Environmental and public health impacts of waste in the Free state province

Abstract

Developing countries, including South Africa, continue to face significant challenges in achieving effective and sustainable waste management, despite progressive legislation. Weak institutional capacity, poor enforcement, inadequate infrastructure, and rapid urbanisation contribute to the growing burden of unmanaged waste. In South Africa, these challenges are especially evident in the Free State province, where municipalities struggle to comply with national waste management standards. This study assessed the environmental and public-health impacts of waste exposure among residents living near landfill sites in the province and explored ways to minimise these impacts through a One Health approach, which recognises the interconnection between environmental integrity, human well-being, and animal health. The research adopted a quantitative, non-experimental, cross-sectional design. Primary data were collected from residents, municipal officials, and waste pickers living near selected landfill sites using structured questionnaires, observational checklists, and field mapping supported by Global Positioning System (GPS) devices. Study sites were purposively selected based on prior evidence of operational deficiencies and exposure risks. Quantitative data were analysed using descriptive and inferential statistics to determine associations between environmental exposure and reported health outcomes, as well as to capture residents’ perceptions, lived experiences, and coping mechanisms. The findings revealed that most landfill sites in the Free State operate below the minimum standards prescribed by the Department of Forestry, Fisheries and the Environment (DFFE). Waste loads were largely uninspected and mixed, leading to the indiscriminate disposal of hazardous and general materials such as healthcare waste, e-waste, absorbent hygiene products, and food waste. Open burning, leachate seepage, and vector proliferation were common across sites. Due to inadequate fencing and limited monitoring, school-age children and domestic animals were frequently observed scavenging at landfills for food or reusable items. The study further highlights operational inconsistencies in landfill classification, as several sites continue to accept mixed waste streams, despite the provisions of the Gauteng Pollution Buffer Zones Guidelines. Residential dwellings were found on seven landfill sites (38.9%), and three sites (16.7%) were located within 2 km of water bodies, the closest being approximately 140 m away, posing a substantial risk of water contamination. Sociodemographic analysis showed that most respondents were low-income earners with an average household income of R1 877,85. The majority were unemployed (57.9%), while 32.2% were employed in low-paying jobs, and 19.8% were waste pickers. A significant proportion (62%) engaged at least occasionally in waste picking, while 9.9% relied on social grants or pensions. Most respondents lived in substandard housing, such as shacks (38.8%), Reconstruction and Development Programme (RDP) houses (29.8%), or backyard dwellings (19%), with limited access to clean water, sanitation and healthcare. The association between limited municipal water access and reliance on wood as a primary energy source was statistically significant (p = 0.026 < 0.05), reflecting poverty-driven adaptive choices. Waste pickers and informal recyclers face heightened occupational hazards due to inadequate personal protective equipment (PPE) and the absence of occupational health monitoring. The ecological dimension of exposure was also evident: reports of sick or dead livestock and increased rodent and mosquito infestations indicated that waste mismanagement extends beyond human health, threatening both animal health and environmental stability. While 62.8% of respondents had never been hospitalised, 21.5% reported admissions due to illnesses related to poor air quality, pathogen exposure and environmental stressors, primarily respiratory ulcers, bronchitis, diarrhoeal infections and tuberculosis. The association between healthcare visits and disease prevalence (p = 0.004 < 0.05) reinforces the environmental health burden faced by communities near landfill sites. Using the One Health framework, the study demonstrated the interconnectedness of environmental degradation, human ill-health, and animal exposure, all driven by weak waste governance systems. The absence of multi-sectoral monitoring perpetuates cycles of vulnerability and exposure. To address this gap, the study proposed a Digitised Community Awareness and Self-Monitoring Tool (DCASMT), an innovative participatory mechanism for real-time environmental and health monitoring, local reporting, and interdepartmental coordination. This model seeks to enhance accountability, data-driven decision-making, and proactive health responses. The study concludes that waste management in the Free State is both an environmental and public health crisis with deep social-justice implications. The ongoing exposure of vulnerable populations to waste-related hazards constitutes a violation of the constitutional right to a safe and healthy environment. To mitigate these risks, the study recommends: • Revising landfill classifications and strengthening compliance monitoring systems; • Enforcing segregation, treatment, and safe disposal of hazardous waste; • Integrating environmental health surveillance into municipal waste management plans; • Institutionalising the DCASMT as part of a broader One Health implementation strategy; and • Promoting waste diversion in alignment with the waste management hierarchy and Sustainable Development Goals (SDGs). By linking environmental quality, public health, and community participation, the study underscores the necessity of multi-level policy coordination and the ethical imperative of protecting both human and ecological health in developing country contexts.