Developing occupational and health susceptibility personas for wastewater personnel in the United States in the age of COVID‐19

Abstract

Compared with the public, wastewater personnel, are at an increased risk of infection and illness from wastewater pathogens due to work-related tasks. Unfortunately, current risk assessment approaches do not consider individual personnel factors (e.g., age and health conditions) that may influence their susceptibility to a health effect. The objective of this study is to establish a baseline level of occupational and health factors among the wastewater personnel population, quantify these factors using a susceptibility evaluation scoring system, and examine relevant susceptibility features using the concept of "Personas." Using survey data from 246 respondents and public health risk data on COVID-19 from the CDC, personnel clustered into three persona groups: "low susceptibility," "high occupational susceptibility," and "high health susceptibility." Results highlight the intersectionality between gender, age, underlying health conditions, job tasks, and level of exposure to wastewater and provide context for incorporating individual variables into risk assessment methodologies with the goal of protecting this essential workforce. Practitioner Points• A risk assessment framework that combines health and occupational susceptibility factors was developed for wastewater treatment plant personnel.• Wastewater personnel clustered into three persona groups: "low susceptibility," "high occupational susceptibility," and "high health susceptibility."• The intersectionality between job related activities and individual health provides a holistic approach to risk assessment for wastewater personnel.

Protecting Wastewater Workers by Categorizing Risks of Pathogen Exposures by Splash and Fecal-Oral Transmission during Routine Tasks

“…In recent years, the number of papers using QMRA to assess the risk of occupational infections at WWTPs increased substantially [14][15][16][17][18][19][20][21]. This QMRA work has highlighted the need for a better understanding of contact exposure levels and pathways to support accurate cumulative risk assessments for wastewater and collection system workers [25].…”

“…The only study that used our approach and defined risk categories was the work conducted by Zhang et al (2021), which clustered workers into three groups: "low susceptibility", "high occupational susceptibility" and "high health susceptibility" [18]. Zhang et al (2021) included health demographics of workers.…”

“…Research investigating wastewater worker occupational health dates back to the early 1900s [10,11] but the term sewage workers' syndrome was only coined in the 1970s [12,13]. While there has been sustained interest in assessing the impacts of exposures to chemical and biological hazards at wastewater treatment plants (WWTP), it was not until the COVID-19 pandemic that the number of papers using quantitative microbial risk assessment (QMRA) at WWTPs to assess risk of occupational infections in wastewater workers increased substantially [14][15][16][17][18][19][20][21]. These QMRAs explored the impacts of aeration or treatment mechanism (e.g., umbrella aeration tank versus microaeration, membranes) [14,16] Waste 2023, 1 or the use of controls to mitigate risk, such as ventilation [16] and personal protective equipment (PPE) [16,17,20].…”

“…Similarly, Gui et al (2022) divide exposure into academic visitors, field engineers and office staff and assign set exposure time and frequency regardless of assigned tasks [20]. Zhang et al (2022) provide the most detailed description of tasks and exposures but do not provide details on corresponding WWTP size or mitigation strategies. Overall, these studies lack practical guidance for utility managers, industrial hygienists and Health and Safety (H&S) staff attempting to identify potential safety improvements [20].…”