Waste collection is a necessary activity all around the world. Fortunately for the health and living conditions of inhabitants, there are professional waste collectors. For waste collectors, however, the risk of disease resulting from exposure to various work hazards is high,^1–5 as is the risk of fatal and non-fatal occupational accidents.⁶

Waste collection can be practiced as either an occupation⁶ or an essential means of survival.⁷ The socioeconomic status of both types of waste collectors is low, and their working conditions are unfavourable. In the occupational setting, however, many preventative measures have been proposed and implemented in order to reduce the risk of accidents and occupational disease. Such measures involve increasing safety and reducing the risk of musculoskeletal, fatigue, respiratory, gastrointestinal, and hearing complaints. The effectiveness of most of these measures, however, has yet to be investigated.⁸

The risk of disease increases with the intensity and duration of exposure to occupational hazards, as well as with the age of the worker. For this reason, the Netherlands adopted an age dependent guideline for waste collection in 1998. The guideline specifies three methods of waste collection (bags, two-wheeled containers, and four-wheeled containers). It also prescribes a maximum amount of waste (or a maximum number of bags/containers) and a maximum number of hours that waste collecting tasks may be performed during an eight hour working day.⁹ In addition to the introduction of this guideline, new collection methods (for example, underground storage systems and automatic collection systems that use trucks with mechanical arms to pick up containers) have been incorporated into the working situation. New techniques will obviously not always lead to the reduction of disease; they may sometimes even bring new risks.⁶ For this reason, the occupational health services of most European countries use specific periodic health surveillance to monitor the specific work related diseases of workers.

When waste collection is an essential way of living or means of survival, as is the situation for the Brazilian ragpickers, measures to reduce the risk of disease are difficult to realise. Ragpickers work informally, without regulation or occupational control. Their living conditions are also very poor, thus further increasing the risk of disease. Combined with high unemployment, ecologically oriented (international) governmental agreements and recycling regulations stimulate the collection and sale of waste by people with little education and poor living conditions. Adults and children alike must often “work” under such conditions. Working at a young age can have a long negative impact on health, and it may result in lifelong exposure to hazards.¹⁰ Most official statistical data do not address ragpicking or other informal working situations.¹¹ The data sampling by da Silva and colleagues therefore makes an important contribution by drawing attention to the various hazards and prevalence of musculoskeletal diseases and accidents in the working situations of the unemployed.

Prevention begins by providing information to the target group and official authorities about these risks and hazards. Publication in scientific journals is a good first step in the effort to convince official authorities and the world about the living conditions of this subpopulation.

The most important tasks are to convince the target group that they are at risk for illness and to distribute protective and safety materials. Another, perhaps more effective, manner is to educate children and young adults about the hazards of working under these conditions and the risks of short term and long term health complaints. In cooperation with the ILO (International Labor Organisation) and ICOH (International Commission on Occupational Health), the WHO (World Health Organisation) has already decided to focus more on child labour and latent health in adulthood.¹² Education (more specifically, education concerning occupational safety and health) and the implementation of knowledge among the target groups is an essential factor in changing the working behaviour of these vulnerable groups. It is our hope that this and other publications about waste collection will not go to waste!