Occupational Health Risks and Safety Gaps: A Cross-Sectional Study Among Brick Kiln Workers in Bahawalpur, Pakistan

1. Introduction

Occupational health and safety (OHS) is a pressing global concern, with the International Labour Organization (ILO) estimating over 2.7 million annual work-related deaths and hundreds of millions of non-fatal injuries. While significant progress has been made in formal sectors of high-income countries, workers in informal industries across low- and middle-income countries remain highly vulnerable. Poor regulatory oversight, lack of employer accountability, and minimal worker protections exacerbate occupational risks in these contexts.

The brick kiln industry in South Asia is one of the largest informal labor sectors, employing millions under hazardous conditions. Previous studies from India, Bangladesh, and parts of Pakistan have reported high rates of respiratory illness, musculoskeletal disorders, and heat stress among kiln workers. However, most of this research is fragmented, with limited systematic data from Southern Punjab, a region characterized by extreme climatic conditions that may intensify occupational hazards. Moreover, few studies in Pakistan have systematically examined both health outcomes and workplace safety gaps within the same framework. This represents a critical gap in the literature.

From a theoretical standpoint, OHS frameworks such as the European Union’s “prevention at source” principle and the hierarchy of controls emphasize risk identification, protective measures, and worker participation. Applying such frameworks to informal sectors like brick kilns can provide valuable insights into how systemic vulnerabilities (e.g., lack of PPE, sanitation, or rest breaks) translate into health outcomes. Yet these theoretical models have rarely been tested or adapted in the Pakistani context, leaving unanswered questions about their relevance and applicability.

This study aims to address these gaps by investigating occupational health risks and workplace safety deficiencies among brick kiln workers in Bahawalpur, Pakistan. Specifically, we ask:

• What is the prevalence of key self-reported health problems (respiratory, musculoskeletal, heat-related) among brick kiln workers?
• What safety provisions (e.g., PPE, sanitation, first aid, shaded rest areas) are available at kilns?
• Are longer daily working hours associated with more heat-related symptoms, and is cumulative employment duration linked to poorer respiratory status?

By combining structured surveys with direct observation, this study contributes empirical evidence from an under-researched region. The findings not only enrich the literature on informal labor and occupational health but also provide a foundation for policy dialogue on improving worker protections in Pakistan’s brick kiln sector.

2. Materials and Methods

Figure 1. Location of the study area (Bahawalpur District, Punjab, Pakistan), showing the sites of the seven surveyed brick kilns.

Figure 1. Location of the study area (Bahawalpur District, Punjab, Pakistan), showing the sites of the seven surveyed brick kilns.

3. Results

A total of 70 workers from seven randomly selected brick kilns in Bahawalpur participated in the study (April-June 2023).

4. Discussion

This study provides evidence on occupational health risks and workplace safety deficiencies among brick kiln workers in Bahawalpur, Pakistan. A summary of the main findings is presented in Table 5 to enhance clarity for readers.

The high prevalence of respiratory symptoms and musculoskeletal disorders observed here is consistent with studies in Nepal and India, where brick kiln workers face significant exposures to dust, smoke, and heavy manual labor (Joshi & Dudani, 2008; Ghosh et al., 2014). A systematic review by Parvez et al. (2019) further confirms that kiln workers across South Asia experience elevated risks of respiratory illness and musculoskeletal pain. Similar findings have been reported in Pakistan, where Khan and Javed (2020) documented widespread occupational health hazards among kiln workers.

Heat-related complaints were more prominent in our study compared to some earlier reports, likely reflecting Bahawalpur’s extreme climatic conditions. This is consistent with evidence linking prolonged work hours in hot environments to increased risk of heat stress and reduced labor productivity (Kjellstrom et al., 2016). The observed association between long working hours and heat-related symptoms in our sample supports these global findings.

Unexpectedly, the correlation between years of experience and respiratory symptoms was weaker than anticipated (r = 0.137). This may reflect limitations of self-reported data, small sample size, or adaptation among longer-term workers. Nonetheless, the positive association suggests that cumulative exposure to kiln dust and fumes remains a health risk.

Findings highlight urgent needs for basic workplace protections. Simple measures such as shaded rest areas, provision of PPE (masks, gloves), safe drinking water, and first aid could substantially reduce risks. Employers should also regulate working hours and ensure rest breaks during peak heat.

Integrating lessons from international frameworks offers valuable guidance. The European Union’s OHS directives, particularly the Strategic Framework on Health and Safety at Work (2021–2027), emphasize risk prevention, employer accountability, and worker consultation (EU-OSHA, 2021). Similarly, China’s Work Safety Law mandates risk assessment, provision of PPE, and protections against heat stress, with enforcement mechanisms that have reduced occupational disease risks in comparable industries (State Council of China, 2021). Adapting such approaches to Pakistan’s informal kiln sector would require stronger labor law enforcement, subsidized PPE programs, periodic health surveillance, and elimination of child labor.

This study addressed three key research questions. First, it quantified the prevalence of major health problems, showing a high burden of respiratory, musculoskeletal, and heat-related symptoms. Second, it identified severe gaps in workplace facilities, with almost no provision of PPE, sanitation, or first aid. Third, it found associations between longer working hours and heat stress, and between years of experience and respiratory symptoms, highlighting how labor patterns translate into health risks. These findings extend existing knowledge by linking health outcomes with safety gaps in the same framework.

5. Limitations

The study has limitations. The sample size was relatively small (N=70) and drawn from a single district, limiting generalizability. Health outcomes were based on self-report rather than clinical or physiological measures, which may under- or over-estimate prevalence. Cross-sectional design prevents causal inference. Nevertheless, the findings provide an important baseline for Southern Punjab and point to clear areas for intervention and future research.

6. Conclusion