Guidance for Reducing Health Risks to Workers Handling Human Waste or Sewage
Workers who handle human waste or sewage are at increased risk of becoming ill (i.e., from water-washed, waterborne and water-carried diseases). To reduce this risk and protect against illness, including cholera, the following guidance should be followed by workers and employers.
Basic Hygiene Practices for Workers
- Wash hands with soap and water immediately after handling human waste or sewage.
- Avoid touching face, mouth, eyes, nose, or open sores and cuts while handling human waste or sewage.
- After handling human waste or sewage, wash your hands with soap and water before eating or drinking.
- After handling human waste or sewage, wash your hands with soap and water before and after using the toilet.
- Before eating, removed soiled work clothes and eat in designated areas away from human waste and sewage-handling activities.
- Do not smoke or chew tobacco or gum while handling human waste or sewage.
- Keep open sores, cuts, and wounds covered with clean, dry bandages.
- Gently flush eyes with safe water if human waste or sewage contacts eyes.
- Use waterproof gloves to prevent cuts and contact with human waste or sewage.
- Wear rubber boots at the worksite and during transport of human waste or sewage.
- Remove rubber boots and work clothes before leaving worksite.
- Clean contaminated work clothing daily with 0.05% chlorine solution (1 part household bleach to 100 parts water).
Personal Protective Equipment (PPE)
Workers handling human waste or sewage should be provided proper PPE, training on how to use it, and hand washing facilities. Workers should wash hands with soap and water immediately after removing PPE. The following PPE is recommended for workers handing human waste or sewage:
- Goggles: to protect eyes from splashes of human waste or sewage.
- Protective face mask or splash-proof face shield: to protect nose and mouth from splashes of human waste or sewage.
- Liquid-repellent coveralls: to keep human waste or sewage off clothing.
- Waterproof gloves: to prevent exposure to human waste or sewage.
- Rubber boots: to prevent exposure to human waste or sewage.
Training for Workers
All workers who handle human waste or sewage should receive training on cholera prevention. The training should include information on basic hygiene practices; use and disposal of personal protective equipment; proper handling of human waste or sewage; signs and symptoms of cholera; and ways in which cholera can be transmitted. Workers must also be urged to promptly seek medical attention if displaying any signs or symptoms of cholera, such as vomiting, stomach cramps and watery diarrhea.
Vaccination Recommendations for Workers
Vaccination recommendations for workers exposed to sewage or human waste should be developed in consultation with local health authorities. Tetanus vaccinations should be up to date, with consideration also given to the need for polio, typhoid fever, Hepatitis A and Hepatitis B vaccinations.
The recommendations made in this document are based on best practices and procedures. Worker health and safety risks are likely to vary among specific locations and a trained health and safety professional should be consulted to create site specific worker health and safety plans.
CDC (Centers for Disease Control and Prevention)  Guidance for Controlling Potential Risks to Workers Exposed to Class B Biosolids. National Institutes for Occupational Safety and Health: 2002-149. http://www.cdc.gov/niosh/docs/2002-149/2002-149.html.
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