Introduction According to a WHO note, since March 11, 2020, the planet has been living with an important pandemic. Human behavior and the environment are different at this point. There are countless deaths. Workers in environmental sanitation services such as water and sewage are considered essential and need a special approach to COVID-19. Until May 9, 2021, there were in Brazil 15,000,000 infected people. This work describes the safety measures of a group of 7,000 workers of the largest environmental sanitation company in Latin America.

Objective To describe measures adopted to deal with COVID-19 through the safety and health protocol.

Methodology We describe the participation of the occupational medical service in the construction and institution of an appropriate protocol from April 2020 to April 2021 considering a bibliographic survey, management discussions, discussions with workers and measures implemented on the site, monitoring of positive cases, guidelines and preventive health care.

Results Approximately 1,000 telephone surveys were carried out for everyone suspected and/or diagnosed COVID-19. The implementation of a health protocol and daily dissemination of guidance via videos/reports. 60% of workers were allocated to teleworking. 770 cases and 12 deaths were identified. 12% of cases occurred in workers of essential activities. Such data in this Unit corresponded to 45% of the cases of the entire company and 30% of deaths.

Conclusion The adoption of specific measures and protocols, increased the participation of workers with the impact of COVID-19 on workers in environmental sanitation. The adoption of preventive measures and protocols before COVID-19 can contribute to the reduction of cases in essential work activities.