Most of the body fluids directed into the sanitary
system are not regulated under the OSHA Bloodborne
However, because several diseases are associated with
exposure to sewage, certain employees who are
involved in drain plumbing activities will be provided
personal protective equipment to prevent contact with
this type of material.
Employees who clear sanitary drain blockages with
plungers are not considered occupationally-exposed to
human blood or other potentially infectious materials
(OPIM) unless visible blood is present in the work area
Workers who "snake" drains shall be considered as
having the potential for occupational exposure for
purposes of compliance with provisions of the
Bloodborne Pathogens Standard.
Appropriate PPE (gloves, eye protection, boots, etc.)
shall be available to any worker clearing a blockage in
sanitary drain systems.
(Other Potentially Infectious Materials)
Saliva in dental procedures
Any body fluid visibly contaminated with blood
Drain Repairs (General)
Flush piping with hot water prior to maintenance of
drain piping, if possible.
Wear appropriate gloves before breaking into the drain
If drain traps are removed, inspect contents for human
blood or OPIM and sharps.
Immediately place any sharp objects (needles, razors,
broken glass) into sharps containers.
Handle contaminated material, especially sharps with
Drain Repairs (Laboratories working with
Employees should take additional protective measures
when repairing drains in laboratories where infectious
microorganisms are handled (BSL2 & BSL3 labs).
Confirm with laboratory personnel that any necessary
decontamination has been performed prior to entry into
Wear appropriate gloves and facemask or goggles/mask
before starting repairs.
If there is a likelihood that drain material will splash onto
clothing, wear coveralls (Tyvek suit).
Health Risks of Raw Sewage
Hepatitis A- transmitted by ingestion, hand to mouth
route; survives on surfaces for months; may cause yellowing
of eyes/skin; can cause liver damage
Rotavirus- transmitted through hand to mouth route,
ingestion; survives on surfaces for several days; fever,
diarrhea, vomiting, abdominal pain (common in children)
Norwalk Virus (Norovirus, stomach flu, gastroenteritis)-
transmitted through hand to mouth route; ingestion;
survives on surfaces for up to a week; nausea, vomiting,
Other Health Risks?
Gram Negative Bacteria- (E. coli, Salmonella)-
headache, fatigue, nausea
Leptospirosis: a flu-like illness; persistent & severe
headache, damage to liver & kidneys may occur
Occupational asthma: attacks of breathlessness, chest
tightness and wheezing, produced by the inhalation of
living or dead organisms.
Infection of the skin or eyes
Rarely: inflammation of lung with fever,
breathlessness, dry cough and aching muscles and
How Do Sewage Micro-Organisms
Enter the Body?
Hand to mouth contact during eating, drinking and
Wiping the face with contaminated hands or gloves or by
licking splashes from the skin
Skin contact through cuts, scratches, or penetrating
wounds, i.e. from discarded hypodermic needles
Aerosols landing on surfaces of the eyes, nose and mouth
By breathing them in, as either dust aerosol or mist
Who Is At Risk?
Employees involved in sewer inspection and maintenance
work (unstoppage of sewer lines)
Construction workers who repair or replace live sewer lines
Sewer spill clean up
PPE Required For Clean Up
PPE should be readily available in
event of an emergency.
Water-proof boots for sewage spills
Coveralls for splash proofing your clothes
Utility Gloves for clean up
Goggles/mask or face shield for splashes
Spray Disinfectant (bleach/Coverage Plus
Sewage Cleanup Operations
The cleanup and disinfection of areas that have been
flooded with sewage is not considered an activity that
falls under the requirements of the OSHA Bloodborne
It is recognized however, that employee exposure to raw
sewage can cause illness.
Employees should use the following procedures for
clean- up of sewage:
Prior to clean up, a designated area outside of the
contaminated area should be set up to allow employee(s)
to put on necessary PPE.
(PPE should readily available for quick response.)
This area should remain contaminant-free, therefore
individuals exiting spill area(s) should spray off boots &
other contaminated PPE before re-entering staging area.
Any grossly contaminated PPE (i.e. boots, gloves, etc)
should be changed/discarded before exiting contaminated
Area outside of the contaminated space should be
designated for disinfecting only.
Remove PPE in a manner that avoids cross-
All contaminated PPE (Tyvek suit, gloves, etc.) &
equipment (wet-dry vac) should be discarded or
disinfected in this area.
Immediately dispose of contaminated items in a
plastic bag and throw them away with regular trash.
Septic pumping trucks are specialized vehicles which combine a powerful
vacuum pump with a holding tank for sewage and wastewater.
The vacuum pump is activated, suction confirmed, the pumper is
connected to a 4" or larger vacuum line, and the operator uses the line to
clean up a sewage spill.
The septic pumper operator lays out the pumping vacuum lines from the
tank to the spill.
The vacuum lines are not yet connected to the pumper truck nor has the
vacuum pump been turned on
In preparing to connect the pumper hose to the truck's transport tank, the
operator must first turn on the vacuum pump. Opening the valve at the
bottom of the pumper tank without first turning on the vacuum pump can
permit sewage to flow back out of the tank onto the operator.
Sewage Cleanup Operations
If cleanup can cause splashing, wear face shields or
Wear gloves for all sewage cleanup.
If sewage depth is greater than 1/8", wear water-proof boots.
Wear Tyvek coveralls for activities that involve splashing of
Remove sewage from floors and surfaces with wet-vacuums,
brooms, squeegees, etc., and dispose into a functioning sanitary
drain or sink.
Do not dump sewage from a spill/backup onto the sidewalks.
Sewage-saturated papers, books and other items must be
If occupants wish to keep sewage-contaminated items, contact
Sewage Cleanup Operations
Watch for recognizable human blood or OPIM such as
feminine hygiene products and sharps.
Place any sharp objects (needles, razors, broken glass) into
sharps containers and other objects (bandages) into disposal
Use tongs, pieces of cardboard or other mechanical means to
pick up sharp objects.
Keep sharps containers closed except when placing materials
inside. Sharps containers must be puncture-resistant, labeled
or color coded as biohazardous material, and leakproof on the
sides and bottom. (EHS can provide)
After vacuuming up the material, apply a bleach solution or
Coverage Plus Steris 6387-08 to all surfaces that came in
contact with the sewage. Hard surfaces should be wiped clean
and left to dry following application of the disinfectant.
Sewage Cleanup Operations
If the spill site is large use a 10% bleach solution or
Coverage Plus for disinfection. The bleach solution should
be prepared by mixing 1 part household bleach with 9
parts water. Bleach solutions should not be used to
disinfect fabrics such as carpets, and should be used
within 24 hours of preparation.
Remove sewage materials from soft or porous surfaces
(carpets, office partitions, etc.) with wet-vacuums, carpet-
cleaners, steam-cleaners, etc. An appropriate disinfectant
should then be applied to these surfaces and allowed to
Disinfect reusable equipment with disinfectant prior to
removal from the site.
Following Sewage Spill
Properly remove & discard PPE (gloves should be removed in
a manner to avoid cross contamination) in disinfecting area
outside area that was contaminated with sewage.
Wash hands thoroughly. If a sink is not available use hand
sanitizer until you are able to properly wash your hands with
soap and water.
If you have any questions regarding clean up procedures please
contact the Biological Safety Section at EHS 919-962-5507.
Secure contaminated area against unauthorized entry.
Designate ‘Staging Area’ outside of contaminated
space for donning PPE.
Set-up ‘Disinfecting Area’ equipped with plastic bags
and disinfectant outside of contaminated space
“Clear Water Event”
Events involving parts of the wastewater stream
including, but not limited to, surface water, ground
water, condensate, roof leaks, steam leaks, potable
water leaks, and/or discharge from swimming pools
and water treatment devices.
Eye Protection (if there is a splash risk)
“Black/Gray Water Event”
Events involving fractions of the wastewater stream
that originates from sewage, dishwashers, showers,
washing machines and food preparation sinks.
Tyvek suit (if there is a splash risk)
Goggles/mask or face shield (if there is a splash risk)
Buildings with Special PPE
Considerations Berryhill and Fetzer Hall:
House laboratories that contain formalin-treated cadavers.
The Chemical Safety Section at EHS (962-5507) should be contacted prior
to the cleanup of water events in this building.
Brinkhous-Bullitt Building Hospital Morgue (11th Floor):
Houses areas containing untreated cadavers and organs.
PPE for the cleanup of these areas will be consistent with that of a “clear
water event” unless:
Visible blood or other potentially infectious materials (OPIM) are present.
PPE consistent with a “black water event” is recommended
Water is suspected to contain hazardous chemicals.
Contact Chemical Safety at EHS prior to cleanup.
Call Biological Safety pager (919-216-3963) prior to ‘after hours’ cleanup .