PDF Version

Storm and flood clean-up activities can be hazardous.  Workers and volunteers involved with storm and flood clean-up should be aware of the potential dangers and proper safety precautions involved with these activities.  The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has urged employers and workers to take appropriate safety measures to avoid injury and illnesses associated with the recovery and clean-up efforts.

A disaster recovery site is likely to have multiple workforces on-site, which include host employees, clean-up and construction contractors, and general labor workers.  The recovery site must have an incident commander and a command structure in place to coordinate recovery efforts safely.  All safety and health conditions must be assessed under the direction of the incident commander.  The incident commander must be identified and have authority over the site’s health and safety system.  The professional in this role will have direct authority and responsibility to protect workers from occupational and environmental hazards on-site.

Some of these hazards include:  Electrical Hazards, Carbon Monoxide, Musculoskeletal Hazards, Heat Stress, Motor Vehicles, Hazardous Materials, Fire, Confined Spaces, and Falls.  In addition, 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.  Exposure is mostly through ingesting contaminated food or water but can also occur from contaminated soil or water entering broken areas of the skin, such as cuts, abrasions, or puncture wounds.  This can result in similar signs and symptoms, including nausea, vomiting, diarrhea, abdominal cramps, muscle aches, and fever.

Human remains may also contain bloodborne viruses such as hepatitis, HIV, and bacteria that cause diarrheal diseases, such as shigella and salmonella.  There is, however, no risk of infectious diseases from being near human remains for people who are not directly handling dead bodies.                                   

Pools of standing or stagnant water become breeding grounds for mosquitoes, increasing the risk of encephalitis, West Nile Virus, or other mosquito-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.

Workers should be advised to drink plenty of fluid and to monitor their bodies for symptoms of heat stress such as red, hot, and dry skin without sweating, headaches, dizziness, nausea, having a strong pulse, and an elevated body temperature (>103F).  Workers should be given access to a shaded shelter and allowed to remove excess protecting clothing if needed.  Protective equipment selection should be light-color and lightweight, and products such as alcohol, caffeinated drinks, or heavy meals should be avoided.

Immunizations

The Centers for Disease Control and Prevention (CDC), and the Department of Health and Human Services, have issued “Immunization Recommendations for Disaster Responders: Updated vaccination recommendations for persons responding to the disaster area are posted on CDC’s website at: https://www.cdc.gov/disasters/disease/responderimmun.html

Required Immunizations:

• Tetanus/diphtheria (Td): Tetanus and diphtheria toxoid (a receipt of primary series and Td booster within 10 years) wounds that are associated with a flood should be evaluated for risk; a physician may recommend a tetanus immunization. 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.
• Hepatitis B vaccine series for persons who will be performing direct patient care or otherwise expected to have contact with bodily fluids.

About 75-80% of adults who have received two valid vaccine doses have developed a protective antibody level.  Standard precautions to protect against exposure to blood or blood-containing fluids should be used.  If a responder who is not fully vaccinated comes into contact with blood or body fluids, post-exposure precautions should be taken according to previously published CDC and OSHA recommendations.

Based on the low probability of exposure in the flooded regions, the CDC does not anticipate the need for the following vaccinations for relief workers or emergency responders:

Hepatitis A vaccine: Even though the water and sewage systems are damaged or out of operation in many areas along the Gulf Coast, the risk of the Hepatitis A epidemic is extremely low.  The vaccine will take at least one to two weeks to provide substantial immunity.

• Typhoid vaccine: Low probability of exposure, even under these conditions, in the U.S.
• Cholera vaccine: In addition to the low probability of exposure, there is no licensed cholera vaccine available in the U.S.
• Meningococcal vaccine: No expectation of increased risk of meningococcal disease among emergency responders.
• Rabies vaccine series: (the full series is required for protection): Persons who are exposed to potentially rabid animals should be evaluated and receive standard post-exposure prophylaxis, as clinically appropriate.
• Coronavirus-19 vaccination and boosters: The CDC recommends everyone stay up to date with COVID-19 vaccination, including all primary series doses and boosters.

Personal Hygiene

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.  To avoid waterborne disease, it is important to wash hands with soap and clean, running water, especially before work breaks, meal breaks, and at the end of the work shift.

Personal Protective Equipment (PPE)

Physical injuries were a source of most injuries following Hurricane Andrew in 1992.

OSHA’s personal protective equipment standards (29 CFR 1910.132-138) require employers to furnish and require employees to use suitable protective equipment where there is a “reasonable probability” that injury can be prevented by such equipment.  The standards also set provisions for specific equipment.  For more information, refer to the IBT Safety and Health Fact Sheet: Protect Yourself with Personal Protective Equipment.

Workers and volunteers involved with flood clean-up should avoid direct skin contact with flood waters if possible and use appropriate PPE and clothing.  In most instances, the selection of PPE will be dependent on site-specific conditions, hazards, and tasks; the list below provides interim guidance by the CDC on PPE and clothing for flood response workers responding to disasters.

Hand Protection (29 CFR 1910.138)

• Heavy, waterproof, cut-resistant work gloves. Other types of protective gloves may be required if handling identified material hazards.
• To prevent skin irritation from exposure to molds, wear long gloves that reach the middle of the forearm. If you are using a disinfectant, a biocide such as chlorine bleach, or a strong cleaning solution, you should select gloves made from natural rubber, neoprene, nitrile, polyurethane, or PVC.  Avoid touching mold or moldy items with your bare hands.
• Use impervious gloves when handling blood and bodily fluids, such as human remains.

Foot Protection (29 CFR 1910.136)

• Electrically insulated, watertight boots with steel shank, toe, and insole. Tennis shoes or sneakers should not be worn because they will transfer contamination and will not prevent punctures, bites, or crush injuries.
• Before entering a contaminated area that has been flooded, you should don plastic or rubber boots to avoid contact with floodwater. Hip waders may be appropriate to help prevent contact with flood waters.
• Safety shoes with slip-resistant soles would be appropriate where there are piles of debris and unstable or slippery work surfaces.

Eye and Face Protection (29 CFR 1910.133)

• To protect against eye injuries caused by dust, flying debris, and welding flash, use safety glasses with side shields (as a minimum) or full-face shields. An eyewear retainer strap is suggested.  Consider safety goggles for protection from fine dust particles or for use over regular prescription eyeglasses.  Only use protective eyewear with an ANSI Z-87 mark on the lenses or frames.  Sun/glare-protective lenses may be needed in some work settings.
• Where exposure to molds may be possible, wear goggles that do not have ventilation holes.
• Use eye protection, such as goggles or a face shield, when large quantities or splashes of blood are anticipated.

Body Protection (29 CFR 1910.132)

• If water is suspected of being contaminated with hazardous chemicals, clean-up workers may need to wear special chemical-resistant outer clothing.
• To decrease the risk of mosquito and other insect bites, such as fire ants, wear long-sleeved shirts, long pants, and socks. Use insect repellants that contain DEET or Picaridin (make sure you follow the directions written on the label).
• Use gowns when large quantities or splashes of blood are anticipated.

Respiratory Protection (29 CFR 1910.135)

Respiratory Protection should be worn to protect against breathing dust containing asbestos, silica, and other toxins, potential chemical exposures.

OSHA’s standard for Respiratory Protection (29 CFR 1910.134) states that respirators should be provided by the employer when such equipment is necessary to protect the employee’s health.  The employer should provide the respirators which are applicable and suitable for the purpose intended.  Under some work conditions, NIOSH-approved respirators may be necessary (e.g., for exposures to mold-contaminated materials/environments or other recognized chemical, physical, or biological hazards).

For more information, see IBT Safety and Health Fact Sheet, Respiratory Protection.

• An N-95 or greater respiratory protection is acceptable for most activities, including silica and Portland cement dust.
• If asbestos is present, use a half-mask elastomeric respirator with N, R, or P-100 series filters.
• If airborne contaminants are causing eye irritation, full-face respirators with P-100 organic vapor (OV)/acid gas (AG) combination cartridges should be used.
• Respirators must fit properly to protect you.
• Surgical masks should not be used because they do not provide adequate protection.
• In dusty environments with strong odors, use a combination particulate filter/organic vapor cartridge if enough breathing air is present.
• If entering a confined space, which may have unknown concentrations of toxic gases or may be deficient in oxygen, a self-contained breathing apparatus (SCBA) may need to be provided. See IBT Safety and Health Fact Sheet on Permit-required Confined Spaces.
• Avoid breathing dust (fungal spores) generated by wet building materials. To prevent wheezing and irritation from exposure to molds, use an N-95 NIOSH-approved disposable respirator as a minimum when working with small areas of moldy or damp materials.  More protection may be needed for extended work.
• Use masks when large quantities or splashes of blood are anticipated.

Head Protection (29 CFR 1910.135)

• Soft hat or other protective head covers. Wear an American National Standards Institute (ANSI) rated hardhat if there is any danger of falling debris or electrical hazards.

Hearing Protection (29 CR 1910.95)

• Use hearing protection when working in an environment with any noise that you must shout over to be heard; for more information, see IBT Safety and Health Fact Sheet, Hearing Conservation, and Occupational Noise Exposure.

Fall Protection

• Fall protection with lifelines tied off to suitable anchorage points, including bucket trucks, whenever possible. For more information, see IBT Safety and Health Fact Sheet, Fall Protection in General Industry.

References

Clean-up Hazards.  Occupational Safety and Health Administration (OSHA), Department of Labor.

United States Department of Labor.  Hurricane Preparedness and Response – OSHA Resources | Occupational Safety and Health Administration.  (n.d.).  Retrieved September 30, 2022

Flood Clean-up. Occupational Safety and Health Administration (OSHA), Department of Labor, 9/2005.

Fact Sheet on Heat Safety.  Occupational Safety and Health Administration (OSHA), Department of Labor

Keeping Workers Safe During Clean Up and Recovery Operations Following Hurricanes.  Occupational Safety and Health Administration (OSHA), Department of Labor.

Protect Yourself with Personal Protective Equipment.  Safety and Health Fact Sheet.  IBT Safety and Health Department.

Safety Awareness for responders to hurricanes: Protecting yourself … (n.d.).  Retrieved September 30, 2022, from https://tools.niehs.nih.gov/wetp/public/hasl_get_blob.cfm?ID=6989

UAW Health & Safety Department.  (2005).  Hurricane Disaster Response Factsheet (pp. 1–6).  Detroit, MI.

Urban flooding: Hazards and tips for prevention – national institute of … (n.d.).  Retrieved September 30, 2022, from https://tools.niehs.nih.gov/wetp/public/hasl_get_blob.cfm?ID=13761

U.S. Department of Health and Human Services.  (n.d.).  Hurricanes & Floods.  National Institute of Environmental Health Sciences.  Retrieved September 30, 2022, from https://tools.niehs.nih.gov/wetp/index.cfm?id=2472