Working with sewage

What is sewage?

The term 'sewage' covers raw sewage (water containing excrement, industrial effluent and debris, such as sanitary towels, condoms etc.); sewage sludge; and septic tank waste.

Sewage can be a major source of harmful microorganisms including bacteria, viruses and parasites. Whilst sewage treatment reduces the water content and removes debris, it does not kill or remove all the microorganisms. Working with sewage may pose some health risks, the most common of which is mild gastroenteritis (i.e. diarrhoea, vomiting and cramping stomach pains). However, exposure can lead to more serious illness such as:

• Weils disease (a flu-like illness transmitted by rats' urine, which can cause severe headaches in addition to flu-like symptoms, and can damage the liver, kidneys and blood);
• hepatitis;
• occupational asthma;
• skin/eye infections;
• inflammation of the lungs.

What does working with sewage mean for employees?

The most common way for microorganisms to enter the body is through hand to mouth contact whilst eating, drinking, smoking or wiping the face with contaminated hands or gloves. It is vital you follow strict hand hygiene measures (e.g. washing hands before eating, changing out of contaminated clothing before eating, drinking or smoking).

Microorganisms can also enter the body through cuts, scratches or from a puncture wound from a discarded hypodermic needle so it is vital that you wear appropriate personal protective equipment (PPE) and to cover any open wounds/scratches.

To avoid developing occupational asthma or inflammation of the lungs, you should wear appropriate PPE to avoid inhaling any sewage dust or spray.

If you develop flu-like illnesses or fever, particularly when associated with severe headaches and skin infections, you should consult their doctor and let them know of the work hazards you are exposed to. In addition, you should advise your employer and doctor if you have persistent chest symptoms.

What are employers' responsibilities?

Employers should consider how to minimise employees' exposure to sewage by using alternative methods (e.g. remote-controlled robotic cameras for sewer inspection). Where exposure cannot be avoided, it is important that employees receive appropriate instruction, training and supervision. Suitable PPE should be supplied, which may include waterproof/abrasion-resistant gloves, footwear, eye and respiratory protection, and face visors that are particularly effective against splashes.

Appropriate welfare facilities should be available to employees including clean water, soap, nailbrushes, disposable paper towels and showers (where heavy contamination is foreseeable). Portable welfare facilities should be provided in remote areas. Storage areas for clean and contaminated equipment should be segregated and separate from eating facilities.

Your employer should monitor your health. Respiratory health surveillance may be required depending on the level of exposure/risk assessment. In addition, health screening is recommended for employees who are required to enter confined spaces or use breathing apparatus.

Employees involved with sewage work should be routinely offered inoculations against Tetanus and Polio, and they should be kept up to date. Hepatitis B immunisation should be offered on the basis of a risk assessment. The risk assessment should take into account the likelihood that employees may come into contact with used syringes or needles. Some sewage workers are also offered vaccinations against Hepatitis A.

What help is available for employees?

The Health for Work Adviceline can offer guidance on the health surveillance programmes that may be necessary for staff working with sewage on the basis of risk assessments, as well giving information on inoculations that may be required.

You can also contact your union or health and safety representative for advice if you have any issues relating to working with sewage.

Sources of further information

• The Clear Water 2010 guide offers guidance on the health hazards of work involving exposure to sewage in the water industry.
• The Health and Safety Executive (HSE) website includes guidance for employees on working with sewage as well as information on safe work in confined spaces.