Methods A cross-sectional study was conducted among waste pickers aged 18 years or older, working in major landfill sites in Johannesburg. Information on health, work hazards and health care access were collected in interviews in the workers own language.

Results A third (27%) of the 363 waste-pickers interviewed in this study were female. These women were on average older and less educated than the men and a significantly larger proportion were born in neighbouring countries. Women waste pickers had a higher prevalence of hypertension (30.9% vs 18.4%) and HIV (24% vs 7.0%) than men. This is unlikely to be a reporting bias as women had higher BMI’s (p=0.0002), glucose blood levels (p=0.022), cholesterol (p=0.0014) and diastolic blood pressure (p=0.0081).

Discussion The factors driving women to work as waste pickers appear different to men and women’s health is worse than that of the men in terms of lifestyle diseases and HIV. Although in general waste pickers have a lower prevalence than the general population. This follows the pattern of the South African Demographic and Health Survey 2016.