Self-Reported Workplace Injuries Among Informal Waste Pickers in Landfill Sites in Johannesburg, South Africa

While South Africa's recycling chain relies heavily on informal labour, the burden of non-fatal workplace injuries among landfill-based waste pickers remains poorly characterised. This study aimed to estimate the prevalence of self-reported non-fatal workplace injuries and identify associated factors among informal waste pickers at landfill sites in Johannesburg, South Africa. We conducted a cross-sectional study at two purposively selected landfill sites in Johannesburg. Using convenience sampling, 354 waste pickers were enrolled (median age 34 years; 73.2% male). A structured questionnaire captured worker characteristics and self-reported injuries over the preceding six months. Robust (modified) Poisson regression was utilised to determine associations with self-reported workplace injury. Overall, 86.2% of participants reported at least one injury. Lacerations caused by contact with waste materials predominated (82.7%), followed by violence (20.5%) and needle-stick injuries (19.9%). Notably, 94.1% of participants reported using personal protective equipment (PPE), yet the injury prevalence was high. In the multivariable model, each additional year of landfill work experience was associated with a 1.0% higher prevalence of reported injury (adjusted prevalence ratio [aPR] 1.01; 95% CI 1.01-1.02). Conversely, pickers aged 51 years and older had a 32% lower prevalence of injury than those aged 18-28 (aPR 0.68; 95% CI 0.51-0.90). To mitigate these risks, municipal authorities should implement mandatory safety training for site entry, provide industrial-grade, puncture-resistant PPE, and formalise the integration of landfill pickers into institutional occupational health frameworks.