Occupational Health Risks and Health-Care Burden Among Informal Construction Workers in Wayanad District, Kerala

The construction sector is one of the most labour-intensive yet hazardous segments of the informal economy. Workers are exposed to multiple occupational risks, including work at height, heavy manual labour, dust and cement exposure, unsafe machinery, heat stress, dehydration, and musculoskeletal strain. This study examines occupational health risks and the associated health-care burden among informal construction workers in Kerala using primary data from 243 workers across various occupational categories. The findings reveal that occupational health outcomes are shaped not only by working hours but also by exposure conditions, safety practices, and access to basic amenities such as drinking water and health insurance. Approximately one-fourth of workers reported work-related injuries within the past year, while protective equipment usage remains irregular. Heat stress and dehydration emerge as critical concerns, compounded by inadequate access to safe drinking water. The study highlights that health-care burden extends beyond treatment expenditure to include substantial wage loss, particularly among daily wage workers. The paper argues for a comprehensive occupational health framework integrating preventive safety measures, worksite welfare facilities, insurance coverage, and income protection mechanisms.

Informal labour, construction workers

1. Adsul, B., Laad, P., Howal, P., & Chaturvedi, R. (2011). Health problems among migrant construction workers: A unique public–private partnership project. Indian Journal of Occupational and Environmental Medicine, 15, 29–32. https://doi.org/10.4103/0019-5278.83001 [Google Scholar] [Crossref]

2. Chen, M. (2016). The Informal Economy: Recent Trends, Future Directions. NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, 26. https://doi.org/10.1177/1048291116652613 [Google Scholar] [Crossref]

3. Erlangga, D., Suhrcke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review. PLOS ONE, 14, e0219731. https://doi.org/10.1371/journal.pone.0219731 [Google Scholar] [Crossref]

4. Härmä, M., Kecklund, G., & Tucker, P. (2024). Working hours and health – key research topics in the past and future. Scandinavian Journal of Work, Environment & Health, 50, 233–243. https://doi.org/10.5271/sjweh.4157 [Google Scholar] [Crossref]

5. Iriart, J., Oliveira, R., Xavier, S., Costa, A., Araújo, G., & Santana, V. (2008). Representations of informal jobs and health risks among housemaids and construction workers. Ciência & Saúde Coletiva, 13, 165–174. https://doi.org/10.1590/S1413-81232008000100021 [Google Scholar] [Crossref]

6. Leigh, J. (2011). Economic Burden of Occupational Injury and Illness in the United States. The Milbank Quarterly, 89, 728–772. https://doi.org/10.1111/j.1468-0009.2011.00648.x [Google Scholar] [Crossref]

7. Lund, F. (2012). Work-related social protection for informal workers. International Social Security Review, 65(4), 9–30. https://doi.org/10.1111/j.1468-246X.2012.01445.x [Google Scholar] [Crossref]

8. Morudu, P., & Kollamparambil, U. (2020). Health shocks, medical insurance and household vulnerability: Evidence from South Africa. PLOS ONE, 15, e0228034. https://doi.org/10.1371/journal.pone.0228034 [Google Scholar] [Crossref]

9. Mwemezi, B., Kikwasi, G., & Phoya, S. (2023a). Perilous Work Zones: Unveiling the Factors Influencing Health and Safety Risks in Tanzania’s Informal Construction Sites. University of Dar Es Salaam Library Journal, 18, 76–92. https://doi.org/10.4314/udslj.v18i1.6 [Google Scholar] [Crossref]

10. Mwemezi, B., Kikwasi, G., & Phoya, S. (2023b). The Paradox of Health and Safety Risks: A Disclose of Handling Strategies in Informal Construction Sites in Tanzania. The Indonesian Journal of Occupational Safety and Health, 12, 372–381. https://doi.org/10.20473/ijosh.v12i3.2023.372-381 [Google Scholar] [Crossref]

11. Nag, P., VYAS, H., & NAG, P. (2016). Occupational health scenario of Indian informal sector. INDUSTRIAL HEALTH, 54. https://doi.org/10.2486/indhealth.2015-0112 [Google Scholar] [Crossref]

12. Nguyen, K., Khuat, O., Ma, S., Pham, C., Khuat, G., & Ruger, J. (2012). Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection. American Journal of Public Health, 102, 1450–1461. https://doi.org/10.2105/AJPH.2011.300618 [Google Scholar] [Crossref]

13. Panikkar, B., Woodin, M. A., Brugge, D., Hyatt, R., Gute, D. M., & Community Partners of the Somerville Community Immigrant Worker Project. (2014). Characterizing the low wage immigrant workforce: A comparative analysis of the health disparities among selected occupations in Somerville, Massachusetts. American Journal of Industrial Medicine, 57(5), 516–526. https://doi.org/10.1002/ajim.22181 [Google Scholar] [Crossref]

14. Pentapati, S., Giridharan, S., Vanni, P., & Jain, R. (2023). P-333 Health related economic burden among unorganized sector workers: A systematic review and meta-analysis. In Occupational and Environmental Medicine (Vol. 80, p. A99). https://doi.org/10.1136/OEM-2023-EPICOH.244 [Google Scholar] [Crossref]

15. Quinlan, M., Mayhew, C., & Bohle, P. (2001). The Global Expansion Of Precarious Employment, Work Disorganization, And Consequences For Occupational Health: A Review Of Recent Research. International Journal of Health Services, 31(2), 335–414. JSTOR. http://www.jstor.org/stable/45131492 [Google Scholar] [Crossref]

16. Ravindranath, D., & Iannotti, L. (2019). Maternal Health and Access to Healthcare among Migrant Workers Engaged in Informal Construction Work, Ahmedabad, India. https://doi.org/10.21203/rs.2.15199/v1 [Google Scholar] [Crossref]

17. Santos, W., Lorente, A., Rojas, C., Mariscal, G., & Lorente, R. (2025). Impact of personal protective equipment in preventing occupational injuries: A systematic review and meta-analysis. Frontiers in Public Health, Volume 13-2025. https://doi.org/10.3389/fpubh.2025.1720363 [Google Scholar] [Crossref]

18. Shrinivas, A., Jalota, S., Mahajan, A., & Miller, G. (2021). Illness and Wage Loss: Longitudinal Evidence from India (and Implications for the Universal Health Coverage Agenda). https://doi.org/10.1101/2021.11.04.21265892 [Google Scholar] [Crossref]

19. Shrinivas, A., Jalota, S., Mahajan, A., & Miller, G. (2022). The importance of wage loss in the financial burden of illness: Longitudinal evidence from India. Social Science & Medicine, 317, 115583. https://doi.org/10.1016/j.socscimed.2022.115583 [Google Scholar] [Crossref]

20. Soundararajan, S., Viramgami, A., Sheth, A., Ravichandran, B., Kalahasthi, R., Sampathraju, R., Venugopal, D., Sarkar, K., & Balachandar, R. (2024). Assessing Health Seeking Behaviors and Economic Consequences of Morbidity in Indian Construction Workers: A Multicenter Study. Indian Journal of Occupational and Environmental Medicine, 28, 49–55. https://doi.org/10.4103/ijoem.ijoem_63_23 [Google Scholar] [Crossref]

21. Vo, T., & Pham, V. (2019). Can health insurance reduce household vulnerability? Evidence from Viet Nam. World Development, 124. https://doi.org/10.1016/j.worlddev.2019.104645 [Google Scholar] [Crossref]

22. Yusiana, V., Muchlisinalahuddin, Martanto, Maluw, F., & Pangemanan, D. D. G. (2025). The Relationship Between Personal Protective Equipment Use and Reduction in Workplace Injuries. Miracle Get Journal. https://api.semanticscholar.org/CorpusID:278940859 [Google Scholar] [Crossref]

23. Zheng, L., & Peng, L. (2021). Effect of Major Illness Insurance on Vulnerability to Poverty: Evidence From China. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.791817 [Google Scholar] [Crossref]

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