Construction micro-organisms: Hepatitis A from sewage

Construction workers may be exposed to Hepatitis A if they are working on sites contaminated with raw or untreated sewage. This page tells you how to control this risk and why. You also need to be aware of the general information on micro-organisms.

What you must do

Follow the Assess, Control and Review model. Pay particular attention to the following things:

Assess

Identify and assess: The risk of workers being exposed to Hepatitis A is mainly when working in an area contaminated with raw, untreated sewage in the last 12 months. In particular:

• work in or near a sewer might lead to contamination of hands, clothing or PPE, or to splashes in the eyes and mouth
• refurbishment of flood damaged property contaminated with sewage

Control

Prevent – Eliminate / limit contact with sewage where possible.

Control: Where work with sewage is unavoidable, control this risk by:

• General Controls – follow the general controls for harmful micro-organisms. Pay particular attention to:
  • following good basic hygiene including regular hand-washing, avoiding hand to mouth/eye and cleaning / protecting cuts. Provide nailbrushes and disposable paper towels. You will need showers where heavy contamination is likely.
  • taking rest breaks, including meals and drinks, away from the work area
  • washing all cuts, abrasions and other breaks in the skin and covering with waterproof dressings and/or gloves.
• Clothing – wear protective clothing. The type of clothing will depend on the work. It may include waterproof footwear and clothing as well as waterproof / abrasion resistant gloves. Face visors provide good protection against splashes.
• Respiratory Protective Equipment (RPE) – wear RPE if the work could generate aerosols. Choose RPE with an assigned protection factor of 20 (eg FFP3 disposable mask or half mask with P3 filter). For longer duration work consider powered RPE with the same protection (eg TH2 powered hood / helmet). Make sure any RPE is compatible with other protective equipment.
• Vaccination – immunisation is available for Hepatitis A. This should only be used after appropriate advice and where needed to supplement the controls above. You should ensure that workers are aware of the advantages and disadvantages of immunisation as well as its limitations. Keep adequate records of any immunisation provided. Follow the information on vaccination in the general page for harmful micro-organisms.

Review

Supervise: Ensure that controls such as work methods, PPE and welfare are effective and used by the workers. Anyone using tight fitting masks needs to be clean-shaven and face fit tested.

What you should know

Hepatitis A is an infection of the liver that is generally uncommon in the UK. Initial symptoms are similar to flu and may lead to:

• yellowing of the skin and eyes (jaundice), very dark coloured urine and pale faeces
• abdominal pain
• itchy skin

The symptoms usually clear up within two months, although may occasionally last up to six months. Older adults tend to have more severe symptoms. In most cases, the liver will make a full recovery.