Health risk Reduction Behaviors Model (HRRBM) of scavenger labors exposed to solid waste at local waste disposal site in Nakhon Ratchasima province, Thailand

Abstract

Objective 1) To investigate the general characteristics and self-protection behaviors of scavengers at local waste disposal sites, Nakhon Ratchasima Province 2) To explore the association between knowledge, attitudes and practices among scavengers exposed to solid waste at local waste disposal sites 3) To develop and evaluate the effectiveness of the Health Risk Reduction Behaviors Model (HRRBM) in regards to solid waste exposure among scavengers at local waste disposal sites at Nakhon Ratchasima Province, Thailand Methods: Phase 1 Cross-sectional study; Questionnaire was conducted by face to face interviewed with 88 scavengers working in local waste disposal site and observed with observation form. Phase 2 Quasi-experimental study was conducted of scavenger subjects divided into two groups. An intervention group of 44 subjects was randomly selected from 63 scavengers at a municipal waste dump site and a control group of 44 subjects was randomly selected from 58 scavengers at 8 additional dump sites. The Health Risk Reduction Behaviors Model (HRRBM) was developed and implemented with the intervention group. Results: Phase 1: The majority of scavengers were female. An average age was 38 years old. They were married and had worked as a scavenger for more than 10 years. The average income was 5,800 baht/month. Most of them graduated in primary school. More than half of the participants in both groups rarely used Personal Protective Equipments (PPEs) during their work time and were careless regarding annual medical checkups. Reinforcing health risk behaviors were smoking, drinking alcohol finding and eating unclean food at the dump sites during their work. Phase 2: the knowledge, attitudes and practices between groups after the HRRBM intervention showed significant difference (p<0.05). The mean difference of knowledge, attitudes, and practices increased significantly in the invention group (p<0.05), but in the control group, there was no difference in knowledge. Physical symptoms slightly decreased in the intervention group, whereas in control group was no difference. There was a significant increase in the proportion of PPEs used in the intervention group (p<0.05) but, this remained the same in the control group. Conclusion and Discussion: The HRRBM significantly reduced self-health care cost, significantly increased knowledge, attitudes and practices regarding working with solid waste, reduced percentage of uncomfortable condition and physical symptoms, and increased proportion of PPEs used the intervention was implemented in the intervention group compared with the control group. In conclusion, scavengers exposed to solid waste at waste disposal sites can reduce health risk exposure if they strictly follow the safety recommendation regarding routine work. The health care coordinator should distribute the HRRBM, media and routine monitor for safety work practices.