Flooding can cause the disruption of water purification and sewage disposal sys- tems, overflowing of toxic waste sites, and dislodgement of chemicals previously stored above ground. Although most floods do not cause serious outbreaks of infectious disease or chemical poisonings, they can cause sickness in workers and others who come in contact with contaminated floodwater. In addition, flooded areas may contain electrical or fire hazards connected with downed power lines.
Floodwater often contains infectious organisms, including intestinal bacteria such as E. coli, Salmonella, and Shigella; Hepatitis A Virus; and agents of typhoid, paratyphoid and tetanus. The signs and symptoms experienced by the victims of waterborne microorganisms are similar, even though they are caused by different pathogens. These symptoms include nausea, vomiting, diarrhea, abdominal cramps, muscle aches, and fever. Most cases of sickness associated with flood conditions are brought about by ingesting contami- nated food or water. Tetanus, however, can be acquired from contaminated soil or water entering broken areas of the skin, such as cuts, abrasions, or puncture wounds. Tetanus is an infectious disease that affects the nervous system and causes severe muscle spasms, known as lockjaw. The symptoms may appear weeks after exposure and may begin as a headache, but later develop into difficulty swallowing or opening the jaw.
Floodwaters also may be contaminated by agricultural or industrial chemicals or by hazardous agents present at flooded hazardous waste sites. Flood cleanup crew members who must work near flooded industrial sites also may be exposed to chemically contaminated floodwater. Although different chemicals cause different health effects, the signs and symptoms most frequently associ- ated with chemical poisoning are headaches, skin rashes, dizziness, nausea, excitability, weakness, and fatigue.
Pools of standing or stagnant water become breeding grounds for mosquitoes, increasing the risk of encephalitis, West Nile virus or other mos- quito-borne diseases. The presence of wild animals in populated areas increases the risk of diseases caused by animal bites (e.g., rabies) as well as diseases carried by fleas and ticks.
After a major flood, it is often difficult to maintain good hygiene during cleanup operations. To avoid waterborne disease, it is important to wash your hands with soap and clean, running water, especially before work breaks, meal breaks, and at the end of the work shift. Workers should assume that any water in flooded or surrounding areas is not safe unless the local or state authorities have specifically declared it to be safe. If no safe water supply is available for washing, use bottled water, water that has been boiled for at least 10 minutes or chemically disinfected water. (To dis- infect water, use 5 drops of liquid household bleach to each gallon of water and let it sit for at least 30 minutes for disinfection to be completed.) Water storage containers should be rinsed period- ically with a household bleach solution.
If water is suspected of being contaminated with hazardous chemicals, cleanup workers may need to wear special chemical resistant outer clothing and protective goggles. Before entering a contam- inated area that has been flooded, you should don plastic or rubber gloves, boots, and other protective clothing needed to avoid contact with floodwater.
Decrease the risk of mosquito and other insect bites by wearing long-sleeved shirts, long pants, and by using insect repellants. Wash your hands with soap and water that has been boiled or disin- fected before preparing or eating foods, after using the bathroom, after participating in flood cleanup activities, and after handling articles con- taminated by floodwater. In addition, children should not be allowed to play in floodwater or with toys that have been in contact with flood- water. Toys should be disinfected.
What to Do If Symptoms Develop
If a cleanup worker experiences any of the signs or symptoms listed above, appropriate first aid treatment and medical advice should be sought. If the skin is broken, particularly with a puncture wound or a wound that comes into contact with potentially contaminated material, a tetanus vacci- nation may be needed if it has been five years or more since the individual’s last tetanus shot.
Tips to Remember
• Before working in flooded areas, be sure that your tetanus shot is current (given within the last 10 years). Wounds that are associated with a flood should be evaluated for risk; a physi- cian may recommend a tetanus immunization.
• Consider all water unsafe until local authorities announce that the public water supply is safe.
• Do not use contaminated water to wash and prepare food, brush your teeth, wash dishes, or make ice.
• Keep an adequate supply of safe water available for washing and potable water for drinking.
• Be alert for chemically contaminated flood- water at industrial sites.
• Use extreme caution with potential chemical and electric hazards, which have great potential for fires and explosions. Floods have the strength to move and/or bury hazardous waste and chemical containers far from their normal storage places, creating a risk for those who come into contact with them. Any chemical hazards, such as a propane tank, should be handled by the fire department or police.
• If the safety of a food or beverage is questionable, throw it out.
• Seek immediate medical care for all animal bites.
This is one in a series of informational fact sheets highlighting OSHA programs, policies or standards. It does not impose any new compliance requirements. For a comprehensive list of compliance requirements of OSHA standards or regulations, refer to Title 29 of the Code of Federal Regulations. This information will be made available to sensory impaired individuals upon request. The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.