First-of-its-kind study gives insight into how solid waste workers view biohazards

Most of the nearly half a million Americans who work in waste management handle solid waste—the garbage produced at homes, industrial and agricultural sites, treatment plants and similar facilities—putting them at risk for exposure to biohazards such as bioaerosols, bloodborne and other pathogens, fungi, and human and animal waste.

The addition of a disease outbreak can compound this risk. After the 2014-2016 Ebola outbreak, for example, a study led by Aurora B. Le, an incoming faculty member with the Texas A&M University School of Public Health, found that medical waste workers believed they were unprepared to manage the highly infectious waste generated by the disease.

Now, a pilot study—thought to be the first of its kind—by Le, Shawn G. Gibbs, PhD, MBA, dean of the Texas A&M School of Public Health, and other researchers gives insight into how solid waste workers who do not specialize in medical waste viewed their biohazard risks and training during the COVID-19 pandemic.

In the fall of 2021, the study researchers surveyed 68 workers at three solid waste sites in Michigan: a small, family-owned waste disposal facility, a county-level recycling facility and a large, industrial facility with a hauling and landfill division. The workers were asked about the biohazards they faced on the job, the stress they experienced as a result, and the training and equipment they received to address biohazards.

Although the study was conducted about 18 months after COVID-19 had been declared a global pandemic, about one-third of those surveyed stated they had not received any training on infection prevention or on safely donning and doffing personal protective equipment in the previous year. About three-fourths of workers also reported that they did not know whether their workplace had a program for monitoring the health of those who had been exposed to biohazards.

“The confidence our study sample has in workers’ health status, and lack of awareness of biohazard exposures, may indicate a lack of training on the basic modes of disease transmission,” Le said. “Furthermore, workers employed in solid waste may experience less perceived severity over time due to desensitization or complacency on personal occupational safety and health measures.”

Nearly 60 percent of these workers reported good or excellent physical health, and more than 80 percent also reported having no concern or only moderate concern about biohazard exposures or the potential for illness as a result of exposure.

Furthermore, nearly 80 percent of these workers also stated they did not regularly encounter blood, feces, bodily fluids or sharp objects such as needles. In addition, while most workers reported that they wore safety vests/reflective clothing and steel-toed boots while on the job, they wore gloves less than half the time. On the other hand, most workers surveyed (71 percent) reported experiencing an accidental laceration or cut on the job, which could potentially expose them to illness-causing biohazards.

The researchers note that while solid waste workers often are outside and not in close contact with others, and while the virus that led to the COVID-19 pandemic has not been demonstrated to be transmitted through contact with solid waste, a California study found that waste management workers had a higher COVID-19 per-capita mortality rate than those in other industries.

“Other industries, such as manufacturing and construction, might also be underserved in terms of employee health and safety training,” Gibbs said. “Additional research that deepens our understanding of how solid waste workers and those in similar industries perceive biohazards could help employers improve workplace safety and help employees prevent, mitigate and manage biohazard exposures.”