Mental health of child workers: Results from a case-control study of the brick manufacturing industry in four countries

Objectives

Internationally, brick kilns employ tens of thousands of children. Due to extreme poverty facing families who work in this industry, child labor in this sector has been challenging to eliminate. This study assesses the association between brick kiln work and child mental health in Afghanistan, Bangladesh, Nepal, and Pakistan.

Method

Working children (aged 11-17 years) were identified from up to three brick kiln sites in each country. Nonworking controls, matched for age, sex, and socioeconomic status were identified from nearby communities. Trained interviewers administered translated, semi-structured questionnaires to consenting respondents.  

Results

918 working and 565 nonworking children participated. Compared to nonworking children, working children experienced more stress and somatic stress. On a scale of 1 to 3 (1=lowest, 3=highest), the mean difference between the child groups for stress and somatic stress was 0.27 (99% CI:0.20-0.33) and 0.28 (99% CI:0.23-0.33), respectively (adjusted for age category, sex, and country). In Afghanistan and Pakistan, working children reported significantly lower self-esteem compared to nonworking children (mean difference=0.4, 99% CI: 0.35-0.42).

Conclusions

Compared to nonworking children, brick kiln workers have lower self-esteem and are likely to experience more stress and somatic stress. The combination of low self-esteem and stress among working children may be lead to anti-social or delinquent behavior and could expose children’s mental and physical health to short- and long-term risks. While the hazardous nature of brick kiln work may be evident, this study provides evidence for parents, brick kiln operators, and policy makers who seek to remove children from this work.