A sanitation worker (or sanitary worker) is a person responsible for cleaning, maintaining, operating, or emptying the equipment or technology at any step of the sanitation chain.World Bank, ILO, WaterAid, and WHO (2019). Health, Safety and Dignity of Sanitation Workers: An Initial Assessment. World Bank, Washington, DC. This is the definition used in the narrower sense within the WASH sector. More broadly speaking, sanitation workers may also be involved in cleaning streets, parks, public spaces, sewers, stormwater drains, and public toilets. Another definition is: "The moment an individual's waste is outsourced to another, it becomes sanitation work." Some organizations use the term specifically for municipal solid waste collectors, whereas others exclude the workers involved in management of solid waste (rubbish, trash) sector from its definition.
Sanitation workers are essential in maintaining safe sanitation services in homes, schools, hospitals, and other settings and protecting public health but face many health risks in doing so, including from exposure to a wide range of biological and chemical agents. Additionally, they may be at risk of injury from heavy labor, poor and prolonged postures and positions and confined spaces, as well as psychosocial stress. These risks are exacerbated under conditions of poverty, illness, poor nutrition, poor housing, child labor, migration, drug and alcohol abuse, discrimination, social stigma and societal neglect. In many developing countries, sanitation workers are "more vulnerable due to unregulated or unenforced environmental and labor protections, and lack of occupational health and safety".
Sanitation work can be grouped into formal employment and informal employment. Sanitation workers face many challenges. These relate to occupational safety and health (diseases related to contact with the excreta; injuries; the dangers of working in confined spaces, legal and institutional issues, as well as social and financial challenges. One of the main issues is the social stigma attached to sanitation work. Sanitation workers are at an increased risk of becoming ill from waterborne diseases. To reduce this risk and protect against illness, such as diarrhea, safety measures should be put in place for workers and employers.
The working conditions, legal status, social aspects etc. are vastly different for sanitation workers in developing countries versus those in high income countries. Much of the current literature on sanitation workers focuses on the conditions in developing countries.
Those workers who maintain and empty on-site sanitation systems (e.g. pit latrines, septic tanks) contribute to functional fecal sludge management systems. Without sanitation workers, the Sustainable Development Goal 6, Target 6.2 ("safely managed sanitation for all") cannot be achieved.Sperandeo, L., Srinivasan, S. (2020). The Heroes behind Sanitation - An insight into faecal sludge management workers in Zambia. BORDA, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Bonn, Germany It is important to safeguard the dignity and health of sanitation workers.
Definition and terminology
A report by World Bank, International Labour Organization, WaterAid and WHO from 2019 defines "sanitation workers" to include toilet cleaners and caretakers in domestic, public, and institutional settings; those who empty pits from pit latrines and vaults of septic tanks and other fecal sludge handlers; those who clean sewers and manholes; and those who work at sewage treatment plants and fecal sludge treatment plants and disposal sites.
Another definition is: "The moment an individual's waste is outsourced to another, it becomes sanitation work."PRIA (2019): Lived Realities of Women Sanitation Workers in India: Insights from a Participatory Research Conducted in Three Cities of India. Participatory Research in Asia, New Delhi, India
Since there are various definitions of sanitation, it is not surprising that there are various definitions of "sanitation worker".
Regional differences in terminology In the United States, the term "sanitation worker" tends to be used exclusively for municipal solid waste collectors: people who collect solid waste and take it to a transfer station, landfill, or incinerator. People who work with excreta management are usually known as environmental engineers or environmental specialists. The importance of sanitation workers in the struggle for human rights is seen in the 1968 labor strike of the sanitation workers of Memphis, Tennessee: The Memphis sanitation strike, supported by Martin Luther King Jr., brought together both waste collectors and sewerage maintenance workers.
Related terms More commonly, a waste collector, also referred to a bin man, garbage collector, etc. deals with municipal solid waste.
Types of work and occupations The types of work that sanitation workers carry out is shown in the table below. +Types of work and occupations along the sanitation chain (based on but with further additions)Toilet/containmentEmptyingConveyanceTreatmentEnd use/Disposal Janitor Restroom attendant (public toilets) Sweeping Latrine or pit latrine cleaning Domestic work (domestic worker) Community/public toilet keeping School toilet cleaning Municipalities, government, and private offices cleaning (commercial cleaning) Vacuum truck operator Desludging operatorRamamoorthy, R., Pandey, K. D., Rajakuma, D. S., Ramasamy, N., Sharma, R. (2018). Desludging Operators in Tiruchirappalli: An Overview. Indian Institute for Human Settlements, India Fecal sludge management worker Manual emptier Mechanical emptier (including septic tank desludging) Manual transport Mechanical transport Sewer cleaning Sewer and pumping station maintenance Manhole cleaning Wastewater treatment plant operator Sewage treatment plant cleaning Wastewater and sludge handling at sewage treatment plants Manual disposal Mechanical disposal
Types of employment Sanitation workers work in different types of employment situations. They are either government-employed workers, workers of private service providers or informal workers.WaterAid (2022) Assessment of the Health, Safety and Dignity of Sanitation Workers in Dar es Salaam, Dodoma and Arusha, Tanzania February 2022 Sanitation workers who are employed by the government usually have comparatively good infrastructure, tools and personal protective equipment (PPE), and face only moderate health and safety risks.WaterAid (2022). Protecting the health, safety, and dignity of sanitation workers in Tanzania (policy brief). WaterAid
For example, the tasks of unclogging of the main sewers or operating wastewater treatment plants are usually performed by formal government workers or private companies, whereas the unclogging of household sewer connections is performed by private companies and informal sanitation workers.
Informal workers In many developing countries, informal workers collect human excreta from certain types of toilets (such as bucket toilets and pit latrines) without mechanical equipment and without personal protective equipment. These workers are "scooping out feces from 'dry' latrines and overflowing pits".Ray, I., Prasad, CS S. (2018). Where there are no Sewers - Photoessays on Sanitation Work in Urban India. Sustainable Sanitation Alliance (SuSanA) secretariat at GIZ, Eschborn, Germany They are usually working in the informal labour sector and are commonly referred to as "informal sanitation workers". They have weak legal protection results from working informally and do not follow occupational health and safety standards.
Informal workers provide "manual emptying services to households, particularly where inaccessible to trucks and to the most vulnerable households". They are not registered or legally recognized, and often work without any protection, facing discrimination and stigma.
Number of sanitation workers While the definition of sanitation workers encompasses a vast line of services, the number of sanitation workers globally is difficult to estimate because they often have multiple jobs or are categorized with other sectors (e.g., solid waste and healthcare facility management). Also, sanitation workers in developing countries are often informally employed which makes it difficult to determine how many there are.
Estimates at country level include: There are an estimated 5 to 6 million "sweepers" (a term used for sanitation workers) in Bangladesh. An estimate in 2018 put the number of "sanitation workers" in India at 5 million, and 50% of them being women.
Challenges
Sanitation workers provide a critical public service, essential for our daily lives and the environment. Yet their working conditions expose them to the worst consequences of poor sanitation such as debilitating infections, injuries, social stigma and even death every day. The challenges faced by sanitation workers can be categorized as follows: occupational safety and health, legal and institutional issues, financial insecurity, and social issues.
In the case of India, the work of sanitation workers (especially those without formal employment contracts) has been described as: Drudgery, dangerous, dirty and dehumanizing.
The five hidden dangers for people working as sanitation workers include health hazards, discrimination, psychological problems, low wages and lack of social security coverage.
Occupational safety and health Occupational safety and health issues for sanitation workers include: diseases related to contact with the excreta; injuries related to the physical effort of extracting and transporting the waste, including falls from height; injuries related to cuts from non-fecal waste (e.g. glass or needles) disposed of down the toilet.HSE (2011) Working with sewage - The health hazards: A guide for employers, Health and Safety Executive UK.Labour Department (2006) Safety Guide for Work in Manholes Occupational Safety and Health Branch of the Labour Department, Hong Kong Government There are also the general dangers of working in confined spaces, including lack of oxygen.HSE (2013). Confined spaces - A brief guide to working safely, Health and Safety Executive UK.
Many sanitation workers in developing countries work without any form of personal protective equipment (PPE) and no or minimal formal training. Physical and medical conditions directly associated with sanitation work that is carried out unsafely can include: "headaches, dizziness, fever, fatigue, asthma, gastroenteritis, cholera, typhoid, hepatitis, polio, cryptosporidiosis, schistosomiasis, eye and skin burn and other skin irritation, musculoskeletal disorders (including back pain), puncture wounds and cuts, blunt force".
Sanitation workers are at an increased risk of becoming ill from waterborne diseases. One specific disease that concerns workers in sewers is Leptospirosis, spread through contact with rat urine.HSE (n.d.) Leptospirosis (Weil's Disease and Hardjo). Health and Safety Executive UK.
The safety of sanitation workers is influenced by: Design and construction of the toilet or other piece of sanitation infrastructure, pressure by the customer or by the employer, as well as materials and equipment available to do the job.Eales, K., Blackett, I. (2019). FSM5 - Thematic Papers. Bremen Overseas Research and Development Association, Bremen, Germany
Estimating occupational health outcomes among sanitation workers