most relevant issues around the world due to its environmental impacts and economic costs. In this work, we evaluate the application of the theoretical-methodological framework provided by Social Metabolism and Material Flow Analysis to analyze the Municipal Solid Waste Management in the Autonomous City of Buenos Aires (Argentina). The quantitative results evidence that 46% of the city's waste was disposed of in landfills outside its geographical limits, transferring environmental costs to the population on the outskirts of the city and other administrative jurisdictions. The city recycled the other 54% of the waste using different strategies like green centers for recyclable domestic waste (operated by 5500 registered Urban Recyclers/waste pickers recover), a Plant for treatment of pruning activities waste, a Plant for the treatment of construction and demolition waste, and a Mechanical-Biological Treatment Plant. Also in the city work, approximately 5000 informal waste pickers contributing to recycling waste. The approach shows the importance of the inclusion of waste pickers in the formal recycling system, and the failures of costly and inefficient large-scale technologies, as the Mechanical-Biological Treatment Plant. Also, the application of Social Metabolism and MFA allowed a characterization of the flows and processes that make up Municipal Solid Waste management in the area of study, despite the lack of systematized quantitative information. It facilitates a holistic visualization of waste management in the city for decision-makers.

Prevalence of musculoskeletal disorders and risk factors in recyclable material waste pickers from the dump of the structural city in Brasília, Brazil.

Solid waste management is a global challenge impacting the lives of thousands of people, among them the recyclable materials waste pickers, through the separation and sale of these materials, make a living for themselves. These workers face unhealthy working conditions and are exposed to various occupational risks, which predispose the prevalence of musculoskeletal as chronic back problems. METHOD: Exploratory cross-sectional study with a semi-structured questionnaire to investigate the prevalence of back pain and related risk factors. RESULTS: 1.025 waste pickers were interviewed, and 970 records of chronic back pain were detected. Among them, 660 were women (68.04%), 310 were men (31.96%), the average age of 40.21 years; 597 were single (61.92%); 629 (64.84%) had over 11 years of work; 942 (97.11%) worked exclusively in the open dump, 899 (92.68%) with bags, 922 (95.05%) on dayshift. We found significant associations between gender (p < 0.001); age (p < 0.001); time at work (p < 0.022) and place at work (p < 0.001). After adjusting, there were higher prevalence of chronic back pain women (OR = 1.7), older age (OR = 2.64); working more than 11 years (OR = 1.09); and working on the open dump (OR = 2.8). CONCLUSION: The prevalence of subjective symptoms of musculoskeletal disorders was high. Women, over 36 years old, who worked more than 11 h a day in the open dump were more exposed to suffer from chronic back problems. The importance of urgently addressing the labor impacts related to solid waste management in developing countries to protect these workers and, especially, women involved in this work is emphasized.

Hepatitis B or C prevalence in waste pickers from South America: a systematic review.

BACKGROUND: Waste pickers are considered a vulnerable population at risk for potential health damage. Taking into account the risk of hepatitis B or C infection in this population, the aim of this study was to show the prevalence of these diseases in waste pickers from South America, through a systematic review. METHODS: The search covered publications until February 2020, accessed through Google Scholar database. Epidemiological studies on hepatitis B or C focused on waste pickers in South America were included. All selected papers were evaluated for quality. RESULTS: Six studies composed this systematic review, all conducted in Brazil and using cross-sectional study. The prevalence of all makers (HBsAg or anti-HBc) for hepatitis B varied from 4.3 to 33.4% while for hepatitis C varied from 1.6 to 12.4%. CONCLUSION: The lack of results showed the requirement for more research about hepatitis including this informal workers group. High prevalences of hepatitis B and C in waste pickers highlighted the need of increase preventive health protection as vaccination against hepatitis B; training on working conditions; and the use of individual protection.

Formal and informal waste selective collection in developing megacities: Analysis of residents' involvement in Bolivia.

The implementation of waste selective collection (SC) schemes in low-income countries is a challenge although it is one important way for improving environmental sustainability. The inclusion of the population is necessary for gaining effective results, and social surveys are support methods for understanding citizens' involvement and behaviour. The aim of the research is to assess the support of the citizens concerning the formal and informal recycling in a low-middle income country. The study presents a questionnaire survey conducted in 2018 in La Paz, Bolivia, where 774 citizens were interviewed for evaluating their support to the formal and informal SC systems. Two questionnaires were submitted to two different users' categories: users of the formal recyclable waste gathering points; and citizens of the neighbourhoods. Evidence of the survey shows that about 8% of the population supports the formal SC while about 48% are used to selecting their waste at home. About 79.2% of them bring the waste to the informal recycling shops or provide it to waste pickers, throwing the waste into or nearby the mixed containers in order to facilitate their collection. This research demonstrates how social inclusion is important for planning recycling systems within a developing big city, starting from the SC. Results suggest that the informal sector can be an effective means for improving the recycling behaviour of the citizens. The study can be of interest to stakeholders involved in introducing recycling policies in developing cities where the SC rate is still low, and informal waste collection exists.

Hepatitis E virus infection and waste pickers: A case-control seroprevalence study.

Whether waste pickers are a risk group for hepatitis E virus (HEV) infection is largely unknown. This study aimed to determine the association between HEV exposure and the occupation of waste pickers and the work characteristics of waste pickers. An age-and gender-matched case-control seroprevalence study of 86 waste pickers and 86 control subjects of the general population was performed. We determined anti-HEV IgG antibodies in sera of cases and controls using a commercially available enzyme-linked immunoassay. The McNemar's test was used to assess the association between HEV seropositivity and the occupation of waste picker. The association between HEV seropositivity and work characteristics of waste pickers was assessed by bivariate and logistic regression analyses. Anti-HEV IgG antibodies were detected in 14 (16.3%) of the 86 waste pickers and in 8 (9.3%) of the 86 control subjects (McNemar's pair test: odds ratio (OR) = 13.0; 95% confidence interval (CI): 0.73-230.77; p = .02). Bivariate analysis showed that HEV exposure was associated with an ill status (p = .01) and reflexes impairment (p = .009). Logistic regression analysis showed that HEV seropositivity was associated with increasing age (OR = 6.52; 95% CI: 1.95-21.78; p = .002) and raising pigs (OR = 12.01; 95% CI: 1.48-97.26; p = .02). This is the first age- and gender-matched case-control study on the association between HEV infection and the occupation of waste picker. Waste pickers represent a risk group for HEV infection. Factors associated with HEV seropositivity found in this study may help in the design of optimal planning to avoid HEV infection.

The role of a socio-integrated recycling system in implementing a circular economy - The case of Belo Horizonte, Brazil.

Waste pickers (WPs) are considered a strong suggestion to become practical mediators of the circular economy (CE) in emerging economies. This new recommendation intends to strengthen WPs' role in household solid waste management while supporting the establishment of CE. Municipalities often do not recognize WPs as service providers and frequently discriminate against them. In such a challenging situation, could a socio-integrated recycling system with integrated WPs be a robust strategy to boost a CE? Belo Horizonte is a learning platform to answer this research question because this Brazilian city has a long-term commitment to social integration. The work applies the combination of participatory observation, multi-year material flow analysis (MFA), and structural agent analysis (SAA) to identify allocative resources, legitimation, and cultural values that are fundamental to operationalizing CE. The MFA results show a significant increase in waste generation, but not more than 4% of recyclable waste generated could be collected as input for WP cooperatives. The number of WPs registered in cooperatives, the market price of recyclables, and regulatory legislation for packaging products are classified as barriers for the successful extension of a socio-integrated recycling system identified in the SAA. This study suggests that knowing the target group (e.g., city hall and industries) brings opportunities for WPs to disclose niches (based on a small network of agents with expectations and visions) and can potentially create socio-technical regimes to implement a conscious and sustainable CE.

Stakeholder views of source separation collection programme in East São Paulo, Brazil.

The investigation of the views of the stakeholders involved in the municipal solid waste separate collection programme (CP) performed in the East Zone of the city of São Paulo is presented in this paper. Aiming to obtain the necessary information to be analysed, interviews with the manager of the Municipal Urban Cleaning Authority (MUCA) of the city, with leaders of recycling worker cooperatives (WCs), and citizens were performed using semi-structured questionnaires. The analysis was performed using the software "IRAMUTEQ". The results show that, in the view of the manager of the MUCA of the city and the WCs' leaders, the low adhesion of the population to the separate CP is the greatest obstacle to a further expansion of the existing programme. At the same time, the citizens have blamed the low diffusion made by the municipality about the separate CP in the East Zone of São Paulo. Thus, it can be concluded that the separate CP available in the East Zone of São Paulo is still flawed; since neither the public power, the WCs, nor the population are satisfied and point out several flaws. This situation highlights the need to establish better venues for discussion between the population, WCs, and the municipality to jointly design a separate collection system with a more participatory approach.

Syphilis and other sexually transmitted infections among waste pickers in Brasilia, Brazil.

There are millions of waste pickers worldwide that are predominantly located in low- and middle-income countries. They survive on sorting and selling reusable orrecyclable materials discarded by society.While sorting, they are exposed to occupational risks and hazards, including cuts from sharp objects and medical wastes, that could be contaminated by infectious diseases. Because of these exposures, a study was conducted to determine the prevalence of syphilis and other sexually transmitted infections (STI's) among waste pickers. A cross-sectional study using a semi-structured questionnaire and blood samples for serological tests were collected. A total of 1,025 waste pickers were interviewed. Most participants were women (67.54%), without a partner (70.11%), were an average of 40 years old, and had between 3 and 4 children. There were 755 samples collected for syphilis, 791 for HIV, 866 for hepatitis B, and 859 for hepatitis C. Of these samples, 28 (3.70%) waste pickers had reagent serology for syphilis, 6 (0.75%) for HIV; 6 (0.69%) for acute hepatitis B and 1 (0.11%) for hepatitis C. Overall, this study identified the serological status of waste pickers; this information can be used to encourage waste pickers to seek health treatment for STIs and receive education to understand the risks associated with being exposed to medical waste or syringes.