Thesis on Occupational Health Hazard among Female Workers

The major purpose of this thesis is to identify occupational health hazard among female worker in a readymade garment factory, namely Hisham Apparels Ltd. Other objectives are to identify the health status of female worker’s in the industry and to assess the relationship of socio-demographic factors such as age with the physical problem. Also describe the relationship of occupational factors such as length of service, working hours and nature of job with the physical problem.

Introduction

In a developing country like Bangladesh, Readymade Garment (RMG) sector plays an important role in the overall economic development. At present, approximately 20 lakh workers (among which 80% is female) are working in this sector which is a great source of employment (EPB, 2006). It is also mentionable that about 76% of our foreign exchange is earned by this sector (BGMEA, 2008).  The garment industry of Bangladesh has been expanding: rapidly since the late  1970s  (Zohir and Majtunder, 1996). As new industries expand, the labor force grew with the economy of the country, at the same times the health hazards for those workers present there in various occupational diseases and accidents highly prevailed among the workers. According to WHO (1948), “Health is a state of complete physical, mental and social wellbeing and not merely the absence-e of diseases or infirmity”. Occupational health hazard is concerned with health hazard in relation to the work environment. The science of occupational health hazards covers a wide field, like work physiology, occupational hygiene, occupational psychology, occupational toxicology etc. (Hanington and Gill, 1990).

The occupational health problems affecting workers of our country, in fact, workers of any developing country are liable to be much more complicated and dangerous as compared to that of developed countries because of the reasons of:

1. Poor health status due to poverty, overcrowding:, illiteracy, malnutrition, higher prevalence  of infections, parasite, and other diseases, lack of adequate medical and health care facilities and a host of other factors.
2. Non-industrial illnesses form a major pa1t of the health problem of Garments In fact incidence of many common illnesses like respiratory ailments (flue bronchitis, cough, and asthma), tuberculosis, peptic ulcer, dysentery etc. are higher among industrial workers as compared to the general population.
3. Sickness absenteeism the major contributory factor to the total The reasons for thus high sickness absenteeism are very much varied and complicated but there is no doubt that the prevalence of sickness is high among our workers. One of the main reasons may be the payment of medical allowances in cash with wages in lieu of plant level medical treatment in kind (as per industrial workers Wages and Productivity Commission). Effective health care measures taken at the place of employment to render immediate treatment at the early stages of many of these illnesses will cut short the course and will prevent the disablement due to sickness to a great extent.
4. Lack of any laboratory facilities for monitoring, analyzing and assessing the harmful contaminants in the work environment and their effect on the health of the workers is causing health hazards.

Ve1y little is known about the health condition of the garment workers because the specific study on the health condition of garment workers was ve1y limited. Nigam et al., (2007) conducted a study on “Safety and health in the chemical industry.” The study addressed the present global industrial scenario, for any industry to be successful, it is essential to inculcate safety culture, health consciousness and environmental awareness in every employee of the organization. Paul- Majumder (2003) conducted a  study  on  the  physical  and  mental  health  status  of  garment   workers  tad  how  problem  affect  labor  productivity, competitiveness of the garment  industry  in the world market and the working life of the  workers, particularly  of female workers. It showed that various illnesses and diseases were widespread among the garment workers. A large number of workers were found to continue their work even they were suffering from various diseases and illness. Though the garment workers were very young they suffered from anemia, female diseases, dysentery, etc. Moreover, the competitiveness of the garment industry  in the  world  market  was seriously affected  by the ill health  of the  workers, since  ill health  decreases the labor· productivity to a great  extent.  Most  of  the  health  problems that  the garment workers  suffered  from arose  from the occupational  hazards   including  long  working  hours,  absence of  leave   facilities, congested  and  over-crowded working conditions, the absence of health facilities and safety measures, absence of staff amenities, lack of safe drinking water etc.

 Rational / Justification:

The RMG industry has been Bangladesh’s key export industry and a main source of foreign exchange for the last 25 years. As a result of an insulated market guaranteed by Multi-Fibre Agreement (MFA) of General Agreement Tariff and Trade (GATT) and supportive policies of the Government of Bangladesh (GoB), it attained a high profile in terms of foreign exchange earnings, exports, industrialization and contribution to the GDP within a short period. In less than a decade it increased its exports, foreign exchange earnings, and contribution to the GDP by 4.39 %. RMG exports reached a steadfast figure of USD 17.91 billion in fiscal year 2010-2011; accounting more than 78% of national export earnings, which was about 4%-5% of the global total of such exports. It further contributes 10% to the country’s GDP (Mahmud R.B., 2012). RMG products are exported mainly to the United States of America and the European Union.

Bangladesh’s garment industry provides employment to about than 3.6 million workers which 2.8 million are women (Mahmud R.B., 2012). Workers in these garment factories are almost always illiterate. They have very limited knowledge of occupational safety and health standard in the garment factories. Occupational disease and injury are significant in Bangladesh.

Musarrat (2001) found  the following  hazards in  the garments Industry of  Bangladesh: crowded conditions, exposed  operating machines,  electrical  connections   are crude   and   unsafe,   a   few   or   no   fire   extinguishers­ inaccessible  or  malfunctioning, no  fire  practice  is ever performed, managers and  workers are not  trained  to  understand health and  safety  issues, stairs  and  floors used as storage; gates remain closed even in emergency; factory not designed as commercial facility, narrow aisles for firefighters  to enter  and  rescue. In a survey, it was revealed that most garment factories of Bangladesh were often dimly lit and poorly ventilated. However, they remained   in operation for long hours and   the workers worked almost without any break during their shifts.

There is an acute need for training in preventive, primitive and curative health services for occupational health hazards as the part of industrial health programmed. The occupational health programmers can play a vital role in developing countries. The task of a nurse is to educate workers, to motivate, develop and practice in preventive measures (Dinesh RR; 1997).

From investigators experience in the accidental emergency department, she has identified that most of the patients reported to the casualty with the complaint of cut injuries and fractures. This increase incidence of injuries has occurred due to occupational health hazards. When the investigator interviewed these patients she observed that they do not have much knowledge on the various occupational health hazards and the way to preventing it.

This experience of the investigator and the fact that this topic has been understudied has interested the researcher to do a study to identify occupational health hazards, particularly among female worker in the garment industry.

 Research Hypothesis:

The research hypothesis is: HO- there is no interaction between female worker’s occupational conditions in affecting worker’s physical health; and H1=there is an interaction between female worker’s occupational conditions in affecting worker’s physical health.

 Objectives of the study

General Objective:

To identify occupational health hazard among female worker in a readymade garment factory, namely Hisham Apparels ltd.

Specific Objectives

1. To identify the health status of female worker’s in the industry.
2. To assess the relationship of socio-demographic factors such as age with the physical problem.
3. To assess the relationship of occupational factors such as length of service, working hours and nature of job with the physical problem.

Review of literature

Review of literature is a key step in the research process. It refers to an extensive and a systematic examination of literature relevant to research study to generate data of what is known and not known about a particular situation and to provide in depth knowledge base needed to study the selected problem (Polit DF, Beck CT;2004).

Many researchers have investigated working conditions in the Bangladesh garments industry. According to Shakila Matin Mridula, Ms.Khoshnur Afrin Khan(2009), most of the garment workers lead very poor lives. They come from different areas of Bangladesh. Most of them live in slum areas with the inhuman living condition. They come with other garment worker of their native villages. Most of the girls are of 16 to 30 years. This age is the proper time for education but they are deprived of that. Garment Workers go to factories very early in the morning and return home at 8 or 9pm at night. They most of the times do not get suitable remuneration. Their salary is very poor. Although they work extremely hard but their salary structure is not attractive at all. A girl hardly receives the monthly salary of 2500 tk approximately and sometimes even lesser than this amount. Most of the cases, there is no doctor, first aid, sufficient light, and ventilation. In some cases, there are no sufficient and pure drinking water and toilets for the workers.

Kumar (2006) focuses; Garments workers are concerned with long working hours or double consecutive shifts, personally unsafe work environment, poor working conditions, wage and gender discrimination. Indeed, employers treat the RMG workers as slaves, exploiting workers to increase their profit margins and keep their industry competitive in the face of increasing international competition (Kumar A., 2006).

Musarrat (2001) found that Fire incidents have killed more than 350 workers since 1990. A factory collapse  killed  60  workers  in  2005 here  unaccounted  for  other non-fatal injuries-falls, machinery  related,  struck by/ against,  cutting  and piercing, etc.

A descriptive cross-sectional study was conducted with purposively-selected 148 workers of a garment factory of the Onus Group in Tongi during October-December 2006.  47.3% of the respondents suffered from  headache and vertigo, followed by low back-ache and joint-pain (35.2%), and 17.5% complained of suffering from respiratory distress while working in the factory. 53.8% experienced needle-prick during their work at the machine, 44.2% had cut injuries, and 2% had burn injuries. (Maleeha, Maheen, Khaled, Habibur,2009)

A cross-sectional study was carried out in Dhaka and Narayangonj among 100 female workers in 2009. The study shows that the common problem the workers face is Headache which is 97%. Moreover, the study shows that a good number of workers face eye problems, respiratory problems, nausea and vomiting, back pain, anemia with the percentage rate of 62,36,28,31,28 respectively. (Shakila Matin Mridula, Ms.Khoshnur Afrin Khan,2009)

N Nahar, R N Ali, F Begum (2010) analyzed the types and extent of occupational health hazards of the garment workers as well as the relationship of various health hazards with the age of the workers and the length of work in garments. Three garment factories from Konabari Upazila under Gazipur district were selected purposively. The sample consisted of 90 workers taking 30 randomly from each of the three garment factories. Results of the study showed d1at d1e highest 95.6 percent of the workers reported that they were affected by a headache. In total 90, 58.89 percent respondents implied that their extent of a headache was severe. 52.22 percent of the respondents opined that they suffered from severe malnutrition, followed by 78.89 percent by musculoskeletal pain, 72.22 percent by eye strain, 68.89 percent by malnutrition, respectively.

Momtaz Jahan (2012) were visited five garment factories located at Mohammadpur and Mirpur of Dhaka City and revealed that physical working conditions in most of the garment factories are not very congenial. It is mainly because of the fact that, most of the factory buildings were not built for manufacturing purposes Regular buildings were hastily converted into garment factories. Thus the physical working conditions inside the factories are not adequate for garment manufacturing (Paul-Majumder, 2008)

She also analyzed that all the factory buildings visited except one are over-crowded, congested and poorly ventilated. The floor space per worker is small and stairways are narrow. In one factory, bundles of cloth and cartons were found on the staircases. The workers work under hundreds of powerful electric bulbs for the whole time of their work. It was observed that, the sound of the operation of 100-200 sewing machines in the same work floor exposed the workers to high noise that exceeded tolerable level.

All the factories visited lack the basic staff amenities. Sanitation facilities for women workers are not satisfactory. There is only one toilet for about 50 women workers. The number of toilets is inadequate and they are not property maintained. The source of drinking water is tap and drum. None of the factories has a lunch room. Staircases, roofs, corridors, workplaces are mentioned as lunch places by the respondents. They use the toilets as their washing place. There is no canteen facility for the workers.

Workers under helper category, who are mostly women, have some additional hardship since they are required to remain either keep standing or moving from one operator to another for most of their work time. The respondents indicated that, their main problem at work is to remain standing. They are not allowed to sit or even to talk with anyone while they are at work.

Again, it has been found that, in the jobs of helper and operator, women are continuously inhaling toxic substances ejected from the dye used in the colored fabric as well as dust and small particles of fabric (Paul-Majumder and Begum, 2000). Masks can protect workers from dust and toxic hazards but only a few workers use masks. Most of the employers do not provide masks to the workers. Only in one garment factory visited, it was found that the workers wearing masks and the supervisors strictly enforced this practice.

Usually, minor accidents and injuries like finger pricking, cuts, and finger burning while ironing are common in garment industries. For protection from physical injury, the workers do not have adequate measures. Metal gloves can protect the cutters from cuts but most of the employers do not provide the gloves. The respondents said that, there are first aid box in their factories to take care of these accidents.

The garment factories are very prone to fire accidents since the materials used in these factories are highly inflammable. In most of the factories, firefighting equipment is minimal. The respondents reported that, they have never been shown how to use the fire extinguisher. Fire exists or emergency exists are also absent. The passages in the factories are so narrow that workers cannot live the factory premises easily in an emergency situation. The single exit door is kept locked during work time. As a result, the workers while working in the factories remain vulnerable to fire accidents and they always worry about fire hazards. Many workers have been killed in factory fire in Bangladesh.

The respondents stated that, many of them suffer from various illnesses after starting work in the garment industries a Cough, cold, eye-pain, headache, chest-pain, breathing problems are most common health problems among the garment workers as mentioned by the respondents. This is mainly due to overwork and uncongenial working environment. But the workers are totally deprived of any kind of treatment facility. None of the factories have a regular doctor and none of the respondents received treatment facilities from the garment authorities. Treatment facility is only provided for major accidents while working in the factories. In some cases, the management refuses to give compensation for accidents. Lack of health care facilities adversely affects the health of women workers.

Material and Method

Study Area:

The study will be conducted in the Hisham Apparels ltd.  in Dhaka. This factory consists of 275 workers and it is located in Mirpur area, Dhaka.

Design of the study:

“The research design is the plan for the study, providing the overall frame work for collecting the data” Polit DF, Beck CT(2004).

The research design selected for the study is “cross sectional study”

Study period:

This study will be conducted for 4 months (Jan-April 2013).

Study population:

“Population is defined as the entire aggregation of cases that meet the designated criteria” Polit DF, Beck CT(2004).

The requirement for defining a population for research study arises from the need to specify the group to which the result of the study can be applied. The population of the present study will comprises of 200 working women in the selected garment factory.

Selection of participants:

Inclusion criteria for sampling

• Women workers from selected the garment factory who are willing to participate and available at the time of data collection.

Exclusion criteria for sampling

• Women workers from selected the garment factory who are not willing to participate at the time of data collection.
• Women workers from the selected garment factory who are absent on the date of data collection.
• Male workers who are also worked in the selected garment factory.

Data collection instrument:

Data will be collected by using a pre-tested structured questionnaire.

Sampling procedure

Sampling procedure refers to the process of selecting a portion of the population to represent the entire population. Based on permission obtained from the management of a select factory, 100 samples will be drawn for the study by simple random sample technique (lottery without replacement).

Sample size calculation:

Sample size was calculated using the following formula

n= z 2pq/d2

Here, p =0.5,   q = 0.5, d = 0.05, z = 1.96

By using this formula, here n = 384. But considering the time and resource constrain the sample size will be 100.

Sampling Size

In the present study sample size will be 100 women workers working in the selected garment factory.

Data collection technique:

After obtaining management permissions the sample will be identified as per inclusion criteria. The 100 workers will be selected using simple random sampling technique. Data will be collected by face to face interview by using structured questionnaire. The time spent with each worker will be 5– 10 minutes for data collection.

Quality of data:

After data collection, data will be checked carefully to ensure correctness and relevant of data. Subsequently data will be entered into the computer.

Data analysis plan:

Descriptive data will be presented by using tables and graphs and influential statistics will be done by using “t” test .

Ethical consideration:

• Inform consent
• Confidentiality
• Ethical approval from Board

The respondents will be explained about the aim and objectives of the study and informed written consents will be taken from the respondents prior to data collection. Respondents’ dignity and respects will be maintained and interviews will be taken with strict privacy. The respondents will be ensured that their personal identity would be kept confidential and the data would be used only for study purpose. Moreover, participants are allowed to withdraw themselves at any stage of the study.

Result:

Table 1: Age of Workers

Among the 100 respondents 29 are under the age of 19 years, 41 are between 19 to 25years, 14 are between 25 to 30 years, 12 are between 30 to 35years.Only 4 are more than the age of 35.

Table 2 : Education Level of the Workers

Among the respondents education level is not so high. Among 100 respondents 10 are illiterate, 76 are primary level whereas 14 are secondary level. It is not unfair to say that this is the most common educational level among garments workers.

Length of service of the Workers

Among 100 respondents 23 female workers work for less than 1 years, 31 female workers work for 1to 3 years, 22 female workers work for 4 to 6 years, 11 female workers work for 7 to 9 years whereas 13 workers work for more than 9 years,

Table 4: Working Hours

Among 100 respondents 20 always work for 8 hours, 58 sometimes work more than 8 hours and 22 always work more than 8 hours.

Family pattern

Among 100 respondents 52 percent are living with their family, 44 percent are living with their coworker , only 4 percent living alone.

Table 6: Pattern of Diseases and illnesses

Results of the study showed (Table: 6)  that the most frequent illness reported by  32 percent workers was affected by a headache. Frequent body ache was more prevalent among the garment workers.  30 percent respondents suffered from frequent body ache.  The third common complaint was the musculoskeletal pain (25%). Only 9 percent suffered from the eye problem, 3 percent are skin irritation whereas 1 percent suffered from diarrhea diseases.

 Table 7: Relationship between Age and Physical Problem

Table 7 revealed that statistically there is no significant relationship (r= 0.15, p> .05) between age and physical problem.

Table 8: Relationship between Nature of job and Physical Problem

Table 8 revealed that statistically there is no significant relationship (r=-0.11, p> .05) between nature of job and physical problem.

Table 9: Relationship between lthe ength of service and Physical Problem

Table 9 revealed that statistically there is no significant relationship (r= 0.12, p> .05) between length of service and physical problem.

Table 10: Relationship between working hours and Physical Problem

Table 10 revealed that statistically there is no significant relationship (r= 0.15, p> .05) between working hours and physical problem.

Discussion:

Most of the garment workers lead very poor lives. They come from different areas of Bangladesh. Most of them live in semi slum areas with limited living condition. They come with other garment worker of their native villages.   Most of the girls are of below 19 to 25 years. This age is proper time for education but they are deprived of that. As a result vast majority female worker’s (76%) had primary level education. Traditionally, the parents of a girl, especially in rural Bangladesh, try to marry her, once she reaches puberty, as she becomes a matter of concern for the family. The study revealed that most of the garment workers (50%) are married who are living with their family. Garment workers go to factories very early in the morning and return home at 8 or 9pm at night. Most of the female workers work more than 8 hours. According to the Labour Law, the maximum working hour per day is 10 including the 2 hours overtime. The salary structure is very poor. Although they work extremely hard but their salary structure is not attractive at all. A girl hardly receives monthly salary of 3000 to 5000 tk approximately and sometimes even lesser than this amount. Sometimes salary is not paid in due time With this meager amount of money, they can ill afford to think about their health since the bulk of the amount of their earnings go for the causes of house rent, foods, clothing etc.  There is no doctor or health care facility. In some cases (44%) there are no sufficient and pure drinking water and toilets for the workers. This study also showed that 59% workers work in a sitting style and 41% workers on standing. They suffer from frequent body ache, musculoskeletal pain because of continuous work in the same position either sitting or standing. 32% worker suffered from headache and most of them complaints about the noise of the machine for this problem. The environment where they work is suitable for working with sufficient lighting and ventilation.

The study also showed that there is no significant relationship between age, length of service, working hours and nature of job with physical problem. The reason could be concluded as below:

• Out of 100 workers 70 are under the age of 25 – the stamina and physical strength are relatively high in this age group.
• 54% of the workers have length of service less than 3 years. This might be one of the reasons for such insignificant relationship.
• Less overtime seems to be a driving factor for this result. 20% workers do not work overtime and 58% workers have overtime for limited extent.

Conclusion

All of us must realize that the current crisis in RMG sector is not something isolated from the overall socio-economic problems. Like everywhere else, there is huge a ‘Trust Gap’. The owners and the labourers cannot build enough confidence among themselves to have an equitable solution to the problem. Both the parties must realize that they have bigger interest at stake to protect the industry. Violence, coercion or anything imposed forcefully will not solve the problems. All the parties must come into an equitable solution keeping in mind the bigger interest of the economy. RMG sector in Bangladesh has come a long way in last two decades. The industry has crossed many hurdles to stay competitive. It has proved many predictions futile and wrong, and compete fiercely even after the abolition of quota. The credit for that achievement goes to both the entrepreneurs and the labourers. Taking that fighting spirit ahead, the RMG sector must formulate an equitable solution for all the involved parties and ensure brighter future for the country as a whole. Last but not the least, the poor female garments workers, who are the major workforce behind this sector must be recognized properly and concrete ideas and their implementation should come to lessen the plight of them. Unless and until we fail to ensure the basic rights of the poor female garments workers, we can’t expect this sector to achieve its desired goal.

Recommendations: 

There is an urgent need for action to improve the working environment of women workers in the RMG industry of Bangladesh. To ensure a safe, secured and healthy work environment the following recommendations may be suggested.

1. The physical layout of the garment factories should be improved. There should be a number of adequate toilets, separate washroom, lunch place and canteen for the workers.
2. There should be adequate fire fighting equipment’s and fire fighting training. More than one path for entry and exit is a must to evacuate the workers in case of emergency.
3. Workers comfort and safety should be given first priority to improve their work environment. Employers should provide equipment’s such as masks, gloves, caps etc for safety and hygienic purpose. Workers sometimes do not feel comfortable to use these safety kits. Employers to motivate them and make it compulsory.
4. Steps should be taken to eliminate overtime work from the garments industry by establishing a two shift working system.
5. There should be a full time doctor in each factory for regular medical check-up of the workers.
6. The negative impact of garment industry jobs on the health of female workers is a matter of grave concern. Here, policy intervention is urgently needed. Providing compensation for injuries and accidents is essential.
7. Day care centre’s might be made available in or around work place. The mental stress of the working mothers can be minimized by introducing day care centres.
8. Attempt should be made to provide secure and low cost housing facilities to the female workers. Initiatives have been taken by Nari Uddyoug Kendra (NUK) in this area. The Bangladesh Garments Manufacturers and Exports Association (BGMEA) have already signed an agreement with NUK to build low cost houses for the garment workers. The BGMEA has provided land for this project (Paul-Majumder, 2008). Many more such projects are needed.
9. To create a cordial social environment in the work place, the management and the workers should interact openly with each other.
10. Women welfare officers may be posted who will visit each floor regularly to hear out the complaints or problems of the female workers.