Beedi rolling and the health hazards associated with occupational exposure: A situational review from Karnataka, India

Introduction

A beedi is a thin South Asian cigarette made of 0.2-0.3 g of tobacco flake wrapped in a tendu (Diospyroxmelanoxylon) leaf and secured with coloured thread at both ends. As it is a cheap form of tobacco consumption, it is extremely popular among the non-affluent but it carries greater health risks as it delivers more nicotine, carbon monoxide and tar than conventional cigarettes. Beedi manufacturing, the traditional agricultural/ forest-based industry in India, is highly labour intensive. The beedi rolling is generally done by women from the poor socio-economic strata.¹ There are about 300 major manufacturers of branded beedis; however, there are thousands of smallscale manufacturers cum contractors who account for the bulk of the beedi production in India. Beedi rolling in entirely a manual process done majorly in households and there is no mechanization involved. Labourers meticulously place the tobacco inside the tendu leaf, roll it tightly and secure the roll by using a cotton thread. A vast majority of the beedi rolling workforce in India is engaged in informal employment. The beedi industry rests on informal employment operating mainly in the interface between the unorganised and organised sector. Even though beedi rolling began in factory settings during the early 20th century; however, in the last three decades this system has increasingly shifted from the factory to household work. The production of beedis is widely dispersed and is undertaken through a chain of contactors and there is no specific employer-employee contract. Beedi industry is one of the oldest industries and employs over 60 lakh workers in India. The workers roll on an average 500-1000 beedis per day handling around 225- 450 grams of tobacco flake. The state of Karnataka in India alone has more than 4,00,000 workers involved in the beedi industry.¹ Beedi rolling remains extremely popular in India especially among women though it has been identified as a hazardous occupation. Long hours of rolling beedis in a fixed posture has a tremendous toll on the health of the beedi workers. The irony is that the women are not even aware that this work is ruining their health. Workers face myriad of problems such as poor working conditions, low wages, fraudulent actions by the contractors, nonpayments, health hazards, etc. Some of the common health problems reported include tuberculosis, skin problems, cancers, eye problems, bronchitis, asthma, etc.

Studies from India have reported that among the occupational health issues identified among beedi workers, 55% were in the age group of 15-35 years, 79% were living in poor environmental and housing conditions, and a majority 90% of the workers developed fatigue and pain in various parts of the body. The most frequently reported pain was shoulder pain in both males and females (75% and 80.85%) followed by back pain (76.6%) and neck pain (76.6%). Apart from that, knee, chest, elbow and wrist pain and musculoskeletal problems were common. This study also reported that cough (27%), breathlessness (20%), acidity (40%), generalized weakness (34%), skin diseases/ dermatitis (21.27%) and tuberculosis (6.8%) were seen. The frequency and intensity of shoulder pain is more followed by back pain and neck pain in both males and females.¹

The Committee of National Commission for Enterprises in the Unorganised Sector-NCEUS (2009) had tried to define the unorganized sector’s workforce in the following way – ‘unorganized workers consist of those working in the unorganized sector or households, excluding regular workers with social security benefits provided by the employers and the workers in the formal sector without any employment and social security benefits provided by the employers’. In the unorganised sector, beedi manufacturing industry is one of the prominent ones. The industry has been classified as unorganized, falling under the small scale and cottage industries sector. Beedi rolling activity is largely carried out at home and characteristically employs a large number of women.^2,3

As shown in the Figure 1, the Ministry of Labour and Employment, Government of India maintains a database on the number of beedi workers engaged in beedi rolling industry region-wise.⁴

Source: Ministry of Labour and Employment, Govt. of India.

Materials and Methods

This study relies on extensive situational review of available data sources on the beedi rolling industry in India. Secondary data included in the analysis includes government dataset on beedi workers, peer-reviewed journal articles, newspaper articles, interviews, and many of these peer-reviewed articles were selected through searches from PubMed, Google Scholar, the ILO website and the Ministry of Labour and Employment, Government of India.

History of beedi rolling in India

There is no definite information as to when and how the manufacture of beedis began in India. It is documented that many tribes in ancient India used to smoke tobacco in a pipe made from leaves of trees and this is probably where the practice of wrapping tobacco in a leaf originated. Beedi smoking was mentioned as early as 1711.^5,6 The first formal production of beedi was documented in 1902, al though it is known that many rural communities were known to have made beedis for their own consumption much before this date. Madhya Pradesh, the largest producer of tendu leaves in India, is one of the first states where beedi manufacturing began in 1902 in Jabalpur district. In 1915, a beedi rolling unit was established by Abdul Noor Mohammed in Sagar. According to a report of the Labour Investigation Committee appointed by the Government of India in 1946, merchants from Gujarat introduced the manufacture of beedis in Madhya Pradesh in the first decade of the twentieth century. Over the last century, Indian tobacco cultivation and trade began to expand, with Andhra Pradesh, Gujarat and Karnataka producing over 70% of the total cultivated tobacco. Nearly 85% of the world’s beedi tobacco is grown in India. Gujarat, Karnataka and Maharashtra occupy about 35% of the area under tobacco cultivation. Annually about 150,000 tons of tobacco and 30,000 tons of tendu leaves are used to manufacture beedis.⁶ Currently, the major suppliers of beedi tobacco leaves are the western states of Gujarat and Maharashtra. According to the British-era ‘Report on Marketing of Tobacco in India and Burma’ (1939), about one-fourth of the total beedi production is concentrated in the Central Provinces (Gujarat, Madhya Pradesh) while about 40% of the total production was contributed by the Provinces of Bombay (Maharashtra and Karnataka) and Madras (Andhra Pradesh and Tamil Nadu) and the remaining was scattered over the rest of the country.⁶

The beedi industry in India

In India, beedi rolling is a traditional activity which is highly labour intensive and predominantly depending on an unorganized labour force. The beedi industry is one of the largest employers of workers in India, after agriculture, handloom and construction.³ However, the estimates of the numbers of beedi workers engaged in this industry vary depending on who is making the estimates. India’s Ministry of Labour estimates that about 45 lakh workers are employed in the beedi rolling industry, a majority of whom are home-based women workers.³ As per the Standing Committee on Labour (2010-11), there are 49.90 lakh beedi workers in India. The trade unions claim that there are over 70 to 80 lakh beedi workers in India. Women make the largest proportion of labour in the beedi industry and published literature estimates that women actually make up nearly 76 per cent of total beedi employment. There are two postulates as to why women takes up this occupation - firstly, the work is done generally from home and women can do it while at the same time attending to their children and other household responsibilities; secondly, their deft fingers are more suited to handle the work of beedi rolling.³

The beedi rolling industry in Karnataka

In Karnataka, beedi tobacco accounts for 65 percent of total tobacco cultivated area. Beedi tobacco is majorly cultivated in Bellary and Belgaum and the tobacco grown here is famous for its quality as it is grown in medium black or red soil. Twenty five percent of the total tobacco cultivated in Karnataka is directed towards beedi production. Of the nearly 6 million beedi workers nationally, Karnataka accounts for 12 percent of the workforce. Dakshina Kannada district is the largest beedi producing centre in the state representing an area with the highest concentration of beedi production centres. There are more than 36 beedi companies in this region, with over 2500 beedi contractors. The total number of beedi workers registered in Karnataka as of 1985 was 2.68 lakhs and of these 80 percent are home-based workers.6 Dakshina Kannada is a coastal district in Karnataka state and was formed in 1997. The district is small in terms of geographical area, but densely populated and predominantly rural in nature. With an average annual rainfall of 4,030 mm, the district is a well rain-fed region. The Human Development Report indicates that the district ranks first in the state in many aspects of human development. The district is also the second most industrialised district in the state. The beedi industry in the district is well known with around 36 beedi companies and over 2,500 beedi contractors. The importance of beedi rolling is reflected in the fact that there are about 100 types of beedi is manufactured under 12 major brands here and these provide employment to about 6 lakh persons, mostly women. Around 27 crore beedi sticks were manufactured every day in the district. The beedi industry provided gainful employment to about four lakh people in Dakshina Kannada district (about seven lakhs in the State and according to the government estimates quoted by ILO). These workers are mainly from the middle, lower middle and poor strata of society.³

The health hazards of beedi rolling

The beedi rollers begin their profession at a very early age in their life. A number of health problems have been reported in studies especially for the women beedi rollers. The continuous exposure to tobacco dust is the source of many a common discomfort and disease conditions among the workers. The beedi dust that is in the air affects not only the beedi roller but also the entire family leading to respiratory problems. The main postural health problems associated with beedi rolling are severe body ache and eye strain. The most commonly seen medical conditions are asthma, tuberculosis, back strain, spondylitis, swelling of lower limbs and digestion problems. Among women, problems related to menstruation where they have heavy bleeding and lower back pain during menstruation and pain in lower abdomen have been frequently reported. Many women beedi rollers have suffered miscarriages too.² The poor socio-economic status of beedi workers predisposes them to work continuously for hours in improper working postures and beyond the normal working capacities.  

Beedi rollers are known to suffer from fading fingerprints and some complain of loss of sensation in their fingertips. However, continuous exposure to tobacco does more than just fade their fingerprints; beedi workers are at an increased risk of aggravated tuberculosis, asthma, anaemia, gynaecological difficulties, and other health issues. However, due to the ongoing rural employment crisis, many of these workers do not have the privilege to consider these health risks as a factor while deciding on continuing with their livelihood. According to the World Health Organization (WHO), an estimated 3.3 million beedi workers currently are employed by the beedi industry. Only 11 percent of workers are registered workers and the vast majority of them remain unidentified by the government. A basic requirement of identification for any individual is their fingerprint, and for an individual who has had limited access to education, this biometric becomes even more essential. However, as most beedi workers have faded fingerprints that result from handling tobacco dust and rolling them into tendu leaves, this record also remains elusive.⁷ The main organ systems affected and their conditions identified include musculo-skeletal problems, gastrointestinal problems, respiratory disorders, neurological disorders, eye problems, skin diseases, gynaecological concerns, cytogenic problems and blood related concerns in (Table 1).⁶

Statutory initiatives related to beedi workers:

The Beedi Workers Welfare Fund Act, established in 1976 is an important development aimed at supporting the beedi worker. This Act functions with the objective to promote financial assistance to the workers through adherence of employer to rules pertaining to the following: registration of workers, providing ID cards, free housing and health, establishment of Beedi Workers Welfare Cess, scholarships to the workers and their children etc .⁵

The Beedi Workers Welfare Cess Act, 1976 collects taxes by way of cess and through imposing excise duty on manufactured beedis. The rate of excise duty on beedis is Rs.7 per thousand beedis rolled and the rate of cess is Rs.2 per thousand beedis rolled. The amount collected is utilized for the welfare of the beedi worker families .⁵

In 2004, the Central Government initiated a scheme known as the Integrated Housing Scheme for Beedi Workers where any beedi worker engaged in the beedi industry for more than one year with monthly income not exceeding Rs. 6,500/- is eligible for the scheme provided that the beedi worker should not have a house of his own or in the name of his spouse or any dependent. The Revised Integrated Housing Scheme (2007)for Beedi Workers addresses the shortage of homes for beedi workers where the respective Welfare Commissioners are empowered to identify the eligible beedi worker based on Economically Weaker Sections, Schedule Caste & Scheduled Tribe and support the construction of homes by providing a central subsidy of Rs. 40000 and rest through assistance in the form of loan from financial institutions like HUDCO .⁵

The latest development aimed at supporting beedi workers in 2013 was the introduction of the medical insurance scheme under Rashtriya Swasthya Bima Yojana (RSBY) which proposes to cover all the beedi workers in India by the 2017. This medical scheme intends to cover the beedi worker families with a medical insurance cover of Rs. 30000 and additional amount incurred would be reimbursed by the Welfare Commissioner to the concerned hospital.⁵

Results and Discussion

Various studies have reported that the beedi workers suffer from many health hazards which can gradually cost them their lives. The initiatives undertaken by the government for the unorganised sectors are beneficial for the workers but not sufficient enough to support their current livelihood and medical needs. In many of the study interviews, beedi workers mentioned that due to the poverty and insufficient wages from the contractors they are forced to undertake multiple occupations to lead their lives. It was also reported that women in the age group of 40– 50 years were mainly engaged in beedi rolling. A large proportion of the women continue in this profession for 20– 25 years, suggesting that they probably start their profession at an early age. About 90% of these women are illiterate and many of them became breadwinners to their families. A study on beedi workers in Murshidabad district of West Bengal had found that a majority of the beedi workers were economically weak and many had no formal education. Due to frequent contact with tobacco dust, many workers had reported of suffering from health-related disorders, such as Tuberculosis, lung cancers, etc. Women beedi rollers suffered from irregular menstruation and other pregnancy problems too.^7-11 Beedi rollers are exposed to unburnt tobacco, mainly through the cutaneous and nasopharyngeal routes.^12,13 Beedi rollers were also affected by respiratory disorders, skin diseases, gastrointestinal illness, gynaecological problems, lumbosacral pain and are susceptible to fungal diseases, peptic ulcer, haemorrhoids and diarrhoea.12 Numbness of the fingers, breathlessness and stomach pains including cramps and gas have also been reported in beedi rollers. It was also reported that postural pains, eye problems and burning sensation in the throat are common ailments in women beedi rollers.¹

Conclusion and Recommendations

The beedi rolling has grown as a household occupation especially in the recent past. Due to the lack of education, training, and the poor socio-economic conditions many women in these households are forced to work continuously in improper work postures. Apart from the dermatological effects of the occupation, many workers also reported the development of serious psychological problems and other respiratory illness. In the era of liberalization and globalization, the numbers of unorganized and contract workers are increasing. Since free flow of technologies is promoted across the globes, it brings us to the point to be more vigilant towards the protection of traditional industrial sectors and their products against the multinational tobacco-based products. The most crucial factor witnessed in the beedi industry at present is the lack of work and in addition lower wages. Hence, there is an urgent need to provide social security to these vulnerable categories of beedi workers by implementing welfare measures under the Beedi Workers Welfare Fund Act, 1976 .⁵

Awareness of the beedi rollers regarding the adverse effects of their occupation and safety measures that have to be taken is currently very low and needs to be improved. Beedi rollers most commonly suffer from musculoskeletal pain and fatigue. The working condition of beedi rollers in the urban areas is also not favourable.⁸ Beedi workers are among the worst paid workers across small scale industries. The welfare benefits received are marginal especially in the case of workers in unregistered manufacturing units or under the contractual system without ID cards. Unregistered companies are not legally bound to provide any social security benefits to their workers. Studies have clearly shown that there are several malpractices and tactics employed by companies and contractors to exploit beedi workers. Beedi workers’ lives are riddled with poor working conditions, chances of being unpaid when quality assessment of beedis rolled are carried out purposely indicating low quality as an excuse, violence and security concerns abound along with discrimination against women. There is also much resistance from companies and their operatives towards unionisation of workers. Long-term exposure to tobacco and poor working conditions tend to wreak havoc on the health of beedi workers. Workers are seen to have a wide range of adverse health conditions owing to beedi related work.⁶

In this context, some of the recommendations for building evidence on beedi rollers issues are:

1) There is a need to address the dearth of research related to tobacco cultivators and tendu leaves collectors. Annual data related to production and cultivation needs to be collected and be made available.⁶

2) Annual data related to implementation of all welfare schemes should be made readily available.

3) Census of all beedi manufacturing units whether small or big, registered or unregistered should be undertaken to build a comprehensive database that would provide all information related to units, workers, contractors etc.⁶

4) Malpractices and unfair employment contracts with the beedi rollers need to be monitored and safety measures brought into place .⁶

5) Research on alternative livelihoods for beedi workers should be undertaken along with providing awareness on the deleterious effects of tobacco to the beedi roller as well as to the consumer .⁶

6) Research on awareness of beedi workers regarding statutory benefits under different welfare schemes should be carried out.