Emergency response plan development 2

Chemical exposures

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. 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. 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.

Biological 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 conditions encourage mold growth. 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. Some methods 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, cleaning up the building within the first 24–48 hours, and moisture control. 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.

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 waters are often contaminated with bacteria and waste and chemicals. Prolonged, direct contact with these waters leads to an increased risk for skin infection, especially with open wounds in the skin or a 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.

Surgical debridement of left leg 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. Other numerous 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 exposures

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.” Substance Abuse and Mental Health Services Administration (SAMHSA) provides stress prevention and management resources for disaster recovery responders.

Employer responsibilities

When an emergency situation occurs, employers may be expected to protect workers from all harm resulting from any potential hazard, including physical, chemical, and biological exposure. An employer should provide pre-emergency training and build an emergency action plan.

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.

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