Sewer Workers: Health Hazards of Working in Sewage & Sanitation

Working in sewage and sanitation is a messy job. Depending on how advanced the sewage system is, it can also be a dangerous job that poses serious health hazards.

From harmful gas exposure to musculoskeletal disorders, heart issues, infections and respiratory issues, sanitation workers face a laundry list of health risks on the job. And it’s not just sanitation workers that face these risks. Construction workers can also be exposed to these dangers when their work takes them underground.

Worker Dies in Texas after Exposure to Sewer Gases

In Lake Jackson, Texas, one worker died while performing manhole lining and repair. The construction company, Matula & Matula Construction Inc., was fined $136,000 by OSHA for health and workplace safety violations.

“This company exposed its workers to hazardous atmospheres while they were working in sanitary sewers,” said Mark Briggs, director for OSHA’s Houston South office. “It is critical that procedures for safe confined space entry are utilized each time a worker enters a confined space.”

OSHA’s citations allege two willful, two repeat, and three serious violations. The citations came after the agency performed an investigation that started after the work’s death on February 8.


While working on the Highway 332 Utility Relocation Project, an employee who was pumping grout into a sewer line was overcome by hydrogen sulfide.

The company received two willful citations for failure to implement confined space entry protocols, which include testing, ventilation and rescue. They were also cited for not training workers on the hazards of working in confined spaces.

Willful citations are issued when OSHA believes an employer is exhibiting indifference to or intentional disregard for employee safety and health.

Matula & Matula was also cited for not training employees on the danger of working with hazardous chemicals, and for not properly inspecting and maintaining ladders. OSHA issues serious citations when serious physical harm or death results from a danger that the employer should have known.

The company was also cited for failing to properly erect a ladder and not making a reasonable estimate of employee exposure to hazardous chemicals. These were repeat violations, which means the company has been previously cited for this violation. Repeat citations are a final order.


Matula & Matula has 15 business days to comply with the citations, contest the citations before the Occupational Safety and Health Review Commission, or request an informal conference with the OSHA Houston area director.

The Health Risks Faced by Sanitation Workers

Death is the worst-case scenario for workers in the sanitation field, but they still face a slew of health risks.

One study looked at 26 sewer workers who were exposed to gases, like methane, hydrogen disulfide, carbon monoxide and ammonia. Researchers found that 53.8% developed troubling symptoms, like breathlessness, sore throat, chest tightness, cough, sweating, thirst, loss of libido and irritability. The greater the exposure, the more severe the symptoms.

Hydrogen sulfide, which is what killed the Texas worker, is a flammable gas that creates sulphur dioxide, a foul-smelling, irritating gas. Explosions are a very real threat to workers who are exposed to hydrogen sulfide.

At low concentrations, the gas irritates the eyes. Mild poisoning can cause severe headaches, pain in the legs, and in some cases, loss of consciousness. Inhaling massive quantities of hydrogen sulfide will cause death by asphyxia. A person may go through epileptiform convulsions, collapse and die without moving again.

Musculoskeletal Disorders

Along with exposure to harmful gases, sewer workers may also develop musculoskeletal disorders. Neck and back pain is common in sewer workers due to stooping and lifting.


Sewer workers are also more likely to develop certain infections. Exposure may occur by:

  • Hand-to-mouth contact while eating, smoking, drinking or wiping the face.
  • Breathing in mist, dust or aerosol.
  • Skin contact through scratches or cuts.

The most common infections contracted by sanitation workers include:

  • Hepatitis: Although preventable through vaccine, hepatitis is still one of the most common infections sewer workers develop. Research suggests that exposure to sewage is linked to a higher risk of contracting hepatitis B.
  • Leptospirosis: This disease affects people who come in contact with animals and their waste. Urine from rodents and other animals in the area can contaminate the sewers, putting workers at risk of developing leptospirosis.
  • Helicobacter pylori: Bacterium Helicobacter pylroi is now considered an important risk factor for gastric cancer and is considered a class I carcinogen by the International Agency for Research on Cancer.

Sewer workers face an onslaught of health risks every day they show up for work. Following the appropriate safety protocols can help prevent the risk of disease and death.

Editorial Staffs at Healthtian, A team of Writers.

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