Sanitation worker
A sanitation worker is a person responsible for cleaning, maintaining, operating, or emptying the equipment or technology at any step of the sanitation chain. 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 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 contribute to functional fecal sludge management systems. Without sanitation workers, the Sustainable Development Goal 6, Target 6.2 cannot be achieved. 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."
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.| Toilet/containment | Emptying | Conveyance | Treatment | End use/Disposal |
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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. Sanitation workers who are employed by the government usually have comparatively good infrastructure, tools and personal protective equipment, and face only moderate health and safety risks.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 without mechanical equipment and without personal protective equipment. These workers are "scooping out feces from 'dry' latrines and overflowing pits". 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. 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" in Bangladesh.
- An estimate in 2018 put the number of "sanitation workers" in India at 5 million, and 50% of them being women.
Challenges
In the case of India, the work of sanitation workers 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 disposed of down the toilet. There are also the general dangers of working in confined spaces, including lack of oxygen.Many sanitation workers in developing countries work without any form of personal protective equipment 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, 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.
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.
Estimating occupational health outcomes among sanitation workers
It is difficult to estimate the burden of disease for sanitation workers. A systematic literature review with 65 studies showed the following: "There was an increased risk of adverse health across a range of outcomes. This is especially true in the case of hepatitis A infections ". The review also showed "an increase in adverse gastrointestinal and respiratory conditions associated with sanitation work". A few studies found some "adverse musculoskeletal and mental/social impacts". With regards to mortality, there was "inconsistent evidence on mortality".Governmental policies and other efforts can work together to mitigate these risks. There are research gaps in characterizing the health risks of sanitation workers in three main areas: "low-income countries, among women and those under informal employment".