Workers who handle human waste or sewage may be at increased risk of becoming ill from waterborne diseases. To reduce this risk and protect against illness, such as diarrhea, 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 contact with human waste or sewage.
Wear rubber boots at the work site and during transport of human waste or sewage.
Remove rubber boots and work clothes before leaving work site.
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 handling 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 disease prevention. The training should include information on basic hygiene practices; use and disposal of personal protective equipment, and proper handling of human waste or sewage. Workers must also be urged to promptly seek medical attention if displaying any signs or symptoms of diarrhea, 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.