Inherent Risk Footwear Industry - DOC

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					      The Blight in the Footwear Industry: Assessment of the Safety, Health and
Environment of Child Workers in the Footwear Industry in Biñan, Laguna, Philippines
      Occupational Safety and Health Center, Department of Labor and Employment
                          E-mail: oshcenter@oshc.dole.gov.ph

I. INTRODUCTION

       1. Background

A 1999 survey of the Occupational Safety and Health Center (OSHC) on child labor in the
footwear industries of Marikina and Binan revealed the existence not only of child labor but
also of considerable workplace hazards, which put children at risk. This study demonstrated
that most places visited were cramped, poorly lit and dusty with little ventilation and poor
sanitary conditions. The presence of solvents were cause for concern as living and working
areas were often the same for the families engaged in footwear manufacturing. The study
served to validate an earlier report on Child Workers in Footwear Manufacturing in Marikina
(Trends-MBL, 1994). Marikina and Binan are towns where much of Philippine footwear is
located.

Both researches demonstrated that children, some as young as 8 years old, both male and
female, were employed in small-scale shoe and slipper producing factories in Marikina and
Binan. The children and their families exposed to hazards at work tended to disregard these
risks and continue to work, primarily to earn money.

In recognition of these facts, the footwear industry has been identified by the ILO-
International Program for the Elimination of Child Labor (ILO-IPEC) as a sector where
intervention is necessary. The ILO-IPEC then held several consultations in 2000 with local
governmental and non-governmental agencies and organizations in connection with the
drafting of a comprehensive, multi-sectoral, Action Program. In support of the broader ILO-
IPEC Action program, the OSHC recommended a two-pronged, hazard-focused approach in
the campaign against child labor: 1) the progressive elimination of child labor through
awareness raising in occupational safety and health; and 2) the protection of working children
from hazards. The specific action program included the following: improving knowledge on
hazards ran by child laborers in the footwear industry; enhancing monitoring of child labor in
this sector; advocacy for parents, support groups, employers, training institutions; and access
of working children to primary health care and specialized organizations, thru a network of
partners and stakeholders. Following approval by ILO-IPEC implementation of activities
commenced in January 2001.

       2. Objectives of the OSHC Action Program

1) To document, record and monitor the health of child laborers, as well as the working
conditions and safety hazards in the footwear manufacturing establishments of Binan,
Laguna; initiate information and education campaigns against child labor within the
community, especially among parents, employers and children; make recommendations on
the improvement of workplace health and safety.

2) To promote linkage between OSH initiatives and economic and educational strategies in
the community to encourage parents, community leaders and employers to withdraw children
from work and find alternatives to child labor.

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3) Case study: This case study is a component of the action program; it involves assessment
and evaluation in the areas of health, safety and work environment, which should serve as the
basis for further - medical follow-up to be provided by local services as well as technical
primary prevention services on workers’ health, industrial hygiene and safety to be provided
by the OSHC.

The findings will also serve as inputs for an information package, for children and their
families, as well as implementors of the program--in the awareness raising for a wider
public. It will equally serve as basis for increasing the capability of partners within the
community in identifying hazards in footwear production, particularly where workplace is
combined with living quarters, as well as managing their risks.


II.        METHODOLOGY

A cross-sectional purposive survey was conducted by a team composed of occupational
health practitioners, industrial hygienists and safety engineers from the Occupational Safety
and Health Center of the Department of Labor and Employment. They simultaneously carried
out clinical, work environment and safety audits among child workers, in their workplaces in
Barangay1 de la Paz, Binan, Laguna. The health team interviewed and examined 93 working
children in Puroks2 4 and 5 of Barangay de la Paz while work environment measurement and
safety audit of 17 pre-selected workplaces in the area were done. Ocular visits and Focus
Group Discussion complemented the technical assessments.

   1. Preliminary visits were held to prepare the ground for the case study. Meetings with
ILO-IPEC staff and members of the League of Binan Leaders were carried out, as well as
ocular visits to the selected worksites.

      2. Health Assessment

For assessing the respondents health status, each child was examined clinically. Chest X-ray,
blood chemistry, urine and urine metabolities were also done. A questionnaire used elicited
information on the children’s socio-demographic and occupational history, and enquired on
symptoms in general.

      3. Work Environment Measurement

Following the ocular assessment, 17 workplaces were visited. The choice was based on the
preponderance of children working in those addresses. The following were measured: dust,
organic solvents, illumination and general ventilation. Most of the work areas where
measurements were conducted were found inside the house of the operators.

Dust
       Dust monitoring was done through area sampling using Sibata low volume sampler
equipped with 35 mm diameter filter. The sampler was operated at the following rates:
1.5l/min for respirable dust of 3.0 l/min for total dust. The collected dust samples were
analyzed gravimetrically with the aid of a Mettler AE 240 analytical balance.

1
    Barangay – smallest geographical unit; subdivided into various puroks
2
    Purok – zone within the barangay

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Organic Solvents
       Area sampling using the Solid Absorption method was used to determine the presence
of the following organic solvents in the environment: n-Hexane, Toluene and Benzene.
During the sampling process, an MP-2N mini pump was used with a flowrate of 0.3 –
0.5L/min. Samples were analyzed using a Shimadzu gas Chromatograph model 14A.

Illumination Measurement

       Illumination at the workplaces was measured using a Topcon Luxmeter.

General Ventilation

      Assessment of general ventilation conditions was done by the use of a
thermoanemometer, Sibata Brand, model ISA-20N to measure air velocity.

   4. Safety Audit

Safety audit of workplaces was done through observation of the footwear manufacturing
processes. The living and working conditions were also noted to determine the presence of
safety hazards.

   5. Focus Groups Discussions

This involved 12 respondents consisting of operators of footwear in the two Puroks, NGOs,
IPEC monitors, and members of the League of Binan leaders. Questions focused on
perception of their working conditions, their ability to identify hazards, as well as the type of
risk management they applied, if any.


III.   RESULTS
       1. Ocular Survey

Majority of the workplaces were in the houses of respondents. Each family visited had 2-5
members working as footwear workers The houses were one-story structures with low
ceilings and mostly beaten earth as flooring. Few had, rough concrete, or elevated wooden floors.
The walls were sometimes made of wood, at times they were combined with some concrete.

The average work area varied from 4 to 60 sq. meters. In two instances, separate workshops
were located in the backyard. All these workplaces had natural ventilation coming through
open windows and doors. The areas used for cutting, drying, boring holes, fastening shoes to
sole and gluing were provided with small wooden tables and stools and lit with 40-watt
fluorescent lamps. Some workers were seated on cans or improvised seats. Children engaged
in folding cartons into shoeboxes were seated in places of their choice in the work areas.
Chemicals used as adhesives and primers were placed on the working tables and stored inside
the house. Some were unlabelled and left without cover. The workplaces were hot and humid.




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 In all the households visited, containers of these chemicals were found anywhere in the
workplace. No specific storage areas were provided and therefore the active harmful
ingredients were not known.

Work processes included pattern making, cutting of leather, application of adhesives such as
rugby and contact cement and shoebox making. The raw materials such as shoe leather,
rubber, or wood were cut and shaped into size based on the patterns. Materials were formed
and glued by using wooden molds and rubber adhesives. All footwear produced were thus
produced by hand in their respective homes. Workers wore rubber slippers, undershirts and
shorts while working. No personal protective equipment were used.

       2. Health Assessment

           2.1 Socio-Demographic Profile

Table 1 shows the socio-demographic characteristics of the working children in Barangay De
La Paz, Binan, Laguna. Ninety-three (93) children were brought by IPEC monitors to their
school and were interviewed, however, only 91 submitted to all medical examinations since
two children refused blood extraction. Of the 93 children, 53% were males and 47% females.
The children’s ages ranged from 5 to 17 years old with 47% between the ages of 11 and 15
years old. 83% of the children attended school, 56% in the elementary level.


                 Table 1: Socio-demographic Profile of Child Laborers

        Socio-demographic characteristics     No. of Subjects (n=93)     Percentage (%)
        Sex:
             Male                                      49                      53
             Female                                    44                      47
        Age (years): (range: 5-17)
             <5                                         1                       1
             6-10                                      38                      41
             11-15                                     44                      47
             > 16                                      10                      11
        Education:
        In school                                      77                      83
            Elementary                                 56                     (73)
            High School                                20                     (26)
            College                                    01                      (1)
        Out-of-school                                  16                      17
            Elementary                                  6                     (38)
            High School                                 8                     (50)
            Vocational                                  1                      (6)
            Other reason                                1                      (6)



       2.2 Most Common Work Given to Children

Table 2 shows that most children interviewed started work at age 7 (20%) while 15% of the
children began helping in making footwear at both 8 and 9 yrs old. The children had worked
in footwear manufacturing for 2.2 years on average. The most common tasks given to
children were: pasting, making boxes or packaging footwear, storing and cleaning. Older
children were allowed to cut and thread the leather.

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The majority of the respondents said that they liked the work they were doing (76 vs. 11
children who did not like the work). The reasons given in favor included: helping the family,
earning extra income, work was fun, and to learn the trade. The reasons cited against
working were as follows: the children preferred to do other things, the work deprived them of
playtime and the strong smell of chemicals at the workplace.


              Table 2: Most Common Work Assigned to Children (n= 91):


          Ave. no. of years working                             2.2 + 1.9 yrs ( r: 0-9 yrs)
          Age when started working (yrs)
               5                                                       2 (2%)
               6                                                       8 (9%)
               7                                                     19 (21%)
               8                                                     14 (15%)
               9                                                     14 (15%)
             10                                                      10 (11%)
            11-17                                                    24 (27%)
          No. of children who liked work                             76 (82%)
             Reasons:
             To help family                                          49 (53%)
             To earn                                                  7 (7.5%)
             Fun                                                      7 (7.5%)
             To learn                                                  2 (2%)
             Avoid scolding                                             1 (1%)
             No reason                                               10 (11%)

          No. of children who did not enjoy work                      11(12%)
            Reasons:
            Would rather do other work                                  3 (3%)
            Tiring/ Cannot play                                         3 (3%)
            Bad smell at work                                           2 (2%)
            Must study and work                                         1 (1%)
             No reason                                                  2 (2%)
          Work Activities of children:
            Pasting                                                         37
            Put shoes in boxes/prepare boxes                                31
            Put away shoes                                                  26
            Cleaning                                                        20
            Finishing                                                       17
            Cutting                                                         16
            Threading                                                       11
            Folding                                                          6




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       2.3 Health Examinations

The most salient findings on physical examination were the presence of cervical lympha-
denopathy among 33 children and findings indicating malnutrition as shown below. Figure 1
shows the Weight for Age of the children examined in terms of percentile. Figure demons-
trates that 52% of boys and 30% of girls fell below the 50th percentile for weight for
Filipinos. Conversely, only 48% of boys but 70% of girls were above the 50th percentile of
the reference population for Filipino children.

Figure 2 shows the Height for Age of the children examined in terms of percentile. The
percentile system is based on Tables containing data on growth and development which
allow comparison of a particular child with children of his own age and with his own pattern
of development. Height and weight are the most practical and useful parameters in the
physical assessment of a child.

The graph shows that 69% of boys and 33% of girls fall below the 50th percentile for weight
for age of the standard values for Filipino children. Only 31% of boys but 67& of girls were
above the 50th percentile.


    Figure 1. Weight for Age distribution among examined children (in percentile)


                                         Weight for Age

                                                               70%
                 70%
                            52%
                 60%                              48%
                                                                      Male
                 50%
                                        30%
                 40%
                                                                      Female
                 30%

                 20%

                 10%

                  0%
                           < 50 %tile             > 50 %tile
                                  Weight for Age Percentile




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     Figure 2 Height for Age distribution among examined children (in percentile)

                                           Height for Age

                               69%                                67%
                  70%

                  60%

                  50%                      33%
                                                      31%
                  40%                                                   Male
                  30%

                  20%
                                                                        Female
                  10%

                   0%
                              < 50 %tile             > 50 %tile
                                  Height for Age Percentile




           2.4 Health Complaints

Table 3 shows a list of subjective complaints that the children experienced in the course of
their work. The symptoms most often experienced; i.e., > 4x/month, were forgetfulness,
headache, fatigue and irritability. The symptoms sometimes experienced, i.e, 1-3x/month,
were: headache, dizziness, fatigue, irritability, nausea, forgetfulness, dry skin, drowsiness,
shortness of breath, heaviness, lightheadedness, chest tightness, nasal irritation, skin rashes,
vomiting and eye strain. Three out of four “often experienced” symptoms, and 5 out of the
sixteen “sometimes experienced” symptoms reported, though general symptoms, may lead
the researcher to a more detailed neurological study in future since these symptoms maybe
early signs of neurological involvement. These symptoms may be secondary to exposure to
the chemicals used at work but other factors in both the home and outside environment may
contribute to these complaints as well.




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            Table 3. Subjective complaints experienced by child respondents

           Subjective Complaints        Frequency               Percent
       Often experienced
          Forgetfulness                     15                   16.13
          Headache                          12                   12.90
          Fatigue                           12                   12.90
          Irritability                      12                   12.90
       Sometimes experienced
          Headache                          45                   48.39
          Dizziness                         38                   40.86
          Fatigue                           21                   22.58
          Irritability                      20                   21.51
           Nausea                           18                   19.35
          Forgetfulness                     18                   19.35
          Skin Dryness                      18                   19.35
          Drowsiness                        17                   18.28
          Shortness of Breath               17                   18.28
          Heaviness                         16                   17.20
          Lightheadedness                   15                   16.13
          Chest Tightness                   15                   16.13
          Nasal Irritation                  15                   16.13
          Skin Rash/Itching                 14                   15.05
          Vomiting                          13                   13.98
          Eye strain                        12                   12.90



In Table 4, the most frequent musculoskeletal complaints were pain in the neck, the
shoulders, lower back, knees and upper back. Five respondents said the complaints were due
to work postures; while others reasoned that the pains originated from playing or resulted
from such accidents as slips and falls.

                 Table 4: Musculoskeletal complaints of child workers

                     Musculoskeletal Disorder                Frequency
                       (Body Part Affected)
               Neck                                               20
               Shoulder                                           18
               Lower back                                         14
               Knees                                              12
               Upper back                                         11
               Wrist, right                                        8
               Hips/Thighs                                         7
               Ankles                                              5
               Wrist, left                                         4
               Wrist, both                                         2
               Elbow, right                                        1
               Elbow, left                                         1
               Elbow, both                                         1




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Table 5 shows some abnormal findings noted in the medical examinations conducted. CBC
results show one person with low hemoglobin value. In the blood chemistry examinations, 17
children were found to have significantly elevated values (1.5x upper limit of normal) of
alkaline phosphatase (AP).

Urinalysis revealed 4 children with protein in the urine which can be related to conditions
ranging from nutritional deficiency, dehydration or possible renal disease. Six (6) subjects
had high number of pus cells per high power field while 3 other children had red blood cells,
indicative of infection. The urine samples were tested for the presence of hippuric acid (HA),
a metabolite of toluene, an organic solvent present in adhesives, however no child showed
high HA levels.

Chest X-rays of the children showed nine who had findings of pneumonitis in one or both
lower lung lobes.

           Table 5: Significant physical and laboratory examination findings
                            noted among child respondents

      Medical Examination Results                Frequency              Percent
   Laboratory Results:
   CBC (n=91)
     Low hemoglobin                                   1                   1.10

   Blood Chemistry (n=91)
      Elevated Alkaline Phosphatase                   17                 18.68

   Urinalysis (n=92)
      Protein (+)                                     4                   4.35
      Presence of Pus Cells                           6                   6.52
      Presence of RBC                                 3                   3.26

   Urine Metabolites (n=92)
     Elevated Hippuric Acid                           0                      0

   Radiologic Findings (n=91)
     Pneumonitis                                      9                   9.89

   Physical Examination Findings
   (n=93)
      Cervical Lymphadenopathy                        33                 35.48


   6. Work Environment Results: The results showing measurements of dust, organic
      solvents, illumination and general ventilation are found below and are summarized in
      Table 6.




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Dust

        Total dust refers to all dust particles in the workplace while respirable dust refers to
that fraction of total dust, which passes through a selector whose size is 7 microns or less in
diameter, which can be inhaled or deposited in the lungs.

        Ambient concentrations of total and respirable dusts were measured in 17 footwear-
manufacturing households. Total dust concentrations ranged from 0.17 to 0.77 mg/m3 while
respirable dust concentrations ranged from 0.02 to 0.36 mg/m3. These were within the
threshold limit values (TLV) of 10.0 and 5.0 mg/m3 for total and respirable dust, respectively,
based on the Occupational Safety and Health Standards (OSHS) of the Department of Labor
and Employment (DOLE), 1990 (Annex 1).

Organic Solvents

         The constituents of commercially used adhesives in the footwear industry were n-
hexane, toluene and benzene. Ambient concentrations of these solvents in all the
establishments were measured and gave values of 1800, 375 and 80 mg/m3 respectively.
Based on the TLV for Airborne Contaminants set by the OSHS of DOLE (1990) these were
found to be below their corresponding threshold limit values (Annex 2). These could be
explained by the low production because of scarcity of orders for their products. During the
work environment measurements, workers were mostly found doing activities like cutting,
boring holes and fastening shoes. Child workers were engaged in folding cartons into shoe
boxes. During the actual measurements, the only source of solvent exposure were from the
cans of adhesives placed in corners of the house.

Illumination Measurement

         The lighting requirement in the workplace is task-dependent. In the case of the
activities involved in footwear manufacturing where close discrimination of details is
essential, the recommended illumination level is 300 lux. Measurements revealed that only
two establishments met this required level. At the time of measurement, the workshops
maximized the use of doors and windows as source of natural lighting. There were also those
who used fluorescent lamps . (Annex 3 ).

General Ventilation

        Although the air movement met the required standards, the relative humidity and
temperature, as well as the congested area contributed to the uncomfortable thermal condition
in the workshops. Based on the results of air velocity measurements, the average air
velocities were within the recommended air movement of 0.25-0.75 meters per second (m/s),
based on Rule 1070.04 of the OSHC, DOLE. (Annex 4).




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        Table 6: Summary of Work Environment Measurement (WEM) Results:

        WEM Conducted             Range of Values    Threshold           Frequency of
                                                     Limit Value     establishments with
                                                        (TLV)       values not within TLVs
                    3
     Dust: (mg/m )
          a. Respirable               0.02-0.36           5.0                  0
               Dust                   0.17-0.77          10.0                  0
          b. Total Dust
     Organic Solvents
             3
     (mg/m ):
         a. n-hexane                0.0001-0.1591        1800                  0
         b. Toluene                 0.0001-0.0088         375                  0
         c. Benzene                 0.0001-0.3764          80                  0
     Illumination (lux)                12-3630            300                 15
     General Ventilation
         Air Velocity (m/sec)        0.10-0.25 -       0.25-0.75               0
                                      0.70-1.0



4.      Safety Audit

Based on the safety audit conducted, the characteristics of the working areas can be
summarized as follows:


        4.1     General Situation of Working Areas

                       Living/dining/sleeping area double as the work area of the family.
                       Generally dirty working area.
                       Galvanized iron roofing without ceiling or any type of insulating
                        material. Other work areas are covered only by tent.
                       Clearance from floor to ceiling varied from 1.5 meter to 3 meters
                       Semi-permanent construction of the entire work area contributing to
                        doubtful stability of the structure.
                       Improvised stacking areas within the work area.
                       Improvised storage areas within the work area.
                       Improvised electrical installation to accommodate lighting, sewing
                        machine and grinding wheel.
                       Improvised work tables and chairs.
                       Natural ventilation from windows or wall openings.
                       Light sources in other areas are from windows or wall openings only.


The work procedures of the families depended entirely on the availability of materials, tools
and equipment. The following procedures were observed in most the work areas visited:

        4.2     Work Processes
                       Use of improvised or inappropriate tools.
                       Use of improvised machines.
                       Absence of machine guards for machines.
                       Inappropriate clothing.

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                  Poor housekeeping. Raw materials, final products and wastes had no
                   designated areas.
                  No designated area for raw materials or final products
                  Awkward position of the worker.
                  Absence of personal protective equipment
                  No provision for fire and other emergencies.


On the other hand, the research team visited several workplaces where the owners had
recently attended a Work Improvement in Small Enterprises (WISE) training. Some of these
workplaces had significantly improved housekeeping and material storage practices. In these
workplaces, efforts were made to store chemicals away from the children. Some families
also observed their hygiene improvements by implementing measures like covering plates
and utensils from contamination of dust and chemicals. This was telling evidence of the
potential for successful , practical interventions to improve living and working conditions.

5.     RESULTS OF FOCUS GROUP DISCUSSION (FGD)

Respondents for the FGD included operators, civic and community leaders from Binan. The
discussion focused on their work processes, particularly making them talk about the
chemicals used in the process, as well as their practices preventing accidents. The
respondents said that adhesives and other chemicals used in the workplace included:

                                Adler                      Rugby
                               UPLY                       Primer
                                ABC                       Super X
                               Greeco                      Tiptop
                               Vulcan                     Huapao
                               Palma                      Boysen

However, operators and workers had no idea what chemicals were contained in these
materials, with the exception of benzene which they thought was in a preparation called
“cement”. Results have however shown that what they call “cement” also contains toluene,
hexane and xylene. They have also referred to a preparation called “lason” which is a Pilipino
word for “poison , merely described by its appearance “It’s a liquid, it’s in a bottle” and it is
distinguishable from other substances in its toxicity because” we have to wear gloves while
applying it”, they said. They use “lason” to remove the slippery quality of the leather, one of
the first steps in the production. Middlemen supply adhesives to the operators.

Though this discussion was short, the respondents began to show some understanding of
hazards, They then volunteered information on three incidents relating to serious, fatal work-
related accidents which have occurred in their workplaces during the past three years. An
incident recounted by one operator was about a worker who tried to burn garbage in the
backyard, but had his fingers burned in the process. He had not removed the glue from his
fingers and hands prior to burning the garbage. Another incident recounted led to the death
of a young child and a mother. This portion of discussion became very animated as the
respondents all contributed in relating their stories, and with new insight found, linking these
accidents to the flammability of solvents found in the glue.




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When asked how they control those hazards and prevent problems from recurring again, they
mentioned the practice of rubbing their hands and fingers with cooking oil for three months
in order to reduce the absorption of the chemicals.


IV. DISCUSSION
The case study has demonstrated a variety of workplace hazards in a village in Binan, Laguna
where footwear production is the main source of economic activity. The workers usually
lived in small, one story houses, with low ceilings and beaten earth as flooring. The
assessment of the children’s health, the work environment and the safety status, revealed that
children and their families are exposed to different chemicals, physical and ergonomic
stresses in their workplaces and in their immediate surroundings.

Foremost among these hazards are chemicals primarily glue and adhesives used in the
manufacture of footwear in this village. Hazards due to exposure to chemicals are
compounded by the lack of awareness on the nature of the materials young and older workers
are using, and the possible ways of entry of the chemicals into their bodies. Due to the
absence of information on the possible implications on workers’ health hazards were thus
ignored. Typical of an informal establishment, none of the containers of chemicals were
labeled. Focus Group Discussions and individual interviews revealed that in four earlier
accidents caused by fire, people did not consciously link the fire hazard to glue and
adhesives. These incidents causing two deaths, serious burns in some other cases were taken
as unfortunate events in their work. Thus, little efforts were made to achieve better working
protection and/or preventive hazard control.

Adhesives used in the footwear manufacturing process are solutions based on organic
solvents. At normal working temperature, they evolve flammable vapours. These solvents
can be divided into the natural rubber elastomers and the polychloroprene elastomers. Natural
rubber elastomer adhesives contain 90.3% (parts by weight) solvents composed of benzene,
petrol (gasoline), hexane and toluene. On the other hand, polychloroprene elastomer
adhesives contain 500% (parts by weight) solvents composed of benzene-ketone-esters,
petrol-benzene-esters, hexane-toluene-esters, hexane-toluene-ketones, benzene and toluene.

Analysis of adhesives under review showed that the main solvents were hexane, toluene,
benzene, methyl ethyl ketone, methyl isobutyl ketone, n-butyl acetate. One ingredient which
were locally called “cement” had xylene as added component. Hippuric acid (HA), a
metabolite of toluene was examined but revealed normal values; a fact which can be
interpreted as a possible competition in metabolism among the three chemicals as the same
enzyme system oxidises all three solvents, thus tending to inhibit each other. Although urine
HA gives a good guide to solvent exposure, its use is limited by the short half life span of 1 to
2 hours. While, the hot and humid environment caused the increased vaporization of volatile
solvents contained in adhesives and glue, all the workplaces had natural ventilation coming
through open windows and doors.

One could nevertheless, safely assume that adults and working children are exposed to these
substances in their average day-to-day work through inhalation, skin contact and possibly
involuntary ingestion of these chemicals. However, the normal TLV values of the three
solvents, and the urine hippuric acid level caused by the low production during the time of


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measurement does not guarantee that the workers are risk-free as daily exposure to small
quantities may have cumulative effects

Poor illumination was confirmed by measurement, while general ventilation were helped by
the natural source of air, thus preventing or minimizing exposre to harmful contaminants.

Environmental health hazards also abound. Poor sanitation was aggravated by limited supply
of water, and improvised toilets. Biological hazards were made worse by the frequent
flooding in the area caused by the proximity to the Laguna Lake. Thus, the barangays were
constantly affected by the high tides. During heavy monsoon rains and typhoon seasons,
waste and garbage spread around their homes and workplaces.

Basically all the workers were exposed albeit to varying degrees, to several types of hazards;
some inherent in footwear production, while some were due to makeshift nature of
workplaces. Examples of the latter were:
          Possible collapse of structure due to unstable construction and use of weak building
           materials.
          Fall, slip, trip, bump, hit by objects due to poor housekeeping.
          Electrocution due to poor electrical installation.
          Cuts, bruises and abrasion from use of improper tools and machines.
          Fire from the use of combustible materials and poor electrical installation.
          Eye injury due to poor lighting aggravated by the absence of safety spectacles during
           grinding operation

Malnutrition was prevalent among the male child workers examined. Both Figures 1 and 2
revealed that more male children were below the 50th percentile in terms of weight and height
compared with Filipino children of the same age. These data served as index of the
nutritional status of the subjects examined and were important in identifying not only the
subjects below the 50th percentile, but also in determining the cause of the poor nutritional
status for proper monitoring.

Another indicator, which validates the poor nutritional status of the working children
examined were the results of the liver profile: 19 % revealed highly, elevated alkaline
phosphatase levels. Although AP levels can also be elevated during periods of skeletal
growth., levels greater than 1.5x the normal value may be attributed to possible liver disease
or to nutritional problems as shown in the findings.. In this present case the highly elevated
alkaline phosphatase levels in working children could be attributed to malnutrition. To rule
out liver involvement, a further follow-up using liver profile tests need to be carried out.
Screening for liver toxicity need to be done. Since elevated liver chemistries are common,
better tests for specificity should be used for screening. The risk of solvent exposure in such
small workplaces is high. Aside from the deficient nutritional status of the subjects,
pneumonitis was noted in 10% of subjects under review through. In a country with a very
high prevalence of Pulmonary Tuberculosis (PTB), such radiologic diagnosis of pneumonitis
and findings of cervical lymphadenopathy seen in 35% of children, the diagnosis of
childhood pulmonary tuberculosis should be entertained. However, to substantiate this point,
confirmatory tests are needed such as sputum examination and PPD (purified protein
derivative) testing.

Possible secondary illnesses due to exposure to solvents need to be considered. Since the
working and living areas of these children are the same, there remains a high risk of exposure

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to chemicals. The symptoms presented such as headaches, dizziness, loss of coordination
maybe considered as manifestations of exposure to toluene, hexane and benzene, components
of adhesives.

In addition to chemicals, there is the possible synergy between malnutrition and the
prevalence of PTB in the community further reducing children’s capacity for health. Studies
have shown that child laborers under these conditions suffer more than those who are only
exposed to the environmental risks outside work.

This project is a contribution to the implementation of the ILO Convention 182 on the Worst
Forms of Child Labor. Work in footwear is included in the list of hazardous work not
allowed for children as contained in the DOLE Department Order No. 4. The study has
demonstrated the range of hazards found in this particular type of work arrangements in the
footwear sector in Binan, Laguna. That majority of the workplaces are found in their homes
poses a difficulty in terms of exposure for all members of the family. Unaware of these
hazards, the community has continued to operate and earn their living under these
circumstances


VI.    CONCLUSIONS AND RECOMMENDATIONS

The OSHC’s case study was undertaken within the context of a comprehensive project on
“Developing and Promoting Occupational Safety and Health Programmes and Services for
Working Children and their families in the Footwear Sector”. More specifically, the case
study is meant to provide a better understanding of the health and safety aspects of children’s
work, and to guide future capability building activities and interventions. These include the
creation of a network of partners designed to carry out information campaigns, training,
production of information materials, provision of primary health care services for children
and where necessary, specialized medical support. This core health and safety network should
link up with the social protection programs organized at community and provincial levels.
Specifically, the following measures are recommended:

       1. Implementation of sustainable information and advocacy drives through local
          training of trainers and through the use of local media. Such trainers would come
          from the multisectoral agencies supporting the ILO-IPEC program in Binan,
          Laguna, as well as from among the operators within the community. To ensure
          continuity, appreciation courses should be carried out by trainors on health and
          safety of children and their families working in the footwear industry.

       2. A task force of community workers, health workers, experienced footwear
          workers and ILO project staff could advise households on how to improve their
          working conditions and work processes through low cost measures using for
          example the Work Improvement in Small Enterprises (WISE) approach.

       3. To further mainstream the promotion of OSH, a network of services should
          include servicing the health and safety needs of the children and their families.
          These services could range from primary health care, directly observed treatment
          (DOT) of PTB, nutrition assistance, immunizations, work environment
          measurements; it could take the form of linking families to other work
          improvement interventions, and networking with teachers in school to ensure that

http: www.childprotection.org.ph                                                            15
Featured Paper for February 2003
          children’s special needs are attended to. The network should also establish links
          with other social protection programs within the Binan community and within the
          Laguna province in general.

       4. A data base of members of the network should be developed and continuously
          updated to widen the support from within the local community.

       5. A medical surveillance mechanism is recommended to follow-up on changes in
          the health status of the working children, to provide appropriate medical
          interventions, and to document progress.

       6. An agenda for further research on the health implications of footwear work on
          children and adults should include:
        The long-term effects of exposure to solvents on children and adults working and
          living in the same area.
        Document the learning problems of child laborers compared with non-working
          children from other barangays in Binan.
        Epidemiological studies on Pulmonary Tuberculosis, malnutrition, etc..
        The health status of infants and pre-school children born to mothers working in
          the footwear workplaces with a control group.
        Improvement of productivity related to health and safety practices.

       7. Since it is impractical to remove children from workplaces which serve as their
          living quarters , it is recommended to relocate workplaces to a special area in the
          community. Support could be gained from the local government, and from the
          different organizations working on child labor in this area.




http: www.childprotection.org.ph                                                          16
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ANNEX 1

   Dust

          Name of Owner of            Dust Concentration, mg/m3
           Establishment           Respirable dust,   Total Dust,
                                       mg/m3            mg/m3
    1. A                                 0.02             0.77
    2. B                                 0.04             0.23
    3. C                                 0.11             0.37
    4. D                                 0.31             0.64
    5. E                                 0.09             0.22
    6. F                                 0.13             0.18
    7. G                                 0.11             0.17
    8. H                                 0.36             0.46
    9. I                                 0.24             0.25
    10. J                                0.22             0.42
    11. K                                0.20             0.56
    12. L                                0.07             0.40
    13. M                                0.22             0.33
    14. N                                0.09             0.46
    15. O                                0.27             0.36
    16. P                                0.04             0.56
    17. Q                                0.20             0.36

    Mean + SD                        0.16 + 0.10      0.40 + 0.16
    Range                            0.02 – 0.36      0.17 – 0.77
    TLV                                  5.0             10.0




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ANNEX 2

       Organic Solvents:
                                                       3                      3                   3
        Measuring Point           n-Hexane, mg/m             Toluene, mg/m        Benzene, mg/m
        A
                OS1a                      0.0004                     Bdl*              0.0005
                OS1b                      0.0003                     Bdl*              0.0006
        B
                OS2a                      0.0001                     Bdl*              0.0017
                OS2b                      0.0005                     Bdl*              0.0048
        C
                OS3a                      0.0008                    0.0002             0.0494
                OS3b                      0.0036                    0.0008             0.3764
                OS3c                      0.0144                    0.0001             0.0058
        D
                OS4a                      0.0022                    0.0002             0.0109
                OS4b                      0.0028                    0.0002             0.0222
        E
                OS5a                      0.0008                    0.0001             0.1061
                OS5b                       Bdl*                     0.0002             0.0686
                OS5c                       Bdl*                     0.0001              Bdl*
        F
                OS6a                      0.0018                    0.0002             0.0142
                OS6b                      0.0160                    0.0010             0.1769
                OS6c                      0.0068                    0.0005             0.1154
        G
                OS7a                      0.0012                    0.0003             0.0043
                OS7b                      0.0039                    0.0005             0.0282
        H
                OS8a                       Bdl*                     0.0002             0.0002
                OS8b                       Bdl*                     0.0002             0.0005
                OS8c                       Bdl*                      Bdl*              0.0001
        I
                OS9a                       Bdl*                     0.0001             0.0004
                OS9b                      0.0009                     Bdl*              0.0005
        J
                OS10a                       bdl                     0.0001             0.0003
                OS10b                     0.0024                    0.0002             0.0041
        K
                OS11a                     0.0007                    0.0001             0.0058
                OS11b                     0.0004                     Bdl*              0.0050
        L
                OS12a                       bdl                     0.0002             0.0055
                OS12b                     0.0049                    0.0003             0.0205
                OS12c                     0.0020                    0.0002             0.0095
        M
                OS13a                     0.0080                    0.0005             0.0021
                OS13b                     0.0018                    0.0002             0.0005
                OS13c                     0.0551                    0.0030             0.0104
        N
                OS14a                      Bdl*                     0.0001             0.0002
                OS14b                      Bdl*                     0.0002             0.0002
                OS14c                      Bdl*                     0.0002             0.0004
        O
                OS15a                     0.0068                    0.0005             0.1154
                OS15b                     0.0006                    0.0001             0.0008
        P
                OS16a                     0.0001                     Bdl*              0.0001
                OS16b                      Bdl*                     0.0002             0.0002
        Q
                OS17a                      0.0988                    0.0050            0.0121
                OS17b                      0.1591                    0.0088            0.0292
                OS17c                      0.0095                    0.0006            0.0039
        TLV                                 1800                      375                80
       *Bdl – Below Detection Limit (Detection Limit = 0.0001 mg/m3)




http: www.childprotection.org.ph                                                                      18
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 ANNEX 3

Illumination Measurement

 Measuring point       Illumination level,     Measuring point   Illumination level,
                              lux                                       lux
 A                                             I
         L1                    80                      L40              314
         L2                    86                      L41              207
         L3                    34                      L42              371
         L4                    93              J
 B                                                     L43              149
         L5                   103                      L44               61
         L6                    72              K
         L7                   310                      L45              310
         L8                    19                      L46               12
         L9                    77                      L47              166
         L10                  115                      L48              539
 C                                             L
         L11                  135                      L49              757
         L12                   98                      L50             1427
         L13                  129                      L51               71
         L14                  135                      L52              200
         L15                  130              M
         L16                   39                      L53               67
 D                                                     L54               96
         L17                  324                      L55              271
         L18                  504                      L56              141
         L19                  425                      L57              107
 E                                             N
         L20                  141                      L58              148
         L21                  227                      L59              160
         L22                   97                      L60              159
         L23                  112                      L61              340
         L24                  113                      L62              309
         L25                  100              O
         L26                   67                      L63              127
 F                                                     L64              940
         L27                   53                      L65              539
         L28                   55                      L66              258
         L29                   41 Cetra E. P
         L30                   48                      L67              209
 G                                                     L68              241
         L31                  437              Q
         L32                 3630                      L69             1580
         L33                 2620                      L70              213
         L34                 3580                      L71               27
 H                                                     L72               90
         L35                  184                      L73               31
         L36                   69                      L74              159
         L37                  339
         L38                   55
         L39                   53




 http: www.childprotection.org.ph                                                      19
 Featured Paper for February 2003
ANNEX 4

General Ventilation:

Measuring Points       Air velocity (m/s)   Measuring Points   Air velocity (m/s)
A                                           I
       V1                   0.50-0.60              V29              0.30-0.40
       V2                   0.20-0.30              V30              0.30-0.40
       V3                   0.20-0.25              V31              0.20-0.30
       V4                   0.40-0.50              V32              0.60-0.80
B                                           J
       V5                   0.50-0.60              V33              0.40-0.50
       V6                   0.60-0.70              V34              0.30-0.40
       V7                   0.60-0.80       K
C                                                  V35              0.25-0.30
       V8                   0.10-0.25              V36              0.30.0.40
       V9                   0.10-0.20              V37              0.35-0.40
       V10                  0.50-1.0        L
       V11                  0.50-1.0               V38              0.20-0.30
D                                                  V39              0.25-0.30
       V12                  0.20-0.30       M
       V13                  0.30-0.40              V40              0.40-0.50
       V14                  0.40-0.50              V41              0.50-0.60
E                                                  V42              1.0-1.40
       V15                  0.30-0.50       N
       V16                  0.10-0.25              V43              0.40-0.60
       V17                  0.50-0.60              V44              0.60-1.0
F                                                  V45              0.90-1.0
       V18                  0.25-0.30       O
       V19                  0.05-0.10              V46              0.60-0.90
       V20                  0.10-0.15              V47              0.50-0.70
G                                                  V48              0.50-0.60
       V21                  0.50-0.70       P
       V22                  0.50-0.70              V49              0.60-1.0
       V23                  1.20-1.80              V50              0.40-0.60
       V24                  0.60-0.80              V51              0.70-1.0
       V25                  1.0-1.30        Q
       V26                  1.0-1.20               V52              0.50-0.55
H                                                  V53              0.60-0.80
       V27                  0.30-0.40              V54              0.30-0.40
       V28                  0.30-0.40              V55              0.50-0.70




http: www.childprotection.org.ph                                                    20
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References:

1.   Sullivan, John B., Krieger, Gary R. Hazardous Materials Toxicology, Clinical Principles
     of Environmental Health.1992
2.   Gust, D.P. Estrella. A Case Study on Child Labour in the Philippine Footwear Industry:
     Health, Safety and Work Environment, Article in the Asian-Pacific Newsletter on
     Occupational Health and Safety, Vol. 7, July 2000.
3.   Gust, D.P. Estrella. Report on Child Labour in the Footwear Industry: An ILO, IPEC and
     OSHC Project, 1999.
4.   Master Plan, Leather Footwear Industry, 1996.
5.   ERDA l’education pour le developpement aux Philippines, 1996.
6.   ILO/SEAPAT "Child Workers in the Footwear Manufacturing in Marikina, Manila, by
     TRENDS-MBL, a focus group discussion report, 1995.
7.   "Attacking Child Labor in the Philippines", ILO, 1997.
8.   National Child Labor Survey in the Philippines, 1996
9.   ILO Convention 182 the Worst Forms of Child Labor, 1999.




http: www.childprotection.org.ph                                                         21
Featured Paper for February 2003
                                     Project Team

Program Coordinator:

       Dr. Dulce P. Estrella-Gust

Senior Members of the Research Team

   Agnes M. Tecson
   Dr. Ma. Teresita Cucueco
   Engr. Jose Maria Batino
   Engr. Nelia Granadillos
   Rosanna Tubelonia

We also acknowledge the support given by the following OSHC staff:

   Dr. Ma. Beatriz Villanueva, Dr. Marissa San Jose, Dr. Joseph Andrew Jimenez,
   Dr. Ma. Pureza Fontelera, Dr. Regina Tan, Dr. Ronald Fajardo, Engr. Melba Marasigan,
   Engr. France Bicomong, Engr. George Sebastian, Engr. Lauro Canceran, Engr. Rosalie
   Fajilan, Engr. Christine Marie Lanceta, Engr. George Gatchalian, Engr. Domingo
   Domingo, Jeane Mendoza, Carmela Manza, Clarissa Yu, Rachel Ann Suing, Ma. Teresa
   Andres, Charlene Parafina, Evelyn Tandayu, Lyndon Mercado, Marisol Policarpio,
   Fortunata Baco, Wilfredo Tandayu, Leah Bautista, Angelito Bonifacio, Rey Jose Soriano,
   Raul dela Cueva, Angelito Macawili, Edna Sarita, Lualhati Alejandro, Edwin Hagoot,
   Rodolfo Mata, Victorio Manuel, Reynaldo Decain, Cesar Maximo.

The ILO-IPEC staff of the Binan Project, and Ms. Maritess de Paz , Administrative Assistant
of the OSHC Footwear Project.




http: www.childprotection.org.ph                                                         22
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