Health and Safety of Sanitation Workers

Sanitation workers are engaged in several steps of the faecal waste management chain. They empty pits and septic tanks, clean toilets, sewers and manholes and operate pumping stations and treatment plants. They provide a fundamental public service, yet often face extreme health hazards and safety risks at work, as well as social discrimination and stigma (Sanitation Workers Knowledge and Learning Hub). Establishing appropriate health and safety measures for sanitation workers is essential.  

Key Actions

    • Provide acknowledgement and the formalisation of employment conditions and rights to the sanitation workforce. This includes  issuing formal contracts, ensuring access to social protection schemes and promoting the inclusion of sanitation workers in labour laws and regulations.

    • Mitigate occupational health risks for sanitation workers by providing adequate PPE, materials and facilities.

    • Provide health services for sanitation workers.

    • Establish standard operating procedures and clear guidelines.

    • Promote sanitation workers’ empowerment through unions and associations.

    • Provide comprehensive training and Capacity Development programmes for sanitation workers to enhance their skills, knowledge, and awareness of health and safety practices. Include training on hazard identification, proper handling of equipment and materials and emergency response procedures.


Despite being an essential component of providing sanitation services, sanitation workers are frequently marginalised, overlooked and exposed to serious occupational and environmental health hazards that jeopardise their well-being.

This factsheet highlights several areas for action to ensure that faecal sludge management initiatives in emergencies do not undermine the dignity, health, and rights of the workforce.


Environmental Health and Safety 

Sanitation workers face diverse occupational risks, such as direct contact with pathogens present in faecal sludge, exposure to hazardous gases and substances, working in confined spaces, and the physical strain of manual labour, that can result in injuries. Therefore, it is essential to implement comprehensive health and safety measures including:

    • Personal Protective Equipment (PPE), i.e. gloves, masks, full overalls and enclosed waterproof footwear. This is particularly important where manual sewer cleaning or manual emptying is practised.

    • Facilities to wash hands with water and soap after work.

    • Facilities for cleaning, disinfection, maintenance and on-site storage of tools and PPE.

    • Vaccination and deworming against diseases relevant to their working conditions.

    • Comprehensive training: ensuring that sanitation workers are trained on the risks of handling wastewater and/or faecal sludge and on standard operating procedures (SOPs) and ensuring that SOPs are adhered to.

    • Avoiding a high turnover of casual workers and monitoring proper and safe tasks of sanitation workers.

Legal and Institutional Issues

Establishing supportive legal and institutional frameworks is essential to protect the rights and well-being of sanitation workers. Organisations engaged in sanitation responses should have a readily available institutional framework that includes the formalisation of employment through registration (a formal contract) and recognition of their work (fair compensation). A clearly defined mechanism to address grievances and ensure compliance is equally important. These mechanisms should be easily accessible, transparent and responsive, allowing workers to voice their concerns without fear of reprisal.

Financial Insecurity 

Sanitation workers often receive inadequate and inconsistent payment, especially if engaged in informal work arrangements (no formal contract). To enhance financial security, it is essential to prioritise fair remuneration, regular payment schedules, the implementation of social security schemes and the provision of livelihood support.

Social Issues 

Sanitation workers are often subject to social stigma and discrimination. This can lead to alcohol and drug use to cope with their working conditions, further exacerbating the problem. Furthermore, to protect their families’ safety and well-being, some sanitation workers keep a low profile and hide their occupation from their communities. To address this issue, promote dialogue and engagement between sanitation workers and the communities they serve. Providing opportunities for skills development and empowerment can also help improve the social standing of sanitation workers and foster a more inclusive and accepting environment.

Ultimately, prioritising the health and safety of sanitation workers is essential for creating a safe and dignified working environment. By implementing appropriate measures, fostering collaboration and promoting supportive policies, the well-being of these essential workers can be ensured and contribute to the achievement of successful sanitation interventions (World Bank 2019).

Author(s) (1)
Catherine Bourgault
Center for Affordable Water and Sanitation Technology (CAWST)
Reviewer(s) / Contributor(s) (1)
Marij Zwart
Netherlands Red Cross (NLRC)

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