Occupational hazards and challenges associated with solid waste management: a case of solid waste workers in Kawempe division, Kampala capital city

Abstract

Background: Municipal solid waste workers provide an essential urban service while working at the interface of environmental contamination, occupational exposure and public health. Evidence from many low- and middle-income settings shows that occupational risks are shaped not only by the physical characteristics of waste but also by equipment, organisational, financial, governance and community conditions. However, locally specific evidence linking waste streams, occupational hazards and system-level challenges in Kampala remains limited. Objective: To assess occupational health and safety hazards associated with the types of solid waste handled by waste workers and to characterise the principal challenges affecting solid waste management in Kawempe Division, Kampala Capital City, Uganda. Methods: An exploratory cross-sectional mixed-methods case study was conducted among waste-management enterprises and personnel operating in Kawempe Division. The study combined questionnaires, key-informant interviews and structured workplace observations. Sixty of 81 targeted enterprises participated (74.07% enterprise response rate), with 122 participants reported in the respondent dataset. Quantitative data were processed using SPSS and summarised using descriptive statistics and factor analysis; qualitative information from interviews and observations was analyzed thematically. The study period covered April–June 2024. Results: Factor analysis identified two principal dimensions of occupational/environmental risk. Environmental risks had an eigenvalue of 4.465 and explained 44.655% of variance, while health risks had an eigenvalue of 2.995 and explained 29.950%; together they explained 74.604% of variance. The strongest individual indicators included toxic fumes from waste burning (loading 0.768), habitat destruction (0.730), leachate contamination (0.711), fire risk from combustible waste (0.709), waterborne disease exposure (0.667), vector-related risks (0.641), flammability of waste (0.638), and injuries associated with inadequate protective gear (0.613). Plastics were the most frequently handled waste stream (68.3%), followed by food scraps (66.7%), carton/paper (50.0%), yard trimmings (43.3%), wood (31.7%), metals (25.0%), textiles/clothing (23.3%) and glass (10.0%). Major systemic challenges included inadequate equipment and PPE, limited financial resources, inadequate skills, political and institutional pressures, customer/community-related difficulties, vehicle accidents and long travelling distances. Existing practices showed elements of circularity: sorting had a mean score of 3.59 (SD 0.40), composting/organic-waste decomposition 3.55 (SD 0.33), plastic recycling 3.42 (SD 0.41), and waste burning 3.33 (SD 0.35). Conclusion: Occupational risk in Kawempe's waste-management system is multidimensional and systemic. Worker protection cannot be achieved through PPE or worker behaviour alone. Source segregation, competent staffing, engineering controls, safer transport, health surveillance, stronger regulatory oversight and community participation should be integrated into waste-management planning. The findings also support a transition from a disposal-oriented model toward prevention, recovery, recycling and controlled biological treatment while minimising uncontrolled waste burning.