Assessment of knowledge, attitudes, and practices towards persistent organic pollutants among informal waste recyclers in Debre Markos, Ethiopia

Informal waste recycling is a primary pathway for exposure to Persistent Organic Pollutants (POPs) in developing nations, yet safety practices in this sector remain under-researched. This study assessed safe practices toward POPs and identified associated factors among informal recyclers in Debre Markos Town, Northwest Ethiopia. A community-based cross-sectional study was conducted among 422 informal recyclers selected via a snowball sampling technique. Data were collected using a structured face-to-face interview questionnaire. Knowledge, attitude, and practice were measured using standardized items, with Bloom’s cut-off point used to define good knowledge and safe practice. Data were analyzed using bivariable and multivariable logistic regression. Statistical significance was declared at p < 0.05 with 95% Confidence Intervals (CI). The response rate was 98.8%. The proportions of participants with good knowledge and favorable attitudes toward POPs were 35.5% and 42.7%, respectively. Regarding practice, only 40.8% of the informal recyclers demonstrated safe practices, while the majority (59.2%) engaged in hazardous handling. In the multivariable analysis, good knowledge of POPs (AOR = 11.84; 95% CI 5.89–23.79), tertiary educational status (AOR = 5.47; 95% CI 2.39–12.53), and having > 5 years of work experience (AOR = 2.41; 95% CI 1.29–4.50) were identified as the independent predictors of safe practices toward POPs. Safe practices toward POPs among informal recyclers were low, with over half the population operating under high-risk conditions. The study highlights that specialized knowledge and formal education are the most critical drivers of safety compliance. Interventions should prioritize POP-specific occupational health training and the integration of the informal sector into formal waste management frameworks to mitigate long-term toxicological risks such as endocrine disruption and cancer.