142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Catherine Pellenq , Laboratory for Education Sciences (Laboratoire des Sciences de l’Education), ESPE & Université Joseph Fourier, Grenoble, France
Susan Gunn, PhD , Hazardous  Child  Labour, International Labour Organization, Geneva, Switzerland
Janessa Graves, PhD, MPH , College of Nursing, Washington State University, Spokane, WA
Mohammed Vaqas Ali, PhD , University of the Punjab, Lahore, Pakistan

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.


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.  


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).


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.

Learning Areas:

Occupational health and safety
Public health or related research

Learning Objectives:
Describe the psychological factors that may impact child workers. List the aspects of psychological functioning that significantly differ when comparing working children to their non-working peers.

Keyword(s): International Health, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My scientific interest is the psycho-social development of children and the role of the context on it. I use statistical measures and models.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.