Binmen contracted by North Herts Council and East Herts Council are planning to take industrial action next month, if a strike ballot gets enough support.
Members of the GMB union who work for council contractor Urbaser in their Letchworth and Buntingford depots are preparing to undertake a strike ballot, in a dispute over pay.
If strike action goes ahead, it will affect services in east and north Herts.
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The union warned it could mean "rubbish being left uncollected and streets not being swept," with household waste "left to pile up and rot".
Around 60 refuse workers could be involved, including bin lorry drivers, rubbish collectors and road sweeper.
Michael Dooley, of the GMB, said: "Our members keep the local environment clean. They are undertaking heavy, dirty work in all weathers, 52 weeks of the year.
"Urbaser are refusing to give one single penny of company sick pay to workers who fall ill, leaving sick people to rely on paltry statutory sick pay.
"Urbaser are a multimillion-pound international company, but unlike other refuse contractors such as Biffa, Veolia and Serco who have company sick pay schemes, Urbaser leave their sick staff to rely solely on the government hand out. We say that it is only reasonable that Urbaser should introduce a company sick pay scheme."
One worker said: "We do heavy graft, working in filth, with the possibility of contamination. If we fall ill, we need to go cap in hand to the government for statutory sick pay, which is only £109 a week. How can we afford to be ill? I can’t see what option we have but to strike."
Tim Guile, regional operations manager at Urbaser, said: "The union is requesting a significant pay increase at a rate we believe is not aligned with the standard pay rates in the surrounding areas.
"We have made an offer that we consider to be a reasonable and fair offer, reflecting both the value we place on our workforce and the economic landscape of our region.
"We are eager to continue constructive discussions with the GMB Union in hopes of resolving this matter amicably and promptly.
"In the interim, we wish to assure residents that we are committed to ensuring the uninterrupted delivery of front-line services in the event of a strike."
The union says it is willing to avoid the strike if Urbaser will discuss increasing their pay offer and introducing a company sick pay scheme.
In a joint statement from East and North Herts District Councils, it said: "Urbaser has notified us that GMB union members at their Letchworth and Buntingford depots have plans to undertake a strike ballot next month.
"In the event of a strike, we will work with Urbaser to minimise disruption to residents and ensure any affected residents are kept up to date.
"We are unable to comment further as we have no involvement in pay negotiation conversations between Urbaser and GMB."
Urbaser held a recent strike over their contract with Welwyn Hatfield Borough Council, which was eventually settled with workers accepting a 13.5% pay rise.
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