Quantitative microbial risk assessment (QMRA) of the work of manual pit emptiers, commonly known as bayakous

Abstract

In Haiti, manual pit emptiers, known as bayakous, face significant health risks. They work by descending naked into latrine pits, exposing themselves to pathogens and contributing to environmental contamination. This study employs the quantitative microbial risk assessment (QMRA) method to evaluate the microbial risks associated with this practice, considering nine prevalent pathogens in Haiti. Three ingestion scenarios were developed: hand-to-mouth contact, ingestion while immersed in excreta, and a combination of both. A sensitivity analysis assessed the impact of input data on study outcomes. The results indicate a high probability of infection and illness during pit emptying operations annually for all scenarios and pathogens. Recommendations include adopting personal protective equipment (PPE) and using a manual Gulper waste pump to eliminate the need to descend directly into the pits, thereby reducing the risk of injury from sharp objects. The study proposes the establishment of intermediate disposal points approximately 5 km from collection sites to deter illegal dumping. National regulations and professionalization of the bayakou profession are suggested, along with awareness campaigns to promote PPE and Gulper pump usage. Addressing these issues is crucial for safeguarding the health of bayakou and public health in Haiti. HIGHLIGHTS This study is the first scientific QMRA study on manual pit emptiers in Haiti.; It considers nine pathogens and three ingestion scenarios, two of which have not been considered in previous studies.; The results indicate that the emptiers are at higher risk of infection and illness.; It recommends the use of PPE to mitigate health risks and the use of a Gulper pump to eliminate the need to descend directly into pit latrines.;

Keywords

• bayakou
• feces
• health
• illness
• infection
• qmra