Health and safety of workers
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Cleanup during disaster recovery involves many occupational hazards. Often, these hazards are exacerbated by the conditions of the local environment as a result of the natural disaster. While individual workers should be aware of these potential hazards, employers are responsible for minimizing exposure to these hazards and protecting workers when possible, including identification and thorough assessment of potential hazards, application of appropriate personal protective equipment (PPE), and the distribution of other relevant information in order to enable safe performance of work. Maintaining a safe and healthy environment for these workers ensures that the effectiveness of the disaster recovery is unaffected.
Physical exposuresedit
Flood-associated injuries
Flooding disasters often expose workers to trauma from sharp and blunt objects hidden under murky waters that cause lacerations and open and closed fractures. These injuries are further exacerbated with exposure to the often contaminated waters, leading to increased risk for infection. When working around water, there is always the risk of drowning. In addition, the risk of hypothermia significantly increases with prolonged exposure to water temperatures less than 75 degrees Fahrenheit. Non-infectious skin conditions may also occur including miliaria, immersion foot syndrome (including trench foot), and contact dermatitis.
Earthquake-associated injuries
The predominant injuries are related to building structural components, including falling debris with possible crush injury, burns, electric shock, and being trapped under rubble.
Chemical exposuresedit
Hazardous material releaseedit
Chemicals can pose a risk to human health when exposed to humans at certain quantities. After a natural disaster, certain chemicals can become more prominent in the environment. These hazardous materials can be released directly or indirectly. Chemical hazards directly released after a natural disaster often occur at the same time as the event, impeding planned actions for mitigation. For example, airborne magnesium, chloride, phosphorus, and ammonia can be generated by droughts; dioxins can be produced by forest fires; and silica can be emitted by forest fires. Indirect release of hazardous chemicals can be intentionally released or unintentionally released. An example of intentional release is insecticides used after a flood or chlorine treatment of water after a flood. The chemical released is often toxic and serves no beneficial purpose when released to the environment. These chemicals can be controlled through engineering to minimize their release when a natural disaster strikes; for example, agrochemicals from inundated storehouses or manufacturing facilities poisoning the floodwaters or asbestos fibers released from a building collapse during a hurricane. The flowchart to the right has been adopted from research performed by Stacy Young et al.
Exposure limits
Below are TLV-TWA, PEL, and IDLH values for common chemicals workers are exposed to after a natural disaster.
| Chemical | TLV-TWA (mg/m3) | PEL (mg/m3) | IDLH (mg/m3) |
| Magnesium | 10 | 15 | 750 |
| Phosphorus | 0.1 | 0.1 | Not established |
| Ammonia | 17 | 35 | 27 |
| Silica(R) | .025 | 10 | 50 |
| Chlorine dioxide | 0.28 | 0.3 | 29 |
| Asbestos | 10 (fibers/m^3) | 10 (fibers/m^3) | Not established |
Direct release
- Magnesium
- Phosphorus
- Ammonia
- Silica
Intentional release
- Insecticides
- Chlorine dioxide
Unintentional release
- Crude oil components
- Benzene, N-hexane, hydrogen sulfide, cumene, ethylbenzene, naphthalene, toluene, xylenes, PCBs, agrochemicals
- Asbestos
Exposure routes
When a toxicant is prominent in an environment after a natural disaster, it is important to determine the route of exposure to worker safety for the disaster management workers. The three components are source of exposure, pathway of the chemical, and receptor. Questions to ask when dealing with a chemical source are the material itself, how it is used, how much is used, how often the chemical is used, its chemical properties, and its physical processes–the physical state of the chemical is important to identify. If indoors, room ventilation and the volume of the room need to be noted to mitigate health defects from the chemical. Finally, to ensure worker safety, routes of entry for the chemical and relevant personal protective equipment to be worn should be determined.
Respirators
The CDC warns “If you need to collect belongings or do basic clean up in your previously flooded home, you do not usually need to use a respirator (a mask worn to prevent breathing in harmful substances)”. A respirator should be worn when performing an operation in an enclosed environment such as a house that creates ample amounts of dust. These activities could include sweeping dust, using power saws and equipment, or cleaning up mold. The CDC says to “limit your contact with the dust as much as possible. Use wet mops or vacuums with HEPA filters instead of dry sweeping and lastly wear a respirator that protects against dust in the air. A respirator that is approved by the CDC/NIOSH is the N95 respirator and can be a good personal protective equipment to protect from dust and mold in the air from the associated natural disaster".
Biological exposuresedit
Mold exposures: Exposure to mold is commonly seen after a natural disaster such as flooding, hurricane, tornado or tsunami. Mold growth can occur on both the exterior and interior of residential or commercial buildings. Warm and humid condition encourages mold growth; therefore, standing water and excess moisture after a natural disaster would provide an ideal environment for mold growth especially in tropical regions. While the exact number of mold species is unknown, some examples of commonly found indoor molds are Aspergillus, Cladosporium, Alternaria and Penicillium. Reaction to molds differ between individuals and can range from mild symptoms such as eye irritation, cough to severe life-threatening asthmatic or allergic reactions. People with history of chronic lung disease, asthma, allergy, other breathing problems or those that are immunocompromised could be more sensitive to molds and may develop fungal pneumonia.
The most effective approach to control mold growth after a natural disaster is to control moisture level. Some ways to prevent mold growth after a natural disaster include opening all doors and windows, using fans to dry out the building, positioning fans to blow air out of the windows, and cleaning up the building within the first 24–48 hours. All wet items that cannot be properly cleaned and dried within the first 48 hours should be promptly removed and discarded from the building. If mold growth is found in the building, it is important to concurrently remove the molds and fix the underlying moisture problem. When removing molds, N-95 masks or respirators with a higher protection level should be used to prevent inhalation of molds into the respiratory system. Molds can be removed from hard surfaces by soap and water, a diluted bleach solution or commercial products.
Human remains: According to the Centers for Disease Control and Prevention (CDC), "There is no direct risk of contagion or infectious disease from being near human remains for people who are not directly involved in recovery or other efforts that require handling dead bodies.” Most viruses and bacteria perish along with the human body after death. Therefore, no excessive measures are necessary when handling human remains indirectly. However, for workers in direct contact with human remains, universal precautions should be exercised in order to prevent unnecessary exposure to blood-borne viruses and bacteria. Relevant PPE includes eye protection, face mask or shield, and gloves. The predominant health risk are gastrointestinal infections through fecal-oral contamination, so hand hygiene is paramount to prevention. Mental health support should also be available to workers who endure psychological stress during and after recovery.
Flood-associated skin infections: Flood waters are often contaminated with bacteria and waste as well as chemicals on occasion. Prolonged, direct contact with these waters leads to an increased risk for skin infection, especially with open wounds in the skin or history of a previous skin condition, such as atopic dermatitis or psoriasis. These infections are exacerbated with a compromised immune system or an aging population. The most common bacterial skin infections are usually with Staphylococcus and Streptococcus. One of the most uncommon, but well-known bacterial infections is from Vibrio vulnificus, which causes a rare, but often fatal infection called necrotizing fasciitis.
Other salt-water Mycobacterium infections include the slow growing M. marinum and fast growing M. fortuitum, M. chelonae, and M. abscessus. Fresh-water bacterial infections include Aeromonas hydrophila, Burkholderia pseudomallei causing melioidosis, leptospira interrogans causing leptospirosis, and chromobacterium violaceum. Fungal infections may lead to chromoblastomycosis, blastomycosis, mucormycosis, and dermatophytosis. Numerous other arthropod, protozoal, and parasitic infections have been described. A worker can reduce the risk of flood-associated skin infections by avoiding the water if an open wound is present, or at minimum, cover the open wound with a waterproof bandage. Should contact with flood water occur, the open wound should be washed thoroughly with soap and clean water.
Psychosocial exposuresedit
According to the CDC, "Sources of stress for emergency responders may include witnessing human suffering, risk of personal harm, intense workloads, life-and-death decisions, and separation from family." These stresses need to be prevented or effectively managed in order to optimize assistance without causing danger to oneself. Preparation as an emergency responder is important, in addition to establishing care for responsibilities at home. During the recovery efforts, it is important to understand and recognize burnout and sources of stress. After the recovery, it is vital to take time away from the disaster scene and slowly re-integrate back to the normal work environment. Substance Abuse and Mental Health Services Administration (SAMHSA) provides stress prevention and management resources for disaster recovery responders.
Volunteer responsibilitiesedit
The Federal Emergency Management Agency (FEMA) advises those who desire to assist go through organized volunteer organizations and not to self-deploy to affected locations. The National Volunteer Organizations Active in Disaster (VOAD) serves as the primary point of contact for volunteer organization coordination. All states have their own state VOAD organization. As a volunteer, since an employer does not have oversight, one must be vigilant and protect against possible physical, chemical, biological, and psychosocial exposures. Furthermore, there must be defined roles with relevant training available. Proper tools and PPE may or may not be available, so safety and liability should always be considered.
Employer responsibilitiesedit
Every employer is required to maintain a safe and healthy workplace for its employees. When an emergency situation occurs, employers are expected to protect workers from all harm resulting from any potential hazard, including physical, chemical, and biological exposure. In addition, an employer should provide pre-emergency training and build an emergency action plan.
Emergency action plan (EAP)edit
The EAP is a written document about what actions employers and employees should take when responding to an emergency situation. According to OSHA regulations 1910.38, an employer must have an emergency action plan whenever an OSHA standard requires one. To develop an EAP, an employer should start from workplace evaluation. Typically, most of the occupational emergency management can be divided into worksite evaluation, exposure monitoring, hazard control, work practices, and training.
Worksite evaluation is about identifying the source and location of the potential hazards such as falling, noise, cold, heat, hypoxia, infectious materials, and toxic chemicals that each of the workers may encounter during emergency situations.
Exposure monitoringedit
After identifying the source and location of the hazard(s), it is essential to monitor how employees may be exposed to these dangers. Employers should conduct task-specific exposure monitoring when they meet following requirements:
- When the exposed substance has specific standard required by OSHA
- When employers anticipate workers will be exposed to more hazards than the action level set by OSHA
- When there is a worker complaint or concern about the exposure
- When an employee questions the effectiveness of the existing hazard control methods
To effectively acquire the above information, an employer can ask workers how they perform the task or use direct reading instruments to identify the exposure level and exposure route.
Hazard controledit
Employers can conduct hazard control by:
- Elimination or substitution: Eliminating the hazard from the workplace.
- Engineering controls
- Work practice or administrative controls: Change the how the task was performed to reduce the probability of exposure.
- Personal protective equipment
Trainingedit
Employers should train their employees annually before an emergency action plan is implemented to inform employees of their responsibilities and/or plan of action during emergency situations. The training program should include the types of emergencies that may occur, the appropriate response, evacuation procedure, warning/reporting procedure, and shutdown procedures. Training requirements are different depending on the size of workplace and workforce, processes used, materials handled, available resources and who will be in charge during an emergency.
The training program should address the following information:
- Workers' roles and responsibilities.
- Potential hazards and hazard-preventing actions.
- Notification alarm system, and communications process.
- Communication means between family members in an emergency.
- First aid kits.
- Emergency response procedures.
- Evacuation procedures.
- A list of emergency equipment including its location and function.
- Emergency shutdown procedures.
After the emergency action plan is completed, the employer and employees should review the plan carefully and post it in a public area that is accessible to everyone. In addition, another responsibility of the employer is to keep a record of any injury or illness of workers according to OSHA/State Plan Record-keeping regulations.
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