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Confined Space Rescue
Health Aspects of Wastewater

by: RescueNet Staff


  • Collection System and Treatment Plant workers.

  • Pump Station maintenance staff

  • Laboratory personnel


Biological contamination due to microorganisms. Pathogenic (disease-causing) microorganisms that may be found in sewage include those responsible for:

  • bacillary dysentery

  • cholera

  • typhoid fever

  • hepatitis type

  • polio

  • gastroenteritis

Other organisms that may be found in wastewater include parasites such as amoebae, roundworms, other protozoans (including hookworms), and tapeworms. These are water-home diseases, transmitted by the FECAL-ORAL route. That is, affected individuals shed the microorganisms iii their feces, and healthy individuals may become ill through the ingestion of water or food contaminated with feces or sewage. Other routes of infection include inhalation (breathing spray or mist containing pathogenic organisms, through the lungs, and into the bloodstream), and direct contact, (through a break in the skin, and into the bloodstream) as in the case of tetanus, or through eye and ear infections.


Personal hygiene and first aid protocols

    1)Wash hands frequently, and always prior to drinking, eating, and smoking.

    2)Eat, drink, and smoke only in designated areas, never while working in direct contact with wastewater.

    3)Wear Personal Protective Equipment:

      a) goggles always, and plastic face shields if there is higher than usual probability of exposure to aerosols.

      b) respiratory protection if there is higher than usual probability of exposure to mist, sprays, and dusts.

      c) long sleeve shirts always.

      d) always wear waterproof latex gloves for light work; reinforced rubber gloves for heavy activities; and puncture-resistant gloves for screening waste and removing sharp objects.

      e) waterproof rubber aprons that can be easily washed, if there is higher than usual probability of exposure to sprays/splashes.

      f) always wear waterproof rubber boots that can be easily washed.

    NOTE: Regarding the wearing of gloves and boots, it is best if garments are not tucked in.

    4)If work clothes become soiled, change into clean garments immediately. If you get drenched, take a shower before changing into a clean uniform.

    5) Do not wash your work uniforms at home, and avoid going home in your work clothes or boots. Change into a clean uniform and clean shoes before going home.

    6)Clean all contaminated tools with a 2 % solution of household bleach and water.

    7)Handle sharp objects with one hand and with extra care to prevent cuts and punctures that may provide direct portals of entry into the bloodstream.

    8)Treat cuts and abrasions promptly, using proper first aid measures. Report all such injuries to your supervisor.

    9)Ensure your tetanus shots are up to date: every 10 years, booster after the 5th year


AIDS is not a water-borne disease; that is, it is not transmitted by the fecal-oral route. Instead, to be transmitted, the HIV must enter the bloodstream directly. Generally, infected body fluids (semen, blood/serum, etc.) discharged into the sewers are immediately diluted to a point where they do not represent a significant risk to workers. Thus, to be infected, a worker would have to he injected with large amounts of sewage, an unlikely event. Yes, a blood-borne virus can gain direct access to the bloodstream through an open lesion of the epidermis or mucosa. However, studies have shown that water is a hostile environment for HIV survivability (Casson et al, 1992). Unlike bacteria or fungi, viruses are unable to multiply outside a living host cell. In summary, the danger of water-home contamination with HIV is virtually non-existent. Merely coming into contact with contaminated wastewater does not imply exposure to AIDS.

HEPATITIS A is transmitted via the fecal-oral route, while HEPATITIS B is a blood-home disease. Vaccines are available, for use after a known or suspected exposure. Consult your personal physician. If you think that you have been exposed while on the job, contact your supervisor.

HEP A series: 2 injections, the second one given 3 months after the first one.

HEP B series: 3 injections given I month apart.

You will have to be tested 30 days after the first injection to see if you are producing antibodies.

Compiled by RescueNet staff.

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