Infection risks from work with sewage
Work with sewage, including untreated sewage, sludge, effluent water, grit, septic tank waste and biosolids, can expose workers to infection risks. Learn how to manage the risks of infection from working with sewage and protect yourself and others.
What do we mean by ‘sewage’?
Sewage is the wastewater from our homes (kitchens, laundries, bathrooms and toilets), industry and business. Wastewater from the sewerage system undergoes treatment to remove contaminants before being reused or released to land, waterways or the ocean.
What are the infection risks of working with sewage?
Workers who handle human waste or sewage may be at risk of becoming ill from waterborne diseases. This is because of the risk of exposure to disease-causing organisms (pathogens) in treated sewage, biosolids and recycled water.
Workers can be exposed to pathogens by skin contact, inhalation or unintentional ingestion. Affected areas can include the nose, throat, respiratory tract, eyes and other parts of the body directly contacted by sewage. Workers can unknowingly contact pathogens through contaminated tools or hands, so good personal hygiene and personal protective equipment (PPE) are essential.
Occupational exposure to sewage can lead to illness from:
- pathogens in body fluids (such as hepatitis B and HIV) and faeces (such as hepatitis A and Salmonella).
- enteric (intestinal) microbial pathogens (such as rotavirus and Cryptosporidium), which can cause gastroenteritis if ingested
- opportunistic pathogens (such as Pseudomonas aeruginosa and Legionella pneuomophila)
- microbial endotoxins (non-infectious substances released by bacteria when they die), which can cause irritation and sensitisation (allergy) with respiratory and gastrointestinal symptoms
- parasites (such as intestinal worms and Giardia duodenalis).
Illnesses can include:
- Gastroenteritis: Germs in sewage can cause gastroenteritis ('gastro') with symptoms of nausea, vomiting and diarrhoea.
- Skin infections: Germs in sewage can cause skin infections if they enter a cut or abrasion.
- Hepatitis A: The incidence of hepatitis A is low, but those who work with untreated sewage may be at increased risk if the disease is circulating in the community. Vaccination can prevent hepatitis A.
- Hepatitis B: The incidence of hepatitis B is low in Australia, but people who work with untreated sewage are at risk of exposure. Vaccination can prevent hepatitis B.
- Leptospirosis: Leptospirosis is caused by bacteria shed in the urine of infected animals, particularly rodents, cattle and pigs. Infection can occur if the bacteria get into a cut or other broken skin or the eyes, mouth and nose. Leptospirosis can cause an influenza-like illness that can progress to severe disease.
People at risk of exposure to sewage include:
- wastewater treatment plant workers, laboratory workers and contractors
- workers who inspect, maintain, repair or replace sewer systems and septic tanks
- plumbers, irrigators and other people who maintain wastewater or recycled water systems
- workers who transport sewage waste
- workers who apply biosolids to the land or irrigate using effluent.
How can I manage the risk?
Workers and management can work together to reduce the risks from hazards at work. A safe place of work benefits everyone. Read more about good work design and how you can create safe work.
As a worker, you have a responsibility under the Work Health and Safety Act 2011 to take reasonable care for your own health and safety and for others who may be affected by what you do or don’t do. You must follow any reasonable health and safety instructions from your employer. Use equipment properly, follow safe work policies and procedures, and attend training. If something is unclear, or you are uncertain, ask for an explanation. Report hazards or work-related injury or illness to your employer.
For employers or persons conducting a business or undertaking (PCBU), it’s your duty to manage workplace risks, as outlined in the Work Health and Safety Act 2011.
Following the four-step risk management process below will help your business meet its responsibilities under work health and safety (WHS) laws. You can also use the practical advice in the How to manage work health and safety risks code of practice 2021 (PDF, 0.65 MB).
Employers or PCBUs must provide and maintain a working environment where their employees, contractors and visitors are not exposed to hazards:
- Ensure safe systems of work are in place.
- Implement safe work practices and provide information, training and supervision.
- Encourage an environment of consultation and cooperation.
- Provide personal protective equipment (PPE), and ensure there are systems for PPE inspection, maintenance, cleaning and storage.
- Provide or support occupational immunisations on a risk basis.
Four steps to manage risk
You can manage risks posed by work with sewage by:
- doing a risk assessment that considers the likelihood and consequences of exposure
- putting suitable control measures in place
- maintaining and regularly reviewing the control measures.
The first step is to identify possible hazards.
- Inspect your business
Think about your workplace and note where your work environment or processes create the risk of exposure to sewage.
- Talk to your workers
Talk to your workers to find out if they have any health and safety concerns. A confidential survey could give workers who are less likely to speak out in public an opportunity to provide feedback.
- Review available information
Read the relevant legislation and codes of practice. Research how other workplaces have managed risks.
Find more information on how to identify risks in How to manage work health and safety risks code of practice 2021 (PDF, 0.65 MB).
If you identify a potential risk, make a risk assessment to identify:
- if there is a risk to you or others
- whether any effective control measures are already in place
- what actions you could take to control the risk
- how urgently you should act.
A risk assessment can include looking at:
- the nature of the work and how this exposes workers and others
- whether the work is required or if it can be rescheduled to a time when the risk of exposure is reduced
- the frequency and duration of contact.
Use this risk assessment template (DOCX, 0.02 MB) to guide and record your assessments.
After assessing the risk, put control measures in place.
The hierarchy of control is a step-by-step approach to eliminating or reducing risks. It ranks risk controls from the highest level of protection and reliability through to the lowest and least reliable protection. Implement control measures in this order:
- Level 1: Get rid of the harm and prevent the risk.
- Level 2: Replace the hazard with something less harmful, separate people from the hazard, or change work processes or the physical work environment.
- Level 3: Use administrative controls to reduce exposure (such as limiting time spent in a hazardous area) or use personal protective equipment (PPE) to protect people from harm.
Eliminating exposure is the most effective way to protect workers, but this may not always be possible. Where you can’t eliminate risk, minimise it.
Minimise contact with sewage
- Avoid direct contact with sewage or recycled water and unnecessary exposure to sprays and aerosols.
- Use remote-controlled robotic cameras to inspect sewer pipelines.
- Install barriers and screens to contain sewage.
- Minimise the time spent in areas where sewage is being agitated or disturbed.
- Manage sewage aerosols and biosolid dust with ventilation controls.
- If using heavy equipment to apply biosolids, fit the cabin with air conditioning and maintain filters and seals.
- Clean any tools or equipment after use.
Workers who have regular contact with untreated sewage should be vaccinated against hepatitis A and B and have current tetanus vaccination. A combined hepatitis A and B vaccine is available for workers who have regular contact with sewage debris such as used needles and syringes. Where required because of risk, provide free vaccination to employees. A vaccination program may also include agreement to vaccination as an employment pre-requisite. Learn more about the recommended vaccinations for people who work with sewage.
Keep the workplace clean
- Clean contaminated surfaces, equipment and tools with clean water and detergent.
- Disinfect heavily contaminated surfaces and equipment after cleaning. Disinfectants need a minimum contact time to be effective. They may not work properly in the presence of organic matter such as sewage, so clean surfaces before applying a disinfectant. Alternatively, use a product that is both a detergent and a disinfectant.
- Separate clean and dirty equipment to prevent cross-contamination.
- Avoid cleaning methods that disperse aerosols (such as high-pressure washing and compressed air).
- Control pests such as rodents and insects.
Maintain personal hygiene
- Wash hands thoroughly with soap and clean water immediately after working, after contact with sewage and contaminated equipment, and after removing personal protective equipment (PPE).
- Keep fingernails short and scrub nails with soap after work.
- If using a waterless hand sanitiser make sure it contains an alcohol content of at least 60 percent. Only use it on visibly clean hands. Wash your hands with soap and water at the first chance.
- Avoid touching your face with contaminated hands or gloves. Don’t eat, drink or smoke when working with sewage.
- Before eating, remove soiled work clothes and wash your hands and face thoroughly. Only eat in designated areas away from sewage-contaminated areas.
- Check your skin before starting work and cover any cuts and other broken skin with a clean, dry dressing. If you get a wound at work, clean and cover it straight away.
- If untreated sewage gets on your skin or in your eyes, nose or mouth, wash the area thoroughly.
- Remove work clothes at the end of the shift and wash or shower. Change clothes before you leave. If possible, leave your work clothes at work.
- Keep work clothes separate from other clothes. Wherever possible, separately launder and store work clothes. Clean work clothing with commonly available laundry disinfectant products or a 0.05% chlorine solution (1 part bleach to 100 parts water).
Employers or PCBUs:
- Provide workers with adequate washing facilities (PDF, 0.57 MB). Include clean running water, soap and paper towels.
- Provide field workers with portable hand washing facilities.
- Use handwashing signage to remind workers to wash their hands.
- Provide workers who have significant contact with sewage access to showers and change rooms.
- Provide workers with first aid facilities, clean eating facilities and drinking water.
Personal protective equipment (PPE)
Basic PPE for working with sewage:
- work clothes (coveralls or clothes with sleeves and long pants)
- enclosed liquid-repellent shoes or rubber boots with non-slip soles
- water-proof gloves (always wear them when cleaning pumps, filters or screens and when handling effluent, recycled water or biogrit)
- eye protection (when the eyes are exposed to dust, flying particles or splashes).
- Wear liquid-repellent coveralls, a disposable or reusable respirator and/or a splash-proof face shield as needed when dealing with raw sewage or confined spaces.
- Wear a properly fitted (PDF, 0.86 MB) particulate respirator (such as a disposable P2 respirator or higher) if exposed to sewage aerosols and biosolid dust.
- Use suitable respiratory protection if there are hazardous chemicals or oxygen deficiency.
Procedures and reporting
Have clear procedures for reporting incidents, injuries and diseases. Tell workers to visit a medical practitioner if they have any of these symptoms:
- stomach cramps
- yellowing of the skin
- symptoms of breathlessness, chest tightness and wheezing
- redness and pain in the eyes
- skin rash and/or pain.
Advise staff to tell the medical practitioner they work with sewage, human effluent, biosolids or recycled water.
Have a documented procedure on what to do if a worker is grossly exposed to sewage (such as a splash to the eyes or mouth).
Information, instruction, training and supervision
Provide workers with information on:
- health risks from contact with sewage and the signs and symptoms of waterborne diseases
- appropriate hygiene practices, particularly the importance of handwashing and correct laundry practices
- use, storage, cleaning and disposal of contaminated PPE and equipment
- reporting procedures for damaged PPE and equipment, incidents and potential illnesses or symptoms
- safe work procedures relevant to the site
- occupational vaccinations
- selecting and using PPE
- first aid.
Risk management is an ongoing process. Check regularly to make sure the control measures are working. If you find problems, go through the steps again, review the information, and decide whether you need new controls.
Under the work health and safety laws you must review the controls:
- when you become aware that a control measure is not working effectively
- before a change that might create a new risk
- when you find a new hazard or risk
- when your workers tell you that a review is needed
- after a health and safety representative requests a review.
You can find a list to help you find any issues in the How to manage work health and safety risks code of practice 2021 (PDF, 0.65 MB).
Standards and compliance
Work Health and Safety Act 2011
Codes of practice
How to manage work health and safety risks code of practice 2021 (PDF, 0.65 MB)
Managing the work environment and facilities code of practice 2021 (PDF, 0.57 MB)
Vaccination for people at occupational risk. Australian Immunisation Handbook. Department of Health and Aged Care, 2017.
Contact Workplace Health and Safety Queensland on 1300 362 128 for information on managing infectious diseases at work. If a person is infected with an infectious disease at work, you must notify Workplace Health and Safety Queensland.
Contact Queensland Health on 13HEALTH (13 43 25 84) for information on infectious diseases. Seek advice from your general practitioner or local public health unit if you have concerns about possible exposure to infectious diseases from work with sewage.