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Hepatitis in Sanitation (Part 2)
By Devi Mc Donald
So, is HAV an issue in the liquid waste industry and if so
what steps should be taken to minimize the risk. For this
issue we have gathered information and quotes from
resources such as the Center for Disease Control {CDC},
Portable Sanitation Association International {PSAI}, www.
hepnet.com, www.hepprograms.com, and www.
reutershealth.com.
As you may remember from last month’s issue, Hepatitis A
(HAV) is a virus that is spread through an oral to fecal
route. Coming in contact with feces infected with the virus
can cause contamination resulting in vomiting, abdominal
pain, jaundice, fever, headache, diarrhea and even
hospitalization. According to www.hepnet.com, an
information resource for Hepatitis A on the internet, a
reported 200,000 people in the U.S. alone become infected
with the virus each year and a reported $450 million
annually is spent on medical care for it.
Speaking with Millicent Carroll of the PSAI, she noted, “No
one discounts the fact that there may be exposure to the
Hepatitis virus in our industry. The biggest error is in
assuming that servicing a portable restroom places you in a
high-risk category of getting the virus.” Carroll further
clarified her point expressing “The fact that doesn’t seem to
be given consideration is that the cleaning solution used to
service the unit also cleans and disinfects as prescribed by
health agencies.
what steps should be taken to minimize the risk. For this
issue we have gathered information and quotes from
resources such as the Center for Disease Control {CDC},
Portable Sanitation Association International {PSAI}, www.
hepnet.com, www.hepprograms.com, and www.
reutershealth.com.
As you may remember from last month’s issue, Hepatitis A
(HAV) is a virus that is spread through an oral to fecal
route. Coming in contact with feces infected with the virus
can cause contamination resulting in vomiting, abdominal
pain, jaundice, fever, headache, diarrhea and even
hospitalization. According to www.hepnet.com, an
information resource for Hepatitis A on the internet, a
reported 200,000 people in the U.S. alone become infected
with the virus each year and a reported $450 million
annually is spent on medical care for it.
Speaking with Millicent Carroll of the PSAI, she noted, “No
one discounts the fact that there may be exposure to the
Hepatitis virus in our industry. The biggest error is in
assuming that servicing a portable restroom places you in a
high-risk category of getting the virus.” Carroll further
clarified her point expressing “The fact that doesn’t seem to
be given consideration is that the cleaning solution used to
service the unit also cleans and disinfects as prescribed by
health agencies.
The CDC’s website, states, “During any part of treatment, transport, or application of sewage sludge, you can be
exposed to materials that can cause disease.”
In the liquid waste industry careful precautions should always be taken to ensure the safety of the
workers/employees. Both the CDC and PSAI offer instructions and guidelines on how the employer should protect
the worker and how the worker can protect his or herself from viruses and harmful bacteria.
Looking at ways to reduce risks, Carroll explains, “There are several ways to reduce the risk of exposure to the
Hepatitis viruses but we limit that ability without understanding the differences affecting each virus and not utilizing
protective equipment.”
Also, according to Carroll, one of the strongest points emphasized and used as part of the health and safety
certification program is, “For optimal protection and safety for the portable sanitation industry service tech. Rubber
gloves must be worn at all times while servicing units. For additional protection, safety goggles are recommended.”
The CDC’s website offers a detailed guideline on safety equipment for sewage workers in listing not only gloves,
goggles, water-resistant suits, but also a “face shield” under the “mandatory personal protective equipment which
should be used on the job” section.
The CDC also says that training and education about the hazards of wastewater and sewage, a place onsite with
clean water for washing your hands, clean areas set aside for eating and smoking, and cleaning facilities or services
for clothing and equipment should be offered by the employer to the worker.
On the subject of the sanitation worker’s personal hygienic prevention of diseases, Millicent said “People in general
would never consider touching urine or fecal matter, wiping their hands on their pants and then putting their fingers
in their mouth. On the other hand, how many times have we witnessed or worst yet do ourselves the exact same
thing – use or service a portable restroom, wipe your hands on your pant leg, open the lunch box, eat sandwich.
However, you can never be too careful when it comes to viruses and diseases associated with cleanliness and poor
hygiene, especially when an estimated 1 in 3 people do not wash their hands after using the restroom.”
The CDC states on their website, “Sewage and wastewater contain bacteria, funguses, parasites, and viruses that
can cause intestinal, lung, and other infections. If equipment, work practices, and personal protective equipment
(PPE) don't protect you from swallowing these agents, you can get sick.”
They also have “Hepatitis A” listed under the category of “Some Biological Hazards That May Be in Sewage Or
Wastewater.” However, both they and the PSAI do not acknowledge sewage workers as being at any higher risk of
contracting HAV.
When asked about HAV in the liquid waste industry, Dr. Oscar Velasco, a family practitioner in Porterville, CA said
that “the form of spread or transmission of the virus (hepatitis A) is by fecal to mouth, thus, any person involved in
cleaning septic tanks are at greater risk because of the contact of human feces.” Dr. Velasco further stating his
opinion said, “I think the Hepatitis A vaccine should be required to add protection to employees.”
Another source who believes sewage workers are at risk includes a board of physicians working at Harvard
Medical School and Massachusetts General Hospital who back a website article on www.reutershealth.com which
lists “Sewage Workers” as being among the people at risk for passing the infection along or being infected.
Stories involving poor sanitary conditions due to a lack of following PSAI’s portable restroom guidelines have been
an issue within the past few years. According to the website www.hepprograms.com, a website devoted to
programs and resources regarding the prevention of hepatitis, in 2003 there was a reported “multi-state outbreak of
HAV among young adults attending outdoor concerts and camping events.” The outbreak started from poor
sanitation conditions involving limited amounts of portable toilets, which did not meet the standards the PSAI has
set for the number of portable toilet units required under those conditions. This issue resulted in the CDC
developing a web site and flyer aimed at helping concert-goers prevent HAV. The CDC offered a solution to users
of portable restrooms while stating that those servicing portable restrooms were not at high-risk.
At the Sanitation Journal we believe your opinions and input are crucial in keeping our magazine running at it’s
absolute best, which is why we’ve been taking polls online at our website regarding the HAV issue, and have
gathered interesting results. According to informal polls, 96% of those responding said that HAV is an issue in the
liquid waste industry. In an earlier polling it was discovered that 32% offer employees an opportunity for
immunization. In our next issue we’ll be gathering information from industry professionals who have experiences
concerning HAV.
exposed to materials that can cause disease.”
In the liquid waste industry careful precautions should always be taken to ensure the safety of the
workers/employees. Both the CDC and PSAI offer instructions and guidelines on how the employer should protect
the worker and how the worker can protect his or herself from viruses and harmful bacteria.
Looking at ways to reduce risks, Carroll explains, “There are several ways to reduce the risk of exposure to the
Hepatitis viruses but we limit that ability without understanding the differences affecting each virus and not utilizing
protective equipment.”
Also, according to Carroll, one of the strongest points emphasized and used as part of the health and safety
certification program is, “For optimal protection and safety for the portable sanitation industry service tech. Rubber
gloves must be worn at all times while servicing units. For additional protection, safety goggles are recommended.”
The CDC’s website offers a detailed guideline on safety equipment for sewage workers in listing not only gloves,
goggles, water-resistant suits, but also a “face shield” under the “mandatory personal protective equipment which
should be used on the job” section.
The CDC also says that training and education about the hazards of wastewater and sewage, a place onsite with
clean water for washing your hands, clean areas set aside for eating and smoking, and cleaning facilities or services
for clothing and equipment should be offered by the employer to the worker.
On the subject of the sanitation worker’s personal hygienic prevention of diseases, Millicent said “People in general
would never consider touching urine or fecal matter, wiping their hands on their pants and then putting their fingers
in their mouth. On the other hand, how many times have we witnessed or worst yet do ourselves the exact same
thing – use or service a portable restroom, wipe your hands on your pant leg, open the lunch box, eat sandwich.
However, you can never be too careful when it comes to viruses and diseases associated with cleanliness and poor
hygiene, especially when an estimated 1 in 3 people do not wash their hands after using the restroom.”
The CDC states on their website, “Sewage and wastewater contain bacteria, funguses, parasites, and viruses that
can cause intestinal, lung, and other infections. If equipment, work practices, and personal protective equipment
(PPE) don't protect you from swallowing these agents, you can get sick.”
They also have “Hepatitis A” listed under the category of “Some Biological Hazards That May Be in Sewage Or
Wastewater.” However, both they and the PSAI do not acknowledge sewage workers as being at any higher risk of
contracting HAV.
When asked about HAV in the liquid waste industry, Dr. Oscar Velasco, a family practitioner in Porterville, CA said
that “the form of spread or transmission of the virus (hepatitis A) is by fecal to mouth, thus, any person involved in
cleaning septic tanks are at greater risk because of the contact of human feces.” Dr. Velasco further stating his
opinion said, “I think the Hepatitis A vaccine should be required to add protection to employees.”
Another source who believes sewage workers are at risk includes a board of physicians working at Harvard
Medical School and Massachusetts General Hospital who back a website article on www.reutershealth.com which
lists “Sewage Workers” as being among the people at risk for passing the infection along or being infected.
Stories involving poor sanitary conditions due to a lack of following PSAI’s portable restroom guidelines have been
an issue within the past few years. According to the website www.hepprograms.com, a website devoted to
programs and resources regarding the prevention of hepatitis, in 2003 there was a reported “multi-state outbreak of
HAV among young adults attending outdoor concerts and camping events.” The outbreak started from poor
sanitation conditions involving limited amounts of portable toilets, which did not meet the standards the PSAI has
set for the number of portable toilet units required under those conditions. This issue resulted in the CDC
developing a web site and flyer aimed at helping concert-goers prevent HAV. The CDC offered a solution to users
of portable restrooms while stating that those servicing portable restrooms were not at high-risk.
At the Sanitation Journal we believe your opinions and input are crucial in keeping our magazine running at it’s
absolute best, which is why we’ve been taking polls online at our website regarding the HAV issue, and have
gathered interesting results. According to informal polls, 96% of those responding said that HAV is an issue in the
liquid waste industry. In an earlier polling it was discovered that 32% offer employees an opportunity for
immunization. In our next issue we’ll be gathering information from industry professionals who have experiences
concerning HAV.
Serving the American Liquid Waste Industry Since 2002