Occupational Health in India: Addressing Challenges in the Formal and Informal Sectors

When we talk about workplace safety in India, we are really talking about two very different realities existing side by side. On one hand, there are factory workers in the formal sector covered by legal protections, health checks, and safety committees. On the other, there are hundreds of millions of agricultural labourers, construction workers, street vendors, and domestic workers who show up every day to jobs that carry real physical risks – with almost no regulatory safety net. Understanding how these two worlds diverge, and why bridging that gap matters urgently, is central to understanding occupational health in India today.

The scale of India’s workforce 🔗

India’s workforce is one of the largest in the world, and its structure is striking. More than 90% of Indian workers are employed in the informal economy, primarily in agriculture and services, while fewer than 10% work in the organized sector. According to the ILO India Employment Report 2024, nearly 82% of the workforce engages in the informal sector and nearly 90% is informally employed. This is not a marginal fringe of the economy – it is the economy’s backbone. And yet, it is the part least protected by law.

The distinction India uses is between the organized (formal) sector – where labour laws, written contracts, and social security schemes apply – and the unorganized (informal) sector, which operates largely outside these frameworks. The unorganized sector includes street food vendors, kirana shop owners, household workers, casual agricultural labourers, delivery persons, and ragpickers, among many others. These workers typically have no written contracts, no paid leave, and no access to employer-funded health benefits.

Formal sector protections: what the law promises 🔗

For workers in the organized sector, India’s legal framework has historically offered meaningful protections. Legislation like the Factories Act of 1948 and the Mines Act of 1952 laid down specific requirements: clean workplaces, adequate ventilation, controlled temperatures, welfare facilities such as canteens and creches, limits on working hours, and medical care provisions. These laws also mandated the reporting of accidents and occupational diseases.

In 2020, the Indian government took a significant step to modernize and consolidate these protections. The Occupational Safety, Health and Working Conditions (OSHWC) Code, 2020 – which came into force on November 21, 2025 – merged 13 existing labour laws, including the Factories Act, Mines Act, and Contract Labour Act, into a single unified framework. Under the new code, employers are required to ensure hazard-free workplaces, conduct annual health check-ups for employees at their own cost, issue mandatory appointment letters, and constitute safety committees in establishments employing 500 or more workers.

The code also introduced gender-sensitive provisions, such as requiring separate washrooms, bathing facilities, and locker rooms for male, female, and transgender employees. Female workers may now work night shifts with their consent and appropriate safety arrangements. The OSHWC Code extends protections to contract and migrant workers as well, though enforcement gaps in smaller establishments remain a serious challenge.

The enforcement gap 🔗

Even within the formal sector, the gap between law on paper and practice on the ground is wide. India faces a shortage of occupational health professionals and inadequate implementation of existing legislation, compounded by meagre public spending on health and a lack of reliable occupational safety data. Pre-consolidation estimates put the inspector-to-worker ratio at roughly one inspector per 50,000 workers – a number that makes consistent enforcement virtually impossible.

The informal sector: working without a safety net 🔗

For the majority of India’s workers, the protections described above remain out of reach. Agricultural workers – who make up nearly 98.41% of the informal agriculture sector workforce – face pesticide poisoning, extreme heat, musculoskeletal injuries from repetitive manual labour, and limited access to clean water or sanitation at worksites. Construction workers are exposed to falls, chemical hazards, and dust-related lung diseases. Home-based workers and domestic workers often labour in isolation, making health monitoring nearly impossible.

A peer-reviewed study on occupational health in India’s informal sector assessed over 1,100 workers across five industries – handloom weaving, construction, transportation, tobacco processing, and fish processing – and found a high prevalence of musculoskeletal complaints, respiratory problems, eye disorders, and skin diseases. The study emphasized that the absence of protective equipment significantly worsened these conditions. Workers faced multiple simultaneous hazards with little or no recourse.

Gender and the informal sector 🔗

The intersection of gender and informal work deepens these vulnerabilities. According to the Periodic Labour Force Survey 2017-18, 88% of employed women in India work in the informal sector, and 40% of those women are domestic workers or home-based workers. Women are concentrated in the most precarious forms of work – where occupational exposure to chemicals, repetitive stress injuries, and unsafe environments is high, but where compensation claims, medical leave, or even acknowledgement of work-related illness is virtually nonexistent. The gendered dimension of occupational risk in India remains severely underreported and under-addressed by policy.

The Bhopal Gas Tragedy: a turning point that demanded more 🔗

No discussion of occupational health in India is complete without examining the disaster that forced the country to confront the true cost of inadequate industrial safety. On December 3, 1984, more than 40 tons of methyl isocyanate gas leaked from a pesticide plant in Bhopal, immediately killing at least 3,800 people and causing significant illness and premature death for thousands more. The Union Carbide India Limited plant had been operating with substandard safety procedures, insufficient staffing, and non-functional safety systems – and the surrounding community had never been informed about what was being produced there or what to do in an emergency.

An estimated 15,000 to 20,000 people died as a result of the disaster, and some 500,000 survivors suffered respiratory problems, blindness, and other lasting health conditions. The settlement reached through India’s Supreme Court – $470 million paid by Union Carbide – was widely criticized as grossly inadequate given the scale and permanence of the harm. Decades later, the consequences have not ended. Research has found that men who were in the womb at the time of the leak had higher rates of disability affecting employment, higher cancer rates, and lower educational attainment over 30 years later – illustrating how industrial disasters compound inequality across generations.

The Bhopal disaster did catalyze some policy change. It marked a turning point in the history of occupational health and safety in India, prompting the government to review existing legislative measures. But as researchers have noted, the response remained incomplete – services were underutilized, monitoring mechanisms were inadequate, and the occupational health needs of informal workers remained structurally ignored.

More recent industrial accidents 🔗

Bhopal was not a historical anomaly. India continues to witness serious industrial accidents. Chemical plant explosions, factory fires, construction collapses, and mine accidents regularly claim workers’ lives – disproportionately in the informal or semi-formal economy, where safety audits are rarely conducted and workers have little power to refuse unsafe assignments. The frequency of such incidents underscores that the underlying structural problems – weak enforcement, inadequate training, and the exclusion of most workers from the formal safety framework – have not been resolved.

Agriculture: the forgotten occupational health frontier 🔗

India’s agricultural sector presents a distinct and underappreciated occupational health challenge. With the majority of rural workers dependent on farming, some of the major occupational risks include pesticide poisoning, musculoskeletal injuries, chronic obstructive lung diseases, and noise-induced hearing loss. Farmers and agricultural labourers typically lack access to protective equipment, safe chemical storage, or occupational health services. Heat stress is a growing concern as climate change intensifies. Women, who perform a substantial share of agricultural labour – particularly sowing, weeding, and harvesting – are especially vulnerable to pesticide exposure and repetitive strain injuries, yet are rarely counted in occupational illness statistics.

There is no sector-specific occupational health legislation for agriculture in India. The OSHWC Code, despite its broader scope, does not meaningfully extend to agricultural workers. This regulatory blind spot leaves hundreds of millions of people without structured health protection at work.

The case for a comprehensive approach 🔗

The data makes clear that India’s current occupational health architecture has a fundamental structural flaw: it protects a minority of workers well and leaves the majority without meaningful safeguards. The three most important occupational safety and health needs identified for India are: legislation to extend OSH coverage to all sectors including the unorganized sector; spreading awareness about occupational safety among all stakeholders; and development of OSH infrastructure and professionals.

A genuinely comprehensive approach would require several interconnected reforms. First, legal coverage must be extended to informal workers – including domestic workers, agricultural labourers, home-based workers, and gig economy workers – through targeted legislation or by expanding the OSHWC Code’s applicability. Second, primary healthcare systems need to integrate occupational health services, so that workers who do not have employer-funded health access can still report and receive treatment for work-related conditions. Third, the gendered dimensions of occupational risk – including the specific hazards faced by women in domestic and informal work – need to be recognized explicitly in both policy design and data collection.

Gig economy workers and a substantial portion of the informal sector remain outside the purview of the OSHWC Code, and migrant workers continue to face barriers in accessing benefits due to identification and enforcement gaps. Government initiatives like the e-Shram portal – which aims to register informal workers – and schemes like the Atal Pension Yojana represent steps toward recognizing unorganized workers, but registration alone is not protection. Without enforceable safety standards and accessible grievance mechanisms, registration remains a bureaucratic formality.

Ultimately, occupational health in India is inseparable from broader questions of economic justice and gender equity. The workers most exposed to physical risk are overwhelmingly poor, female, rural, or migrant – and they are the workers who have historically had the least political voice to demand protection. Building a safety system that reaches them is not just a public health imperative; it is a prerequisite for any claim to inclusive development.

What do you think? Given that the vast majority of India’s workforce operates in the informal sector with little legal protection, should occupational safety legislation be completely redesigned from the ground up to centre informal workers, rather than treating formal sector protections as the default? And how might recognizing the specific occupational health risks faced by women – particularly in domestic and agricultural work – reshape what we consider a “safe” workplace in the Indian context?

References

1. https://pubmed.ncbi.nlm.nih.gov/22790480/
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4. https://www.taxmann.com/post/blog/govt-notifies-enforcement-of-occupational-safety-health-working-conditions-code
5. https://www.impriindia.com/insights/occupational-safety-health-code-2020/
6. https://link.springer.com/article/10.1007/s44282-025-00239-9
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12. https://pubmed.ncbi.nlm.nih.gov/20442828/