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Health and Safety Guides » Health and Safety Guide for Sewage Workers

The term sewage relates to raw sewage, sewage sludge or septic tank waste. Raw sewage consists mainly of water, excrement, industrial effluent and debris and is a major source of harmful bacteria and other microorganisms. Sewage treatment reduces the water content and removes debris but does not kill or remove all the microorganisms. Workers whose activities bring them into contact with sewage or sewage products are at risk of contracting a work-related illness.

The UK water industry employs over 166,000 people, and sewage workers are well-trained specialists whose skills and knowledge are in high demand in the industry. As there are countless safety hazards working with sewage that need to be overcome on a daily basis, sewage workers will need to maintain their own safety, as well as the safety of the area and the people around them.

What is the role of a sewage worker?

Sewage workers are responsible for maintaining the sewer systems in their communities. They commonly work with heavy equipment and can spend most of their days underground, clearing blockages, repairing pipes, and performing other tasks to keep things running smoothly. The job can be very physical as they often have to lift heavy objects or climb into tight spaces. Depending on where they work and the type of work that they are doing, which may involve undertaking work focusing on the cleaning and treatment of fresh water and sewage, or maintenance of the sewage system itself, the role of a sewage worker may involve:

  • Carrying out planned maintenance on water and wastewater pipes.
  • Checking for faults.
  • Replacing cracked or damaged pipes.
  • Responding to customer callouts and emergencies, such as burst mains pipes or sewage blockages.
  • Installing new pumping equipment and water meters.
  • Lifting manhole covers, providing central teams with a visual report and an initial diagnosis.
  • Using computer-generated maps and plans to trace where underground pipes are located and which underground chambers they feed into.
  • Using closed circuit television (CCTV) to check for blockages in pipes and drains.
  • Clearing blockages with steel rods and high-pressure jets.
  • Switching off or diverting water supplies while work is carried out.
  • Digging holes by hand or with mechanical digging equipment.
  • Laying and repairing water mains and pipes.
  • Recording details of jobs done and materials used.
  • Filling in holes, repairing pavements and clearing rubble away once work is completed.
  • Entering sewage chambers.
  • Using specialist software to measure water flowing in and out of pipes.
  • Checking for dangerous gases using specialist equipment.
  • Working closely with engineers, surveyors, building contractors and other tradespeople.
  • Following set safety procedures to ensure that they are not endangering their work colleagues or members of the public.


The above list is not exhaustive. Whatever the environment they work in, a sewage worker will be responsible for ensuring the safety of their work and any equipment to protect the safety of themselves and other people.

Health and Safety for Sewage Workers

What are the main hazards of working with sewage?

Working with sewage, including, for example, untreated sewage, sludge, septic tank waste or effluent water, can expose sewage workers to a variety of infection risks. Sewage workers most at risk include workers involved in sewer inspection and maintenance work, construction workers who repair or replace live sewers, and plumbers who may be exposed to sewage sludge.

There are a number of health risks associated with occupational exposure to sewage. The majority of illnesses are relatively mild cases of gastroenteritis, an infection of the gut (intestines) which is a very common condition that causes diarrhoea and vomiting caused when microorganisms have entered the body via contaminated tools or hand-to-mouth contact while eating, drinking or smoking, and by wiping the face with contaminated hands or gloves. Contact with other pathogens can cause diseases, a number of which are potentially fatal diseases that can pose a health risk to sewage workers, such as:

  • Leptospirosis (Weil’s disease) – this is contracted from the urine of infected rats. The bacteria get into the body through cuts and scratches or through the lining of the mouth, throat and eyes after contact with infected urine or contaminated water. The risk of Weil’s disease is linked to areas where rats are or have been present. Work is considered higher risk where there is evidence of rat infestation and includes work linked to canals, rivers or sewers. More severe cases of Weil’s disease can lead to meningitis, kidney failure and other serious conditions and, in rare cases, the disease can be fatal.
  • Hepatitis – hepatitis A is an infection of the liver that is generally uncommon in the UK. Initial symptoms are similar to flu and may lead to yellowing of the skin and eyes (jaundice), very dark coloured urine and pale faeces, abdominal pain and itchy skin. The symptoms usually clear up within two months, although may occasionally last up to six months. Older adults tend to have more severe symptoms. In most cases, the liver will make a full recovery. The risk of workers being exposed to hepatitis A is mainly when working in an area contaminated with raw, untreated sewage in the last 12 months. In particular, work in or near a sewer might lead to contamination of hands, clothing or PPE, or to splashes in the eyes and mouth.
  • Hepatitis B – the incidence of hepatitis B is low, but people who work with untreated sewage are at risk of exposure.
  • E. coli – this is spread by the faecal-oral route. Most strains are usually harmless. A few strains cause diarrhoea / bloody diarrhoea, vomiting and stomach pains and cramps. One strain can lead to kidney failure if not properly managed.


Sewage workers can be infected with parasites such as intestinal worms and Giardia duodenalis, also known as Giardia intestinalis, which can cause a variety of intestinal symptoms, including diarrhoea, stomach cramps or pain, nausea and dehydration.

Germs in sewage can cause skin infections if they enter a cut or abrasion, and they can also cause eye and ear infections.

Due to the fact that microorganisms are an innate characteristic of sewage, it is not possible to eliminate the hazard completely; however, measures should be in place to reduce the risk of infection and illness. Sewage workers should assume that everything, including equipment, clothing and themselves, that might be in contact with sewage in the course of their work is contaminated, and have effective decontamination procedures in place.

Sewage workers should always use safe systems of work and wear the protective equipment that is provided. We will look at PPE in more detail later in this guide. They should recognise the risks to health and safety and avoid becoming contaminated with sewage by:

  • Avoiding breathing in sewage dust or spray.
  • Changing out of contaminated clothing before eating, drinking or smoking and washing hands and face thoroughly with soap and water.
  • Cleaning contaminated equipment on site and not taking contaminated clothing home – leave on site for cleaning or disposal.
  • Cleaning all exposed wounds, however small, and covering with a sterile waterproof dressing.
  • Seeking medical advice in the event of any flu-like fever or illness.


It is essential that a COSHH risk assessment is carried out when working with sewage as some workers will suffer from at least one episode of work-related illness each year.

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) places duties on employers, the self-employed and people in control of work premises (the responsible person) to report certain serious workplace accidents, occupational diseases and specified dangerous occurrences (near misses). Exposure to microorganisms that lead to diseases such as hepatitis is reportable under RIDDOR when a work activity causes accidental contamination sufficient to cause damage to the health of any person. Such situations are likely to arise when work is carried out without suitable controls, or where those controls fail.

Sewage workers may work on underground pipes and sewers, at reservoirs and water towers or at sewage treatment plants. Most of their time is spent working outside in all weathers. Conditions are often wet, dirty and smelly. They may work in confined spaces, which is governed by The Confined Spaces Regulations 1997. The various confined space hazards that pose a risk include toxic gases, oxygen deficiency, oxygen enrichment, flammable atmosphere, excessive heat and flowing liquids. Some of the other factors that should be taken into consideration during the risk assessment include lighting, communication methods and additional equipment needed for the task at hand. All workers must be equipped with the correct gas monitors, body protection, fall arrest and breathing devices, depending on the area that they are entering.

Manual handling injuries have a major impact on all workplaces and sectors, costing the economy hundreds of millions every year. Manual handling encompasses a wide range of actions including lifting, lowering, pulling, pushing, and carrying awkward and heavy objects. The risks are endless for sewage workers as the work can be quite physical, with lots of bending and lifting, and they may experience manual handling injuries such as:

  • Back injuries
  • Hernias
  • Musculoskeletal disorders (MSDs) such as shoulder strain
  • Repetitive strain injury (RSI) such as wrist strain
  • Soft-tissue injuries to the wrists, arms, shoulders, legs or neck
  • Long-term pain in the arms, legs or joints


Injury from poor, damaged or inadequate equipment – ensuring tools and equipment are in proper working condition is key to ensuring safety on a job. Inspect all equipment before use and only use if in good working order. Sewage workers should always use equipment properly, follow safe work policies and procedures, and attend any training required. Always ask for an explanation if something is unclear, or uncertain.

Slips, trips and falls are always a risk for sewage workers as they are often working on uneven surfaces and are exposed to all weather conditions. Each year slips, trips and falls cause thousands of preventable injuries. They can cause various injuries such as bruises, sprains, scrapes, broken bones and head traumas. Around 1,000 of these injuries involve someone fracturing bones or dislocating joints, so make sure footwear with a good grip is worn; we will look at PPE later in this guide.

Risk assessments

Maintaining a safe work environment is important, particularly in the high-risk work environment faced by sewage workers. It is important that every hazard is met with elimination or, at the minimum, a control measure to mitigate any potential risk.

Under the Management of Health and Safety at Work Regulations (1999), the minimum a business must do is:

  • Identify what could cause injury or illness in your business (hazards)
  • Decide how likely it is that someone could be harmed and how seriously (the risk)
  • Take action to eliminate the hazard or, if this isn’t possible, control the risk


Risk assessment requires making a judgement on Risk Severity. Risk Severity = probability of risk materialising x impact of risk on, for example, a person or people, a business, a property etc.

Probability may be understood as:

  • Low (Level 1) – a reasonably informed person would think it very unlikely this risk would materialise in the foreseeable future.
  • Medium (Level 2) – a reasonably informed person would think there is a significant possibility this risk would materialise in the foreseeable future.
  • High (Level 3) – a reasonably informed person would think there is a very significant or even likely possibility the risk would materialise in the foreseeable future.


Impact may be understood as:

  • Low (Level 1) – any impact that is minimal, having regard to the importance of interests affected, impairment of function and duration. Typically, the impact is isolated and short-lived.
  • Medium (Level 2) – any impact that is significant, having regard to the importance of interests affected, impairment of function and duration. Typically, the impact is limited to one function or group, but there is a material operational impact and the effects may continue.
  • High (Level 3) – any impact that is severe, having regard to the importance of interests affected, impairment of function and duration. Typically, the impact impairs a critical function and/or has a systemic impact and the effects may be long-lasting or permanent.


Sewage workers must ensure an assessment has been made of any hazards, which covers:

  • What the potential hazard is – the risk assessment should take into consideration the type of equipment used, the way in which it is used and the environment it is used in
  • Who or what could be harmed by the hazard
  • How the level of risk has been established
  • The precautions taken to eliminate or control that risk


Managing risk is an ongoing process that is triggered when changes affect a sewage worker’s work activities; changes such as, but not limited to:

  • Changing work practices, procedures or the work environment
  • Purchasing new or used equipment or using new substances
  • Workforce changes
  • Planning to improve efficiency or reduce costs
  • New information about the workplace risks becomes available


Risk assessments should be recorded and records regularly reviewed and updated whenever necessary. Should an accident occur, the Health and Safety Executive (HSE) will request copies of the risk assessments.

There are a number of laws and regulations that apply to the management of health and safety risks to sewage workers.

These include, but are not limited to:

It is a requirement of the Control of Substances Hazardous to Health Regulations (COSHH) for employers to assess all exposures to hazardous substances in the workplace and implement necessary control measures in order to protect their workers’ health.

Under the Manual Handling Operations Regulations 1992 (MHOR), manual handling which might cause injury is prohibited unless an assessment has been made, and if the operation cannot be avoided, suitable control measures should be in place. In all cases, reasonable alternatives to manual handling should be employed.

The Provision and Use of Work Equipment Regulations 1998 (PUWER) place duties on people and companies who own, operate or have control over work equipment. PUWER also places responsibilities on businesses and organisations whose employees use work equipment, whether owned by them or not.

PUWER requires that equipment provided for use at work is:

  • Suitable for the intended use.
  • Safe for use, maintained in a safe condition and inspected to ensure it is correctly installed and does not subsequently deteriorate.
  • Accompanied by suitable health and safety measures, such as protective devices and controls. These will normally include emergency stop devices, adequate means of isolation from sources of energy, clearly visible markings and warning devices.
  • Used in accordance with specific requirements.


Generally, any equipment which is used by an employee at work is covered by PUWER, for example hammers, knives, ladders, drilling machines, power presses, circular saws, photocopiers, lifting equipment (including lifts), dumper trucks and motor vehicles. Similarly, workers providing their own equipment will be covered by PUWER and it will need to comply.

The Water Services Regulation Authority (Ofwat) is the regulator for the water and sewerage sectors in England and Wales.

Why is PPE important

The Personal Protective Equipment Regulations 2002 place a statutory duty on employers concerning the provision and use of Personal Protective Equipment (PPE) at work. Personal protective equipment (PPE) protects workers from hazards such as trips, burns, electrocution and falls. While there is some PPE that is universal to many trades, sewage workers have certain PPE which is specific to their job.

This includes:

  • Face masks and respirators – prevent potentially inhaling substances. For proper use and to ensure compliance, be sure to fit test the respirator, undergo formal training, always make sure it is clean and never borrow or use another worker’s respirator.
  • Goggles to protect eyes from splashes of human waste or sewage and protective face mask or splash-proof face shield to protect the nose and mouth from splashes of human waste or sewage.
  • Head protection for overhead impact or electrical hazards – sewage workers in the wastewater industry need head protection they can rely on to protect from falling objects or electrical hazards. Protection against mechanical impacts to the head safeguards the user against possible consequences such as brain injuries or skull fractures.
  • Gloves – gloves are critical for protection from a wide range of hazards; use waterproof and/or anti-cut gloves to prevent cuts and contact with human waste or sewage.
  • Hi-visibility and liquid-repellent coveralls – these should be worn to keep human waste or sewage off clothing and play a vital role in ensuring the safety of workers.
  • Safety footwear – these should be designed specifically for tough, outdoor environments with deep treads for excellent stability and protection.
  • Hearing protection – sewage workers are often exposed to noise from drilling etc. Failure to wear dedicated hearing protection equipment such as noise-cancelling headphones, earplugs or earmuffs, either reusable or disposable, can lead to severe damage to the eardrum, tinnitus or even irreversible hearing loss in one or both ears.


In addition to proper PPE usage, additional general safety precautions for sewage workers might include:

  • Being up to date on immunisations in accordance with local health guidelines such as tetanus, hepatitis A and hepatitis B.
  • Decontamination facilities on site where sewage workers can remove boots, PPE and work clothes before leaving the worksite.
  • Washing facilities with soap and water to wash before eating or drinking and leaving the worksite.

A full risk assessment must be undertaken before it is decided which PPE should be worn by the sewage worker.

What training should sewage workers take?

To become a qualified sewage worker, a person may need to study for one of the following:

  • An apprenticeship
  • NVQ Level 2 in operating process plant (water/wastewater)
  • City & Guilds Level 2 Certificate in water engineering
  • City & Guilds Level 2 Certificate/Diploma for water sector competent operator
  • NVQ Level 3 in water and sewage
  • Diploma in engineering
  • An engineering degree

Training Courses

When sewage workers are trained to work safely, they should be able to anticipate and avoid injury from job-related hazards. Safety training is essential for all sewage workers appropriate to their role, and training should be directly applicable to the responsibilities and daily practices of the person being trained.

This training for sewage workers might include, but is not limited to:

  • Health and Safety for Employees
  • Health and Safety for Managers
  • Manual Handling
  • Workplace First Aid
  • COSHH Awareness
  • Slips, Trips and Falls
  • Personal Protective Equipment (PPE)
  • PUWER Awareness
  • Assessing Risk
  • Confined Spaces
  • RIDDOR Awareness


Sewage workers should at a minimum refresh their safety training at least every 2 years and participate in continuing professional development (CPD).

Get started on a course suitable for sewage workers

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