Abstract：
To estimate the effect of improving waste collection services on waste disposal behaviour and exposure to environmental risk factors in urban, low-income communities in Pakistan.
We enrolled six low-income communities in Islamabad (Pakistan), four of which received an intervention consisting of a door-to-door low-cost waste collection service with centralised waste processing and recycling sites. Intervention communities underwent community-level and household-level mobilisation. The effect of the intervention on waste disposal behaviour, exposure to waste and synanthropic fly counts was measured using two cross-sectional surveys in 180 households per community.
Intervention communities had less favourable socio-economic indicators and poorer access to waste disposal services at baseline than control communities. Use of any waste collection service increased from 5% to 49% in the intervention communities (difference 44%, 95% CI 41%, 48%), but the increase was largely confined to two communities where post-intervention coverage exceeded 80% and 90%, respectively. An increase in the use of waste collection services was also found in the two control communities (from 21% to 67%, difference 47%, 95% CI 41%, 53%). Fly counts decreased by about 60% in the intervention communities (rate ratio 0.4, 95% CI 0.3, 0.4) but not in the control communities (rate ratio 1.52, 95% CI 1.1, 2.2). The decrease in fly counts was largely confined to the two high-coverage intervention communities.
Introduction of a low-cost waste collection service has the potential for high uptake in low-income communities and for decreasing the exposure to waste and synanthropic flies at household level. Intervention success was constrained by low uptake in half of the intervention communities.
We enrolled six low-income communities in Islamabad (Pakistan), four of which received an intervention consisting of a door-to-door low-cost waste collection service with centralised waste processing and recycling sites. Intervention communities underwent community-level and household-level mobilisation. The effect of the intervention on waste disposal behaviour, exposure to waste and synanthropic fly counts was measured using two cross-sectional surveys in 180 households per community.
Intervention communities had less favourable socio-economic indicators and poorer access to waste disposal services at baseline than control communities. Use of any waste collection service increased from 5% to 49% in the intervention communities (difference 44%, 95% CI 41%, 48%), but the increase was largely confined to two communities where post-intervention coverage exceeded 80% and 90%, respectively. An increase in the use of waste collection services was also found in the two control communities (from 21% to 67%, difference 47%, 95% CI 41%, 53%). Fly counts decreased by about 60% in the intervention communities (rate ratio 0.4, 95% CI 0.3, 0.4) but not in the control communities (rate ratio 1.52, 95% CI 1.1, 2.2). The decrease in fly counts was largely confined to the two high-coverage intervention communities.
Introduction of a low-cost waste collection service has the potential for high uptake in low-income communities and for decreasing the exposure to waste and synanthropic flies at household level. Intervention success was constrained by low uptake in half of the intervention communities.
摘要：
评估改善废物收集服务对城市废物处置行为和暴露于环境风险因素的影响，巴基斯坦的低收入社区。
我们在伊斯兰堡（巴基斯坦）注册了六个低收入社区，其中四个接受了干预，包括门到门的低成本废物收集服务，以及集中的废物处理和回收地点。干预社区进行了社区一级和家庭一级的动员。干预措施对废物处置行为的影响，对每个社区180户家庭进行了两次横断面调查，测量了废物暴露和同人蝇数量。与对照社区相比，干预社区的社会经济指标较差，获得废物处理服务的机会较差。在干预社区中，任何废物收集服务的使用从5％增加到49％（差异为44％，95%CI41%，48%），但增长主要限于两个社区，干预后覆盖率超过80%和90%，分别。在两个控制社区中，废物收集服务的使用也有所增加（从21％增加到67％，差异47%,95%CI41%，53%）。在干预社区中，苍蝇数量减少了约60％（比率为0.4，95％CI0.3，0.4），但在对照社区中没有减少（比率为1.52，95％CI1.1，2.2）。苍蝇数量的减少主要限于两个高覆盖率的干预社区。
引入低成本的废物收集服务有可能在低收入社区中大量吸收，并减少家庭对废物和同人蝇的接触。干预成功受到一半干预社区的低摄取的限制。
我们在伊斯兰堡（巴基斯坦）注册了六个低收入社区，其中四个接受了干预，包括门到门的低成本废物收集服务，以及集中的废物处理和回收地点。干预社区进行了社区一级和家庭一级的动员。干预措施对废物处置行为的影响，对每个社区180户家庭进行了两次横断面调查，测量了废物暴露和同人蝇数量。与对照社区相比，干预社区的社会经济指标较差，获得废物处理服务的机会较差。在干预社区中，任何废物收集服务的使用从5％增加到49％（差异为44％，95%CI41%，48%），但增长主要限于两个社区，干预后覆盖率超过80%和90%，分别。在两个控制社区中，废物收集服务的使用也有所增加（从21％增加到67％，差异47%,95%CI41%，53%）。在干预社区中，苍蝇数量减少了约60％（比率为0.4，95％CI0.3，0.4），但在对照社区中没有减少（比率为1.52，95％CI1.1，2.2）。苍蝇数量的减少主要限于两个高覆盖率的干预社区。
引入低成本的废物收集服务有可能在低收入社区中大量吸收，并减少家庭对废物和同人蝇的接触。干预成功受到一半干预社区的低摄取的限制。
