At 2 pm one day in the last week of October, Sheela Devi, a coolie in East Kidwai Nagar, one of Delhi's largest construction sites, had completed a little over half of her 12-hour work shift. Spreading out a cement sack, she sat on the ground to rest for a few minutes. Behind her, a 20-foot-deep foundation pit for a gigantic apartment block was being dug, continuously churning dust up into the air. The plot looked like a quarry.

Devi was wearing a red buttoned shirt over a green salwar. A cotton towel covered her hair. “This load is so heavy, 25 kg to 30 kg, that sometimes it feels my head will collapse under it,” said Devi, pointing to the sacks of cement she carried for a living.

The young worker had left her village in Bihar’s Rohtas district eight months before to join her husband to work at construction sites in Delhi. It was her first trip to the national capital. “The cement and sand mix in the air make it very difficult to breathe,” said Devi. “In the evening, I go home and have jaggery [which is believed to boost immunity] and water to avoid falling sick. But no matter how much I wash up, my nose and mouth seem filled with dust.”

Construction dust, along with burning refuse, is one of the biggest contributors to Delhi’s increasing Respirable Suspended Particulate Matter. Last year, the Indian Express had reported that the levels of this kind of particulate matter were estimated to have doubled between 2007 and 2014 to 316 micrograms per cubic meter of air. This is more than five times the permissible norms set by the Central Pollution Control Board.

On Sunday, after more than a week of horrifically high pollution levels in Delhi, Chief Minister Arvind Kejriwal announced several emergency measures to wrest the situation into control. One of them was to stop all construction work in the city for five days. This restriction adds to the burdens of daily wage workers like Sheela Devi at building and infrastructure sites, who are already most vulnerable to the effects of the pollution crisis.

Deadly exposure

Dr Yatin Dholakia, a physician who specialises in chest medicine at the Foundation for Medical Research in Mumbai, said that the exposure of construction workers to cement and construction dust could severely affect their lung immunity, leading to serious conditions. Cement dust often contains chromium and metal.

“While larger dust particles may get filtered and thrown out in sputum, very small particles PM 2.5 are particularly deadly,” said Dholakia.

PM 2.5 refers to particulate matter that measures less than 2.5 microns across – 30 times smaller than the average width of a human hair.

“These enter the lungs and damage the alveolar macrophage, the cells which form the first line of defence in lungs, and cause fibrosis,” said Dholakia. “As local immunity reduces, tuberculosis germs enters easily and further reduce the blood supply.”

Long hours of work, poor nutrition and unsanitary living conditions – often in makeshift tents at the building site – make construction workers more susceptible to health risks due to prolonged exposure to dust.

‘Cement work most risky’

At construction sites, each worker’s exposure to fine dust varies according to the work they are assigned.

Ram Jitan Sharma, a 36-year-old landless migrant from Khagariya in Bihar, who moves to Delhi a few months each year in search of work, earns Rs 250 a day working with a mason.

Photo credit: Anumeha Yadav.

He enumerated the different tasks at a construction site and the risks involved.

“If your job is to mix sand with cement in water to make a wet plaster, and doing sariya ka kaam [work with iron construction rods], you face less dust since the cement is wet,” said Sharma. “If you work on digging the foundation, scraping walls or demolition work, or loading and unloading cement then you have it the worst.”

These cement workers, who faced the maximum risk, also earned the most money of all workers at the site. They earned Rs 10,000 a month and an additional Rs 2 per sack they lifted, he said.

Devendra Kumar, a supervisor at the Kidwai Nagar construction site, spoke of how he first heard of the risks of inhaling fine dust from some workers he managed.

“At the first large construction site I supervised at in Noida, 20 km from Delhi, the workers at the cement mixing plant warned me to be careful because it could cause illnesses,” he said. “There, as well as at this site, as a precaution, most workers eat jaggery, and only a few wear a nose mask.”

The Building and Other Construction Workers Act 1996, which regulates the employment and conditions of service of construction workers, makes employers responsible for monitoring particulate matter at construction sites and ensuring that water is sprayed regularly to help the dust settle. Employers also also expected to supply workers with personal protective equipment such as masks. But workers interviewed at five construction sites in Delhi said most of them had not received such masks.

Rajesh Kumar, general secretary of the All India Federation of Trade Unions, said employers and contractors violated laws that required them to provide workers with personal protective equipment as well as facilities to protect their children at construction sites. He added that emaciated labour departments lacked enforcement machinery.

“When we approached the District Labour Commissioner in South West Delhi, he told us, we should prepare a list of places where construction was going on in the district,” Kumar said.

Jaggery to avoid disease

While a few older workers spoke of the risks from dust exposure, such as tuberculosis and chest diseases, the majority spoke of simply eating jaggery to prevent illness. Most bought it themselves. In some cases, their contractors provided it to them.

Sujit Mandal, a migrant from Katihar in Bihar, who is working at construction site in South Delhi’s Jangpura, said he and four other workers received shakkar, a form of powdered jaggery, every evening.

“The contractor gives us shakkar after work, we eat a portion at night, it helps prevent respiratory illness,” said the worker, who has, for the last 15 years, worked at construction sites in the national capital for a few months every year during the lean farming months.

At the East Kidwai Nagar construction site, Jageshwar, who led a group of eight workers from Muzzaffarpur in Bihar at the on-site cement plant – which made these workers one of the most exposed to dust – spoke of a similar routine.

“This is hard work,” said the middle-aged worker as he stood on a trolley handing out 50 kg sacks of cement to younger workers, who carried it to a mixing plant. “When we finish, we bathe and eat a 250 gram portion of jaggery each with water every day before cooking dinner together. It cleans the dust from the system.”

Photo credit: Anumeha Yadav.

Ravi Kumar, a 22-year-old whose job it is to sweep the roads inside the massive construction site four times a day, said he also follows a similar routine of eating jaggery in the evenings. But he added that this had not prevented him from having frequent bouts of cold from dust allergies.

Did the widespread belief among workers across construction sites in the power of jaggery to protect them from respiratory illnesses have any scientific backing?

“Whether you have jaggery or apple, it may have some benefits for immunity,” said Dr TK Joshi of the Centre for Occupational and Environmental Health at Maulana Azad Medical College, Delhi. “But it will not protect exposed workers from respiratory disease. Diseases among construction and cement workers can only be prevented if employers are regulated strictly to provide measures for controlling the hazards. But overburdened labour departments fail to do this.”