Invisible Hands, Unprotected Lives: Occupational Health Risks Among Urban Indian Rag Pickers

Abstract Background: Ragpickers form a crucial but invisible workforce in India’s urban waste management system. Despite their ecological and economic contributions, they face serious occupational risks and are excluded from health protections, safety nets, and formal recognition. Their marginalization persists due to policy neglect, hazardous working conditions, and widespread social stigma. Methods: A narrative review was conducted using literature sourced from Google Scholar, PubMed, and grey literature from 2004–2025. Thematic synthesis was performed across six major domains: physical/chemical risks, biological ailments, social stigma, COVID-19 impact, government and NGO support, and child labor. The review also draws on comparative international literature to position India's situation in a broader global context.Conclusion: Findings reveal a disproportionately high burden of occupational hazards and social exclusion among urban ragpickers in India. The review underscores the need for formal recognition, access to protective equipment, healthcare, and inclusion in welfare schemes. Addressing these gaps through policy reforms and targeted interventions is essential to safeguard this vulnerable population and ensure sustainable urban health systems.