Index IntroductionHealth Risk FactorsBenefits of InterventionConclusionIntroductionRegardless of location, cycle rickshaw has a tradition of being the most popular vehicle for urban residents. These are the environmentally friendly and non-polluting transportation systems. In another way, rickshaw pullers are low-wage transportation service providers who play the role of the backbone of the transportation system. According to estimates by Porier (2009), around 8 million rickshaw drivers work in India. Approximately 6-8 billion passengers travel by cycle rickshaw in India every year (Rajvanshi, 2000). Regardless of the circumstances, rickshaw drivers have to work daily to earn a living. Pedal rickshaw endangers the health of the rickshaw driver in many ways. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get Original Essay Manual rickshaw pulling is one of the strenuous and laborious tasks performed by human being which requires enormous stamina and a lot of energy. Poor working and living conditions, coupled with a lack of basic services such as safe drinking water and sanitation, make them highly susceptible to health risks. Rickshaws are often prone to road accidents. Improper balance of rickshaws and heavy road traffic are the causes of accidents. Heavy road traffic also increases the risk of rickshaw drivers being exposed to high levels of air and noise pollution. Long working hours (average 8 to 9 hours per day) and poor diet cause long-term health problems among rickshaw drivers (Kumar et al., 2016). Common health problems of rickshaw drivers include back pain, fatigue, stress, headaches, muscle pain, joint pain, heart problems and respiratory disorders. A survey conducted in Aligarh city revealed that rickshaw drivers mostly suffer from cough, cold, joint, back and chest pain, asthma, tuberculosis, gastroenteritis, diabetes, blood pressure and gallstones (Khan et al., 2010 ). they also become victims of various health problems due to harsh weather conditions and also get affected by several skin related problems due to extreme hot and humid weather conditions. Irregular, incorrect and unhygienic diet leads to gastrointestinal problems in rickshaw drivers. Most rickshaw drivers consume alcohol and are addicted to other drugs. Many of them are unaware of the negative health effects caused by alcohol and drug use. There is always a risk of contracting sexually transmitted infections (STIs) and HIV/AIDS among rickshaw drivers. Social factors, including personal behavior, ignorance, poverty, and lack of basic healthcare facilities, significantly affect the health of rickshaw drivers (Rosato et al., 2008). Health Risk Factors There are many problems responsible for the poor health of manual rickshaw pullers. Rickshaw drivers often face heavy traffic jams, dust, air, noise pollution, unhygienic food intake, direct sunlight, massive rainfall, accidental injuries and misbehavior of passengers. The long-term health problems of rickshaw drivers arise from the extreme physical stress that rickshaw drivers are subjected to on a daily basis (Begum and Sen, 2005). Air Pollution Air pollution levels cause serious health problems among rickshaw drivers who are exposed to ambient air pollutants in both cases.short and long term periods of time. There are an estimated 670,000 deaths per year due to air pollution in the most polluted Indian cities in the world (Lim et al., 2013). Symptoms of respiratory problems, lung function disorders, infections, bronchitis and asthma are common. Air pollution loads are responsible for undesirable birth outcomes, such as immature births and low birth weight. Recent studies have also reported the increasing risk of diabetes and neurological disordersAilments are associated with air pollution (Yang et al., 2018). Noise Pollution Rickshaw drivers are continuously exposed to noise pollution during working hours, which leads to ear problems. The most common ear problems include hearing impairment, deafness, infections, earwax and ear infections. Aage R. Moller also claims that deafness can result from continuous exposure to noise. Poor nutrition and low body mass To accommodate more passengers and increase income, rickshaw drivers often skip meals and work on an empty stomach. Irregular and insufficient food consumption does not meet the demand for necessary nutrients. They therefore often suffer from gastrointestinal problems and have a low body mass index (BMI). Unsafe drinking water leads to diarrheal disorders among rickshaw drivers. A study conducted in Bangladesh to find out the health status of manual rickshaw drivers revealed that about 52% of the surveyed rickshaw drivers had a low body mass index (<18.5 kg/m2) and about 50% were identified as suffering from chronic energy deficiency grade I (Ahmed and Islam, 1997). Extreme Weather Rickshaw pullers expose themselves to adverse weather conditions such as extreme heat and humidity and heavy rain when they work. They suffer from heat stroke, cold, cough and various dermatological problems such as eczema, scabies, dermatitis, itching, rashes, fungal infections etc. Musculoskeletal problemsThe strenuous exercise of manual rickshaw drivers causes musculoskeletal problems such as chronic joint and muscle pain . Satapathy et al., 2007 also found musculoskeletal morbidity in 89% of rickshaw drivers working for more than 5 years. Drug AddictionMost of the rickshaw drivers consume narcotics like opium, Ganja (weed) and marijuana "Charas". This triggers instant energy to undertake these physical activities. They are unaware of the deadly effects of drug use. Drug addictions are associated with various health problems including cardiovascular problems, lung disease, hepatitis (B and C), cancer, and mental illness. Most rickshaw pullers are also vulnerable to sexual interactions with sex workers and become victims of sexually transmitted diseases and HIV (Kumar et al., 2016). The work of Kumar et al., 2016 also reported that 73% of rickshaw pullers in Ranchi consume alcohol and 77% of them are unaware of the consequences of unprotected sex and diseases like HIV/AIDS/STIs . Laxmi et al., 2006 demonstrated the presence of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) among 10-15% of rickshaw drivers. Psychological problems Most of the rickshaw drivers come from the marginalized section of the society. The occupation of rickshaw driver is also associated with social stigma, leading to low dignity and thus psychosocial stress. Psychological problems of rickshaw pullers include insecurity, relationships with other people, behavioral changes, depression, drug and alcohol addiction, etc. All these problems lead to long-term diseases such as headaches, diabetes, problemscardiac, hypertension. There are also chances of psychosomatic disorders among rickshaw drivers due to addiction. Other Health Related Problems There are some direct health effects of rickshaw pulling such as varicose veins, hydrocele and lymphadenopathy along with increasing chances of tuberculosis infection and chest congestion. Another serious problem is injuries due to road accidents. They also face eye-related problems, such as poor vision. Benefits of the Intervention The Indian transport system is in a transition phase. In 2015, a Motor Vehicles (Amendment) Act was passed in which the battery-powered electric rickshaw became valid for commercial transportation in India. Recently, the Department of Heavy Industries, Government of India took up a significant initiative, called NMEM-2020 (National Electric Mobility Mission) to introduce electric vehicles and their manufacturing in the country. The NMEM plan focused on vehicular pollution, energy security and electronic vehicle manufacturing capacity. The Indian government has also planned to convert traditional vehicles to electric transportation by 2030. There is a need to adopt electric mobility due to rapid reduction in fossil fuel consumption, rising cost of energy, environmental impact of transportation and concerns on health aspects. To adopt electric mobility, there are some challenges including charging facilities, EV performance, maintenance costs and consumer acceptability. These challenges need to be overcome by building infrastructure and increasing awareness among users. Various interventions need to be considered to adopt this energy-efficient and cost-effective electronic transportation system. Traditional rickshaws carry his legacy. However, the strenuous work that manual rickshaw drivers have to undergo has had a long-term impact on their health. These are exposed to heavy traffic problems and pollution loads in urban areas which also worsen their health. Traditional rickshaws covered the distance from point to point, sometimes a journey nearly a mile long for very little pay. The effort they have to put in to complete the services is nothing compared to the profit they would get at the end of the day. But they experience high work stress. Musculoskeletal disorders are very common among them. With the advancement of technologies, the next generation of rickshaw drivers is trending towards services that are less time consuming, require less physical effort and have better economic benefits. In such circumstances the e-rickshaw has the potential to become an effective alternative vehicle. The battery-powered two-seater electric rickshaw can reduce daily physical workloads and the tendency to get entangled in health risks. It can be the most convenient means of transportation for the entire population. In another way, it has the potential to create space for a better income with less impact on the health of the rickshaw puller. E-rickshaw drivers can afford better nutritional diet and improve their immunity and lifestyle due to relatively less stressed service and better income. Thus, to achieve the targeted indicators, rickshaw drivers need to convert their manual rickshaw to two-seater electric rickshaw or exchange the old manual rickshaw for a new electronic one. Therefore, there is an immediate need for environment-friendly and low-cost transportation in Indian cities that can generate better earning opportunities for the marginal population, such as rickshaw pullers, and at the same time.