title: Respiratory and general health impairments of ragpickers in India: a study in Delhi.
abstract: OBJECTIVE
  This study attempted to assess the respiratory and general health of ragpickers who rummage through the garbage dumps and landfill sites in India to collect and sell recyclable materials for a living.
  
  
  METHODS
  98 ragpickers and 60 controls from Delhi, matched for age, sex, and socioeconomic conditions, were examined. Health data were obtained from questionnaire survey, clinical examination, and laboratory investigations. Lung function was evaluated by spirometry.
  
  
  RESULTS
  After controlling for smoking as a confounder, respiratory symptoms and lung function decrement were recorded in 94% and 52% of the ragpickers, respectively, compared with 56% and 34% of controls. The ragpickers showed a higher prevalence of low hemoglobin, high circulating eosinophil and monocyte counts, unhealthy gums, frequent diarrhea, and dermatitis, when compared with controls. Their sputum showed an abundance of alveolar macrophages, siderophages and inflammatory cells, and a very high frequency of squamous metaplasia and dysplasia of bronchial epithelial cells, suggesting inflammation and cellular changes in the airways.
  
  
  CONCLUSIONS
  The ragpickers suffer from a multitude of health problems which seem related to their occupation.
authors.affiliation: Experimental Hematology Unit, Chittaranjan National Cancer Institute, 37 S.P. Mukherjee Road, Kolkata, 700 026 West Bengal, India. manasrray@rediffmail.com
authors.forename: Manas Ranjan
authors.initials: MR
authors.lastname: Ray
authors.forename: Gopeshwar
authors.initials: G
authors.lastname: Mukherjee
authors.forename: Sanghita
authors.initials: S
authors.lastname: Roychowdhury
authors.forename: Twisha
authors.initials: T
authors.lastname: Lahiri
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003247:Conservation of Natural Resources / Q000379:methods; D005260:Female; D005735:Garbage; D006304:Health Status; D006402:Hematologic Diseases / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D014171:Transients and Migrants