Risk factors for problematic alcohol use among male waste pickers and caddies in Johannesburg, South Africa: a cross-sectional study

Tahira Kootbodien,Kerry Wilson,Simbulele Mdleleni,Vusi Ntlebi,Matimba Makhubele,Nonhlanhla Tlotleng,Felix Made,Nisha Naicker

doi:10.1080/19338244.2021.1879720

Abstract

Informal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income. The aim of this secondary analysis was to investigate problematic alcohol use risk factors among male informal workers in Johannesburg, South Africa. Alcohol use among the two groups of informal workers in the analysis y golf caddies and waste pickers was measured using the World Health Organization (WHO) Alcohol Use Disorder Identification Test (AUDIT) tool. The WHO self-reporting questionnaire (SRQ) for common mental health disorders (CMD) was used to assess mental health. A multivariate logistic regression model was used to explore the predictors of problematic drinking in informal workers. The study consisted of 514 participants, of which 48.4% were golf caddies and 51.6%, waste pickers. Most participants were younger than 40 years (50.9%). Over half of the participants (54.7%) were alcohol consumers and 74.1% were smokers. Over 60% of the participants who were alcohol consumers had a probable drinking problem. Unstratified regression results showed that common mental distress (aOR = 1.06; 95%CI: 1.01–1.09), age: 30–40 years (aOR = 2.17; 95%CI: 1.18–3.97), smoking (aOR = 2.25; 95%CI: 1.34–3.79), and other water sources (aOR = 0.2; 95%CI: 0.04–0.99) were associated with a probable alcohol problem. Waste pickers (aOR = 0.33; 95%CI: 0.20–0.70) were less likely to be problematic drinkers compared to golf caddies. Problematic drinking in this study was common in both caddies and waste pickers along with smoking. Problematic alcohol use was associated with caddying, mental distress, age, and smoking. Measures such as providing counseling services to informal workers and improvement of working conditions may help change the behaviors of these vulnerable groups.

Highlights

The International Labour Organisation (ILO) defines an “informal economy” based on two methods
Problematic alcohol use was associated with the type of informal work, mental distress, age, and smoking
Measures such as providing counselling services to informal workers and improvement of working conditions are needed to change the behaviours of this vulnerable group

Summary

Introduction

The International Labour Organisation (ILO) defines an “informal economy” based on two methods. The first method is based on whether an enterprise in which workers are employed is registered with the authorities. The informal economy is often characterised by lowincome opportunities, temporary employment, low productivity, and small-scale enterprises using labourintensive activities [4]. South Africa (SA) is characterised by a relatively small economy, high levels of unemployment, high poverty levels, and high-income inequality leading to informal employment [1, 2]. In 2018, the informal sector comprised approximately 2.5 million workers and business owners [5]. Informal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income.

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